Divisional Court Accepts Religious and Conscientious Infringement on Ontario Doctors

News Release

Catholic Civil Rights League

TORONTO, ON January 31, 2018 – The Catholic Civil Rights League (CCRL) is gravely disappointed in the ruling released today by the Ontario Divisional Court in the case CMDS et al v. CPSO.

The application was brought by several religious physicians and groups to challenge the mandate of the College of Physicians and Surgeons of Ontario (CPSO), that requires doctors who object to certain procedures on religious or conscientious grounds, such as assisted suicide, to provide nevertheless, an “effective referral” to another physician or caregiver who would perform the service.

The court upheld the policy that requires life affirming physicians to act against their religion and conscience.

It is an alarming development which places Ontario doctors at the risk of professional complaints for refusing to make such referrals.

While finding that the CPSO policies were in breach of the constitutional right to freedom of religion (the court declined to make a ruling on freedom of conscience given its assessment), it found that the policy choice of the CPSO engaged a “reasonable limit” on the exercise of such freedoms.  Speaking on behalf of the three-member panel, Mr. Justice Wilton-Siegel asserted that the CPSO limit on such rights, while not trivial, did not create a substantial infringement, even if it meant forcing a physician to violate one’s conscience, to accommodate his or her practice choices, even to the extent of stepping aside from certain practice areas.

The CCRL has maintained that the CPSO’s insistence on obligating Ontario physicians to perform an “effective referral” for objectionable procedures does nothing to honour the Charter right of freedom of conscience and religion. Rather it is a breach of a physician’s rights and a serious incursion into the professional standing of a physician.

A proper balancing of the rights of physicians with the concept of patient autonomy must not result in the trumping of the rights of physicians in their medical practices.  Such rights extend not only to refusing to perform assisted suicide and euthanasia, but the right not to be obliged to refer to other practitioners who may be willing to provide such services. This clearly constitutes participation in wrong.

According to a recent statement from the John Paul II Academy for Human Life and the Family:

“Seeking to impose on a doctor the duty to perform abortions or euthanasia (or, alternatively, to leave the medical profession or a given hospital), or to impose on him the duty to refer a woman to an abortionist, is gravely sinful and a direct violation of his inalienable human dignity and freedom of conscience.”

“The same also applies to the case where a prolife physician is claimed to be obliged to refer a patient (who requests physician-assisted suicide or euthanasia) to a colleague who would perform such acts.  Not only is the prolife physician not obliged to refer a patient to a colleague who would perform intrinsically wrong acts, he is also absolutely morally forbidden to do so,” they continue.

Speaking to the fallacy of the imposition of personal autonomy on others, “One can hardly imagine a worse perversion of moral truth and natural right than the idea that a person has a right to demand that other persons commit the crime to murder him. Nobody has any right whatsoever to demand from society to assist him to commit a crime against himself, or to oblige others to commit the crime of murdering him.”

“Quite the contrary, the others and the State, in virtue of their true moral autonomy, a moral autonomy subjected to the truth, have the absolute moral duty to reject such a request.”

The CCRL asserted in our legal argument, and relying upon previous authorities, that in a free and democratic society, the state should respect choices made by individuals and, to the greatest extent possible, will avoid subordinating these choices to any one conception of the good life.

Demanding that someone participate in perceived wrongdoing demands the submission of intellect, will and conscience, reducing the person to the status of a thing, to a tool to be used by others, to servitude that cannot be reconciled with principles of equality. It is an assault on human dignity that deprives physicians of their essential humanity.

The court missed an opportunity to require the CPSO to create a policy that would recognize that doctors have different views of what proper accompaniment of vulnerable patients entails.  Many patients not only share the views of the appellants, but also desire to be served by physicians who hold such views. Such doctors care deeply about their patients, and do not wish to be engaged in “referring” patients to their unnatural deaths.

The court instead accepted the arguments of the CPSO and has given its approval to a policy that serves to infringe upon the rights of such physicians.  Such an infringement is by no means insubstantial.

An appeal is required.


About the CCRL

The Catholic Civil Rights League (CCRL)) assists in creating conditions within which Catholic teachings can be better understood, cooperates with other organizations in defending civil rights in Canada, and opposes defamation and discrimination against Catholics on the basis of their beliefs. The CCRL was founded in 1985 as an independent lay organization with a large nationwide membership base. The CCRL is a Canadian non-profit organization entirely supported by the generosity of its members.

For further information: Christian Domenic Elia, PhD CCRL Executive Director 416-466-8244 @CCRLtweets

Why would my terminally ill father be denied a medically assisted death?

The Globe and Mail

Paul Taylor

The question: My father was in the advanced stages of prostate cancer and wanted a medically assisted death. He was told he needed the approval of two health-care providers. One said yes, but the other said no because he “was not in any distress.” But that decision was so wrong. My father was a very stoic man, and was not one to complain. Did the doctor want him to break down in tears and beg to be put to death? My father died two weeks later in a hospice – instead of his home, the place where he wanted to die.

The answer: It has been over a year and a half since Parliament passed a law that makes medical assistance in dying – called MAID for short – legal across Canada. The story you tell reflects one of the many challenges in creating a standardized system to handle these requests and to ensure that patients and their families are properly informed.

One key failing in your father’s case is that he was not apparently told he could have asked for another assessment after the second MAID assessor turned him down. If another assessor had agreed that he was eligible, he could have proceeded with an assisted death.

It’s impossible to say whether his assessors were unaware he had this option or simply failed to mention it.

Whatever the case, “we need to do a better job educating health-care providers about what they must be disclosing to patients,” says Jocelyn Downie, a professor in the faculties of law and medicine at Dalhousie University in Halifax.

In the meantime, it’s certainly worthwhile reviewing how the process is supposed to work. . . [Full Text]

‘Pro-life medics must have conscientious objection rights’

The Christian Institute

A Bill designed to afford better protections for medical professionals who conscientiously object to abortion has passed its second reading in the House of Lords.

The Conscientious Objection (Medical Activities) Bill has been described as “important and timely”.

It seeks to ensure conscience objection rights for all medics and has now moved on to Committee Stage in the House of Lords. However, since it is a Private Member’s Bill, the Bill is not expected to pass. . . [Full Text]

Conscientious Objection: A Quick(ish) Answer

Journal of Medical Ethics

Mary Neal

The Conscientious Objection (Medical Activities) [HL] Bill, introduced by the crossbench peer Baroness O’Loan, received its second reading in the House of Lords on Friday 26th January and successfully proceeded to the committee stage.  In a post on this blog the following day, Iain posed a very reasonable question about clause 1(1)(a) of the Bill.  That clause would allow health professionals to refuse to be involved in “the withdrawal of life-sustaining treatment”, and Iain asks how this can be compatible with existing civil and criminal law, under which it is unlawful to fail to withdraw treatment (including life-sustaining treatment) from a competent patient who no longer consents to it, or from a patient who lacks capacity if treatment is no longer in her best interests.

Before responding, I should declare an interest: I’m a spokesperson for the Free Conscience campaign, which supports the Bill.  I endorse the Bill’s premise that healthcare professionals should, in key areas of practice, benefit from statutory conscience rights that are both meaningful and effective. . . [Full Text]

Christian doctors and other medical staff opposing abortion face serious disadvantage, lords told

Press Association

Some doctors and midwives are suffering “serious disadvantage and discrimination” for their beliefs over abortion and other medical activities, peers have been told.

Baroness O’Loan also claimed young healthcare professionals are leaving the UK as they cannot carry out certain tasks, arguing there is a need to “reestablish legal protection” for medical conscientious objections.

The Crossbench peer’s Conscientious Objection (Medical Activities) Bill – which is being supported by the Free Conscience campaign – would apply to the withdrawal of life-sustaining treatment, human embryo research and activity linked to preparing, supporting or performing an abortion.

But her proposal split the Lords, with Labour’s Baroness Young of Old Scone among those voicing their opposition and describing it as “unnecessary and potentially dangerous” given existing protections. . .  [Full Text]