Category: Assisted suicide

Legalised euthanasia: Christian doctors in Canada want ‘conscience rights’ protected

World

Shianee Mamanglu-Regala

A Christian physician organisation, which represents several thousand Christian physicians in Canada, is sounding an alarm about the implications of a new bill that when passed, will forced them to perform legalised euthanasia, which could violate their conscience rights.

In February 2015, the Supreme Court of Canada struck down the law against assisted suicide, ruling that it was a breach of an individual’s Charter rights. The court gave the federal government one year to pass a new legislation but recently extended the deadline to June. . . [Full text]

Submission to the College of Physicians and Surgeons of Nova Scotia

Re: Standard of Practice: Physician Assisted Death

Abstract

The Project considers the proposed standard of practice satisfactory with respect to the accommodation of physician freedom of conscience and respect for the moral integrity of physicians. Neither direct nor indirect participation in euthanasia and assisted suicide is required.

The Project offers simple and uncontroversial recommendations to avoid conflicts of conscience associated with failed assisted suicide and euthanasia attempts and urgent situations.

The standard does not adequately address the continuing effects of criminal law. The College has no basis to proceed against physicians who, having the opinion that a patient does not fit one of the criteria specified by Carter, refuse to do anything that would entail complicity in homicide or suicide. College policies and expectations are of no force and effect to the extent that they are inconsistent with criminal prohibitions.

While the standard is satisfactory with respect to freedom of conscience, the fundamental freedoms of physicians in Nova Scotia will remain at risk as long as the College Registrar and others persist in the attitude and intentions demonstrated in his presentation to the Special Joint Committee on Physician Assisted Dying.

Contents

I.    Outline of the submission

II.    Avoiding foreseeable conflicts

II.1    Failed assisted suicide and euthanasia
II.2    Urgent situations
II.3    Project recommendations

III.    SPPAD and criminal law

IV.    Remarks of the Registrar

IV.1    The Registrar before the Special Joint Committee on Physician Assisted Dying
IV.2    The Registrar, the Conscience Research Group, and “effective referral”
IV.3    The Registrar’s intentions
IV.4    The Registrar’s complaint
IV.5    An ethic of servitude, not service

V.    Conclusion

Appendix “A”    Supreme Court of Canada, Carter v. Canada (Attorney General), 2015 SCC 5

A1.    Carter criteria for euthanasia and physician assisted suicide
A2.    Carter and the criminal law
A3.    Carter and freedom of conscience and religion

Appendix “B”    Conscience Research Group

B1.    Attempts to coerce physicians: abortion
B2.    Plans to coerce physicians: assisted suicide and euthanasia
B3.   Plans to coerce physicians: the CRG Model Policy
B4.    CRG convenes meeting with College representatives

2ublic

Docs will flee, experts warn

London Free Press

Jonathon Sher

Dr. Maria MacDonald laboured 12 years as a student and medical resident to become a neurologist, but the Londoner may give that up if she’s forced to refer patients to a physician-assisted death.

“My freedom of conscience has been violated,” she said. “Do I have to leave and go to another field?”

Other doctors are asking that same question in Ontario, whose regulatory college is the only one in Canada to demand that physicians who oppose helping patients die refer them to a colleague willing to assist in a death.

“It’s an extensive belief,” said Larry Worthen, executive director of the Christian Medical and Dental Society of Canada.

A month ago, Worthen said, he teleconferenced with 40 doctors and some already had taken steps so they could leave Ontario and practise medicine elsewhere. . . [Full text]

Assisted dying: Parliament must let doctors practise with a clear conscience

Globe and Mail
Reproduced with permission

John Carpay

Since the Supreme Court legalized physician-assisted dying last year, some have argued that physicians should be required to help patients kill themselves, even if this violates their Charter-protected conscience freedoms.

As Parliament creates new legislation to respond to this court ruling, some insist that doctors must simply provide whatever a patient may want, or else refer the patient to another doctor who will. This claim trivializes the freedom of conscience of all Canadians, and the role of ethics and morality in medicine.

For more than 2,000 years, physicians have been guided by ethics and morality, not science alone, through the foundational principles embodied in the Hippocratic Oath and its modern incarnations.

In deciding what is best for their patients, doctors are not mindless dispensaries for medication. Science can inform us about what quantity of which drug is required to end a patient’s life, but science cannot tell us whether it is right to end a patient’s life through assisted suicide or other means of deliberate death.

 

Physicians routinely refuse to provide  –  and offer referrals for  –  drugs and procedures that the physician considers contrary to a patient’s best interest. From the patient’s standpoint, this produces inconvenience and possibly hardship. But the patient is not prevented from finding another doctor, whereas the doctor cannot go and find another conscience. She has only her own.

To refer for something is to participate actively. If a man asks me to sell him a gun to rob a convenience store, and I respond by refusing to sell the gun, but nevertheless provide him with the name and contact information of someone who will, I am complicit in the resulting robbery. This is why the provincial Colleges of Physicians and Surgeons, when they prohibit a doctor from performing female “circumcision” (genital mutilation), they also prohibit doctors from referring for that service.

Opponents of conscience protection denounce the prospect of a patient having to face a delay because her physician could not, in good conscience, provide a referral to another physician. Yet thousands of Canadians suffer in pain while waiting for months (and sometimes years) for medically necessary diagnosis and surgery. The law prevents these suffering patients from accessing private treatment outside of the government’s monopoly over health care.

With the exceptions of Canada, Cuba and North Korea, every other country in the world gives patients the right to choose between private and government-run health care. France, Japan and Australia are among the dozens of countries where patients count their wait times in days and weeks, not in months and years as Canadian patients do. If our goal is truly to get rid of delays in accessing medical services, then legalizing private health insurance would do far more than attacking the conscience rights of physicians, nurses, pharmacists and other health-care providers.

To protect the integrity of the medical profession, Parliament, as well as the provincial Colleges of Physicians, should promote and encourage the ability of physicians to practise medicine knowing that their freedom of conscience is being respected.

http://www.theglobeandmail.com/opinion/assisted-dying-parliament-must-let-doctors-practise-with-a-clear-conscience/article28569267/

 

 

Supreme Court of Canada respect for physician freedom of conscience and religion is not “a cop-out”

Responding to “Patient rights – even in death – must trump a doctor’s discomfort.” Globe and Mail, 1 February, 2016

Sean Murphy*

According to André Picard, the Supreme Court of Canada decided last year that patients could ask to be killed by physicians or ask physicians to help them commit suicide, but physicians could not be compelled “to actually kill a patient.” He describes this as “a perfectly reasonable balancing and reconciling of rights.”1Supreme Court of Canada respect for physician freedom of conscience and religion is not “a cop-out”

Indeed, it is perfectly reasonable to believe that physicians should not be forced to actually kill a patient. However, Mr. Picard is mistaken when he claims that the Supreme Court of Canada reconciled or balanced the rights of patients and physicians in the Carter ruling. The Court did not even attempt to do so, stating, instead, that patient and physician rights “will need to be reconciled.”2

With respect to physicians, the Court stated that “nothing” in the ruling would compel physicians to “provide” or “participate in” euthanasia or assisted suicide. This is precisely the language and thinking adopted by the Canadian Medical Association (CMA) in its policy framework.3 Mr. Picard is clearly angry about this, calling it “a cop-out that creates real barriers for desperately ill patients,” one that “regulators and legislators cannot and should not accept.”

However, in the face of the Carter ruling, Mr. Picard cannot expect the CMA, regulators and legislators to impose his deeply held personal belief that refusing to compel physicians to provide or participate in homicide or assisted suicide is an unacceptable “cop-out.”

Mr. Picard clearly prefers the policy of the College of Physicians and Surgeons of Ontario (CPSO) on “effective referral,” which demands that physicians who refuse “to actually kill a patient” must help find someone willing to do the actual killing.

Contrary to his claim that effective referral is a “well-established policy,” it was first imposed by the CPSO in Ontario last year in the face of overwhelming opposition, on the basis of deficient, erroneous and seriously misleading briefing materials, and without evidence that even a single person in Ontario had ever been unable to access medical services because of conscientious objection by a physician.4 It is the subject of an ongoing constitutional court challenge,5 and is not supported by the BC Civil Liberties Association – one of the driving forces behind Carter’s challenge to the law.6 None of this seems to concern Mr. Picard.

“Patient need takes precedence over physician discomfort,” he says, “and patient rights trump physician rights.”

However, the CMA’s Dr. Jeff Blackmer told the joint parliamentary committee on assisted dying that this is a false dichotomy. There are enough physicians willing to provide euthanasia or assisted suicide to meet the expected demand, he said, and other jurisdictions do not require “effective referral” by objecting physicians but there is no difficulty with access.7

“This should not be a debate between patient access OR the right to conscientious objection by health care professionals,” writes CMA President, Dr. Cindy Forbes. “We can absolutely accomplish both.”8

Mr. Picard’s demand that physicians must get over discomfort about killing people at least to the extent that they will contract out the actual killing no doubt reflects his deeply held personal beliefs. However, if the real goal is to ensure access – not ideologically driven ethical cleansing – there is no reason to demand that physicians do what they believe to be wrong. If the real goal is to ensure access to services – not to punish objecting physicians – that goal is best served by connecting patients with physicians willing to help them, and that can be done without demanding “effective referral.”

Notes

1. Picard A. “Patient rights – even in death – must trump a doctor’s discomfort.” Globe and Mail, 1 February, 2016 (Accessed 2016-02-04).

2. Carter v. Canada (Attorney General), 2015 SCC 5, para. 132. (Accessed 2016-02-04).

3. Canadian Medical Association,  Principles-based Recommendations for a Canadian Approach to Assisted Dying (2016) (Accessed 2016-01-09).

4. Protection of Conscience Project, Submission to the College of Physicians and Surgeons of Saskatchewan (5 June, 2015) Re: Conscientious Refusal (as revised). Appendix “A”: Ontario College briefing materials .

5. Ontario Superior Court of Justice, Between the Christian Medical and Dental Society of Canada et al and College of Physicians and Surgeons of Ontario, Notice of Application, 20 March, 2015. Court File 15-63717.

6. Legislative Assembly of British Columbia, Report of Proceedings (Hansard), Select Standing Committee on Health. Wednesday, July 15, 2015, Issue No. 17, p. 270 (Accessed 2016-02-02).

7. Special Joint Committee on Physician Assisted Dying, Evidence: Wednesday, January 27, 2016. (Accessed 2016-02-04)

8. Forbes C. “Time for myth-busting on assisted dying.” Canadian Medical Association (4 February, 2016)