Protection of Conscience Project News
Service, not Servitude
International Law Office
The Supreme Court recently deemed that a municipality’s termination of its agreement with a general practitioner (GP) after she refused to insert an intrauterine device (IUD) for a patient for reasons of conscience relating to her religion was invalid.
Legal background
The criterion for terminating an agreement with a GP is the same as that for terminating an employment agreement under Norwegian law (ie, it must be objectively justified). . . [Full text]
The Province
. . . an individual who is suffering intolerably and whose death is reasonably foreseeable has a constitutional right to medical assistance in dying (MAiD) if certain other criteria are met. . .
. . . most people in Vancouver’s West End will end up at St. Paul’s, a hospital run by Catholic-based Providence Health, which doesn’t allow MAiD to be performed in any of its facilities. Anyone wanting to access MAiD once at St. Paul’s must be transferred to Vancouver General Hospital or another willing facility. . .
. . . end the practice of forced transfers by insisting that all taxpayer-funded facilities, including Providence facilities, provide MAiD on site. . .[Full text]
The Irish Times
The controversy over the governance and ownership of the new national maternity hospital when it moves from Dublin’s Holles Street to a site at the St Vincent’s hospital campus “will be resolved when it is resolved”, the Taoiseach has said.
Leo Varadkar told the Dáil that Minister for Health Simon Harris was still engaging with the existing National Maternity Hospital at Holles Street and the St Vincent’s Hospital Group to get it right “but we are confident that we can get there”. . . [Full text]
The Irish Independent
A leading bishop has called on doctors, nurses, teachers and pharmaceutical workers to “resist” the new abortion regime.
He urged such professionals to “stick together” in their resistance to the new law.
Bishop Kevin Doran said the Regulation of Termination of Pregnancy Bill, which is before the Seanad this week, has no moral force and must be resisted. “Catholics have no obligation whatsoever to obey this law,” he told the Irish Independent. . . [Full text]
Documents filed in an important Canadian court case bring into question the value and purpose of “public consultations” held by medical regulators, at least in the province of Ontario.
In March, 2015, the College of Physicians and Surgeons of Ontario (CPSO) approved a highly controversial policy, Professional Obligations and Human Rights. The policy requires physicians to facilitate services or procedures to which they object for reasons of conscience by making an “effective referral” to a colleague or agency willing to provide the service. A constitutional challenge to the policy was dismissed by the Ontario Divisonal Court in 2018.[1] An appeal of that ruling will be heard by the Ontario Court of Appeal on January 21-22, 2019.
Among the thousands of pages filed with the trial court are a number dealing with the public consultation conducted by the CPSO from 10 December, 2014 to 20 February, 2015. In response to its invitation to stakeholders and the public, the CPSO received 9,262 submissions about the proposal, the great majority of which opposed it.[2]
College officials finalized the wording of the policy on 19 January, 2015,[3] a month before the consultation ended; only about 565 submissions would have been received by then.[4] 727 submissions had been received by the time the policy was sent to the Executive Committee on 28 January,[5] which promptly endorsed it and forwarded it to the College Council for final approval.[6]
According to the briefing note supplied to the Council, by 11 February, 2015 the College had received 3,105 submissions.[7] Thus, the final version of the policy was written and approved by the College Executive before about 90% of the submissions in the second consultation had been received.
During the first 40 days ending 11 February, the College received an average of about 18 submissions per day. Assuming someone spent eight full hours every working day reading the submissions, about 22 minutes could have been devoted to each. Three staff members dedicated to the task could have inceased this average to about an hour, so the first 700 submissions could conceivably have received appropriate attention.
However, this seems unlikely in the case of more than 8,000 submissions received later.
By 11 February about 183 submissions were arriving at the College every day, increasing to about 684 daily in the last ten days of the consultation – one every two minutes. A College staffer working eight hours daily without a break could have spent no more than about two minutes on each submission, and only about one minute on each of those received in the last ten days – over 65% of the total.
A minute or two was likely sufficient if College officials deemed consultation results irrelevant because they had already decided the outcome. This conclusion is consistent with the finalization and approval of the policy by the six member College Executive (which included the Chair of the working group that wrote it [8]). To do this weeks before the consultation closed was contrary to normal practice. CPSO policy manager Andréa Foti stated that working groups submit revised drafts to the Executive Committee after public consultations close[9] – not before.
One would expect government agencies that invite submissions on important legal and public policy issues would allow sufficient time to review and analyse all of the feedback received before making decisions. The CPSO’s failure to do so does not reflect institutional respect for thousands of individuals and groups who responded in good faith to its invitation to comment on the draft policy. Rather, such conduct invites a reasonable apprehension of bias that is unacceptable in the administration of public institutions.
Notes
1. The Christian Medical and Dental Society of Canada v. College of Physicians and Surgeons of Ontario, 2018 ONSC 579 (Can LII) [CMDS v CPSO].
2. CMDS v CPSO, supra note 1 (Respondent’s Application Record, Volume 1, Tab 1, Affidavit of Andréa Foti [Foti] at para 121.
3. Foti, supra note 2 at para 133.
4. Estimated daily average based on the total received by 28 January (727).
5. CMDS v CPSO, supra note 1 (Respondent’s Application Record, Volume 4, Tab WW, Exhibit “WW” attached to the Affidavit of Andréa Foti: Executive Committee Briefing Note (February, 2015) (CPSO Exhibit WW) at 1724.
6. CMDS v CPSO, supra note 1 (Respondent’s Application Record, Volume 4, Tab XX, Exhibit “XX” attached to the Affidavit of Andréa Foti: Proceedings of the Executive Committee – Minutes – 3 February, 2015) (CPSO Exhibit XX) at 1746-1748.
7. “Council Briefing Note: Professional Obligations and Human Rights – Consultation Report & Revised Draft Policy (For Decision)” [CPSO Briefing Note 2015]. In College of Physicians and Surgeons of Ontario, “Annual Meeting of Council, March 6, 2015” at 61.
8. Dr. Marc Gabel. See CPSO Exhibit WW, supra note 4 at 1722 (note 1), and CPSO Exhibit XX, supra note 5 at 1746.