Category: Project Essays

Canadian MP introduces protection of conscience bill

Bill C-268 (2016)  Protection of Freedom of Conscience Act

Sean Murphy*

Conservative Member of Parliament Kelly Block has introduced a bill that would make it a crime to coerce medical or nurse practitioners or other health professionals to take part, directly or indirectly, in “medical assistance in dying.” The preamble of the bill makes clear that it is intended as a protection of conscience measure.

The text of the bill is much the same as a bill proposed by MP Mark Warawa in 2016.

“Medical assistance in dying” means euthanasia and assisted suicide provided by physicians or nurse practitioners. Since it is considered medical treatment in Canada, it falls within provincial jurisdiction over health care. Similarly, provinces have primary jurisdiction over human rights like freedom of conscience. Thus, the federal government has been easily able to refuse amendments like this on the grounds that they unconstitutionally trespass on provincial jursidiction.

The federal government has constitutional jursidiction in criminal law and could make it a crime to compel someone to be a party to homicide and suicide. Since “medical assistance in dying” is non-culpable homicide and non-cuplpable assisted suicide, such a law would provide protection for health care professionals unwilling to be parties to killing their patients or helping them commit suicide, without intruding upon provincial jurisdiction.

The Protection of Conscience Project has repeatedly made this suggestion to Canadian parliamentarians, but its submissions have been ignored.

It is remarkable that the Canadian government clearly believes it is acceptable to compel citizens to become parties to homicide — killing other people — and punish them if they refuse. It is, perhaps, even more remarkable that Canadians are unwilling to talk openly about this.

Physician  freedom of conscience in Saskatchewan

Sean Murphy*

Abstract

Physician Assisted Dying adequately accommodates both physician freedom of conscience and patients’ access to services. It demonstrates that the College of Physicians and Surgeons of Saskatchewan could have taken the same approach to freedom of conscience in relation to other procedures and produced a satisfactory policy on conscientious objection.

Conscientious Objection is ambiguous with respect to effective referral and polemical in its treatment of a physician’s traditional obligation to render assistance in an emergency. It demonstrates the authors’ intention to suppress physician freedom of conscience by compelling them to provide or facilitate morally contested procedures, as well as the intricate wordplay necessary to achieve that end. . . [Full text]

Quebec law and freedom of conscience for health care professionals

Sean Murphy*

Unlike other Canadian provinces, Quebec codes of ethics for health care professionals are enacted by provincial statute. Quebec is also unique in having a provincial euthanasia law, which includes a protection of conscience provision for health care professionals specific to that service.

Freedom of conscience for services other than euthanasia
Physicians

The Code of Ethics for Physicians1 and the gloss on the Code by ALDO Quebec,2 an authoritative document, require objecting physicians to advise patients of the consequences of not receiving the contested service, and “offer to help the patient find another physician.” They are not obliged to help the patient find someone willing to provide the contested service. Objecting physicians are normally quite willing to explain how patients can find other physicians or health care professionals. . . [Full text]

Quebec’s Act Respecting End of Life Care

Reportable and non-reportable euthanasia

Sean Murphy*

Introduction

Quebec’s euthanasia law, the Act Regarding End of Life Care (ARELC), permits two kinds of euthanasia, distinguished here as reportable and non-reportable euthanasia.

Reportable euthanasia is identified as “medical aid in dying” in ARELC.1 Only physicians may administer a lethal substance, and only to a legally competent person who is at least 18 years old, meets other criteria and personally gives informed consent. Physicians must conform to procedural guidelines and reporting requirements. Most people probably believe that this is the only type of euthanasia authorized by the law.

Non-reportable euthanasia is not explicitly identified in the law, but is permitted for legally incompetent patients (including those under 14 years old) who are not dying. Substitute decision makers acting under the authority of Quebec’s Civil Code2 can order them to be starved and dehydrated to death. There are no procedural guidelines, no reporting requirements, and it appears that the order can be carried out by anyone responsible for patient care.3 All of this was incorporated into ARELC by a revision of the original text.

Note that section 50, the protection of conscience provision in ARELC for health care professionals, pertains ONLY to reportable euthanasia. The Act does not recognize the possibility of conscientious objection by health care professionals unwilling to participate in euthanasia by starvation and dehydration. . . [Full text]

Pharmacist  freedom of conscience in Alberta

Sean Murphy*

Code of Ethics (2009)

A protection of conscience provision is found in the Alberta College  of Pharmacy Code of Ethics (2009).1 Objecting pharmacists are directed

  • to help patients “obtain appropriate pharmacy services from another pharmacist or health professional within a time frame fitting the patient’s needs” (clause 3);
  • to arrange their practices so that “the care of [their] patients will not be jeopardized” when they refuse to provide services for reasons of conscience (clause 4);
  • to continue “to provide professional services” until another pharmacist or health professional has assumed responsibility (clause 1).

The text seems to presume that the objecting pharmacist need not provide the morally contested service. The requirement to continue to provide “professional services” until someone else assumes responsiblity does not impose an obligation to provide it if another professional is not available within the relevant time frame. . . [Full text]