Category: Canada

Submission to the College of Physicians and Surgeons of Ontario

Re: Professional Obligations and Human Rights

Ontario Medical Association

The Ontario Medical Association is grateful for the opportunity to provide comments on the College’s draft policy Professional Obligations and Human Rights. The OMA undertook a broad member consultation to gather views on the draft policy. The OMA Board deliberated extensively on the draft policy and the implications it could have for physicians’ freedom of conscience. This Association struggles with endorsing the draft policy which, although progressive in its efforts to ensure patient access, forces physicians to take actions that may conflict with their fundamental beliefs. We disagree that enforcing a single, strict ‘rule’ governing physician behaviour when it comes to an issue as personal as moral or religious beliefs is feasible. We suggest that the College withdraw the current draft and undertake further study, particularly given the direct comment on point in the recent Supreme Court decision in Carter v. Canada.

Both patients and physicians are protected under the Ontario Human Rights Code as well as the Canadian Charter of Rights and Freedoms. That being the case, it is imperative that the policy does not undermine a physician’s right to freedom of conscience. Furthermore, the decision emphasized the need to reconcile patient and physician protections. The draft policy has not reconciled these protections since an “effective referral” (an affirmative action that contributes to the outcome) cannot be said to address the physician’s right to freedom of conscience. This recent Supreme Court decision provides further evidence that the policy must have flexibility in terms of the options available to physicians who are unable to provide services because of moral or religious beliefs.

We propose that this policy not focus on forcing physicians to perform services to which they object. Instead, the policy should focus on improving information about and access to alternative options. The OMA believes that in circumstances where the physician is unable to personally provide medical services, he or she must not impede the patient in accessing those services elsewhere. The issue of access when it comes to contentions medical services is a complex one that will require stakeholder collaboration to develop a more nuanced approach “Effective referral” represents only one tool – a fairly blunt one at that – we can use to resolve these conflicts. The policy should contemplate intermediate options. For example, the College might allow physicians to post general information about their scope of practice in a visible place for all patients. Another option would be for the policy to allow physicians to make generic referrals to third party organizations or agencies that maintain information about service providers. Incorporating any of these approaches would require further discussion.

We understand that the goal of this policy is to protect patient dignity and ensure patients can access the medical services they seek and we support that aim. However, we believe the College will have more success in achieving its goal if physicians are not forced to comply with a rigid process that may present serious moral dilemmas and diminish their dignity. In reassessing this draft policy, we urge the CPSO to consider the fact that physicians are also protected under the Code and that the College will be obliged to consider the Code when determining whether physicians’ conduct is consistent with the College’s expectations.

Thank you for considering these comments.

What is plagiarism? Saskatchewan College of Physicians provides “teachable moment” for students, teachers

Sean Murphy*

High school and post-secondary teachers plagued by the problem of plagiarism can thank the College of Physicians and Surgeons of Saskatchewan for providing them with a “teachable moment.”

Saskatchewan’s College of Physicians has published a draft policy intended to force objecting physicians to do what they believe to be wrong, including participation in euthanasia, assisted suicide, and abortion.  The policy is virtually a word-for-word copy of the Model Conscientious Objection Policy proposed by euthanasia and abortion activists – without attribution.

Bryan Salte, speaking for the College, denied that the College document was taken from the Model Conscientious Objection Policy, though he did admit that it was a “significant source.”

Now Saskatchewan students have a comeback for teachers who award a “0” for plagiarism because they have copied most of a paper from a “significant source” on the internet.  They can quote Mr. Salte.

On the other hand, Saskatchewan teachers might take this as a “teachable moment”  to explain that it is unethical to pass off someone else’s work as one’s own – even if one likes it and agrees with it entirely and the real authors are pleased with the results.

It might even be a good topic for a class on ethics in medical research.

‘This is moral genocide’: Canadian doctors blast plans to force them into helping patients procure abortion

LifeSite News

Steve Weatherbe

REGINA, Saskatchewan, February 17, 2015 (LifeSiteNews.com) – Christian doctors across Canada are vowing to challenge the constitutionality of the requirement now being considered by the Saskatchewan medical profession that all its members be required to perform abortions or assist at suicides—or refer patients to other doctors who will.

“This is moral genocide,” Saskatoon emergency room doctor Philip Fitzpatrick says of the policy, already approved in principle without consultation with doctors or the public by the Saskatchewan College of Physicians and Surgeons.

“There’s no medical reason for these clauses overriding our consciences,” he continued. “The people who want euthanasia and abortion on demand just don’t like the fact somebody disagrees. They are trying to chase us out of the profession.”

“We have to sue the College if it approves this policy,” Larry Worthen, executive director of the Christian Dental and Medical Association of Canada, told LifeSiteNews. “Half our members will have to quit if it were enforced. It goes against their very reason for being in medicine.” . . .[Full Text]

Saskatchewan doctors could face discipline over assisted suicide

Global News

Doug Lett

SASKATOON – Doctors in the province who refuse to cooperate with physician-assisted suicide could face discipline according to the College of Physicians and Surgeons of Saskatchewan.

“If a physician feels the directives are wrong, they will still, we would expect, they will still follow those directives,” said Bryan Salte, associate registrar of the college, “in spite of the fact they may not agree with them.”

While the college has not come up with policies around assisted suicide, it is circulating a draft policy on conscientious refusal. It says while doctors can refuse to provide a legally provided service if it violates their freedom of conscience, they do have to make a referral to another health care provider who will do it.

That means a doctor who believes suicide is wrong would still have to refer a patient to a doctor who would help them kill themselves. . . [Full Text]

 

Submission to the College of Physicians and Surgeons of Ontario

Re: Professional Obligations and Human Rights

Christian Medical & Dental Society, Canadian Federation of Catholic Physician Societies

The Christian Medical and Dental Society of Canada (“CMDS”) and the Canadian Federation of Catholic Physician Societies (“CFCPS”) welcome this opportunity to provide feedback to the College of Physicians and Surgeons of Ontario (“CPSO”) on the draft policy “Professional Obligations and Human Rights”. Together our organizations represent 1800 physicians, all of whom are seriously concerned about the implications of the policy and their ability to continue to practice medicine should the policy be passed.

Freedom of conscience

Freedom of conscience is protected under the Canadian Charter of Rights and Freedoms. As a creature of provincial statute, the CPSO is bound by the Charter, and must respect it. Yet this draft policy requires physicians to refer for, and in some cases carry out services that are contrary to their conscience. (Lines 156-168)

Conscience rights were recently reasserted by the Supreme Court of Canada in the Carter case. The Court confirmed that “a physician’s decision to participate in assisted dying is a matter of conscience” (para 132). The Court favourably cited the factum of the CMDS and CFCPS who had reproduced the comments of Justice Beetz in Morgentaler (para 132), who stated that a physician could not be compelled to participate in abortion. These comments are directly applicable to the draft policy and we urge the CPSO to revise the draft in light of the Supreme Court’s decision.

The reasoning of the Carter case can also be used to determine whether s.1 of the Charter can be used to limit doctors’ freedom of conscience. The Carter case made clear that in the absence of evidence that patients are being denied a Charter right, the Court will determine that it is not necessary to force physicians to refer patients or perform procedures in violation of the physician’s Charter right to freedom of conscience and religion. It is noteworthy as well, that the Charter does not apply to physicians, but rather, protects them. Under the principles in Carter physicians who object to engaging in certain procedures or pharmaceuticals, including through referrals, will be successful if they can show that there is a regulatory system that ensures access to procedures like abortion and euthanasia without incorporating the conscientiously objecting physician into the process of referral. This test is already met, because in Ontario patients can access abortion through self- referral. There is no reason to insist that a conscientiously objecting physician refer for abortion when the patient already can self refer.

Furthermore, it is not the CPSO’s role to ensure access to abortions. Even if it were, there would be an onus on the CPSO to prove that it cannot ensure access to abortions without infringing on the Charter rights of individual physicians (para. 118). A theoretical or speculative fear cannot justify an infringement (para. 119).

There is no human right in Canada to demand and receive particular services from a specific physician. Provincial human rights legislation prohibits discrimination against the public on a number of grounds that include among others, race, ethnicity, sex, religion, sexual orientation, age or disability. Human rights legislation does not dictate what services must be delivered. So, if a restaurant chooses not to serve pork because of the owner’s religious beliefs, there is no violation. If the restaurant chooses to exclude people of a particular ethnic group, however, that would amount to discrimination and a violation of provincial human rights legislation. In the same way, a physician who is unable to participate in a procedure or prescribe a pharmaceutical product for moral or religious reasons is not discriminating against his or her patient provided all patients are treated the same. Unfortunately, this draft policy suggests that a physician’s objection to a specific procedure or pharmaceutical may be a violation of a patient’s rights under the Charter or the Code. This reference makes clear that those who prepared this policy misunderstand the application and function of Ontario and Canadian law.

Provided the services are delivered in a respectful way, there are no competing rights. In such a case, the only human rights present are the physician’s human rights to freedom of religion and freedom of conscience. Furthermore, when the physician is an employee they have the additional right to be accommodated by their employer. [Full text]