Tag: referral

No legal “duty to refer” for euthanasia or assisted suicide anywhere in the world

 

Maurice Vellacott, MP
Saskatoon-Wanuskewin

For Immediate Release

OTTAWA – In anticipation of the possible striking down of Canada’s laws against euthanasia and assisted suicide (pending the Supreme Court’s decision in the Carter case), and given the College of Physicians and Surgeons of Ontario’s (CPSO’s) draft policy “Professional Obligations and Human Rights” [i] which, if passed, would require Ontario physicians to make referrals for controversial medical procedures regardless of their conscientious/religious convictions, Member of Parliament Maurice Vellacott today issued the following statement:

I am deeply concerned about the assault on the fundamental freedoms of Ontario’s doctors should CPSO’s policy forcing doctors to make referrals for morally objectionable “treatments” pass. If the Supreme Court of Canada strikes down Canada’s current laws on euthanasia or assisted suicide, then CPSO’s policy would mean Ontario’s physicians would have a “duty to refer” patients for treatments intended to kill the patient.

From the research I have conducted, with the help of the Library of Parliament, I have learned there is not a single jurisdiction in the world that forces doctors to violate their consciences through mandatory referrals for these life-ending “treatments.” (See attached list of laws in jurisdictions which have legalized euthanasia or assisted suicide.)

We all recognize it is criminally wrong to aid or abet the commission of a criminal act.[ii] In the same way, it would be morally wrong for a doctor to aid or abet (i.e. through referral) the commission of what that doctor deems to be an immoral act – in this case, intentionally killing, or assisting in the killing of, their patient. Following one’s conscience in the provision of euthanasia or assisted suicide, then, entails making a conscientious decision not only about performing euthanasia or assisted suicide, but also about making referrals for them.

The Canadian Medical Association has long been a defender of a physician’s freedom to abstain from being involved in morally objectionable procedures. Last August, the CMA clearly expressed its support for physicians’ freedom of conscience in the provision of euthanasia and assisted suicide should those acts ever be legalized.[iii]

In spite of no jurisdiction in the world imposing on physicians a legal duty to refer for euthanasia or assisted suicide, and in spite of the support for freedom of conscience by the national medical organization representing Canada’s physicians, we have the regulatory body in Ontario poised to punish physicians who act upon their moral guidance system that tells them that killing their patients is wrong.

Over the years, there have been repeated attempts by activists and special interest groups to impose their version of morality on all health care workers (almost succeeding in 2008 to convince CPSO to impose mandatory referral, until a loud public outcry from right across the country compelled CPSO to reverse course.) Such was the threatening climate that compelled me to introduce several private members bills, in successive Parliaments, that would protect health care workers who had conscientious objections to being involved in practices that deliberately take human life.

If the Supreme Court strikes down our laws against assisted suicide/euthanasia, then it will be up to Parliament to come up with a new law. It is clear from CPSO’s actions that we can’t leave it to the regulatory bodies to protect freedom of conscience. Any new law to regulate these life-ending medical procedures will need to include explicit protection for those health care workers who won’t take part in any action that aids or abets the killing of their patients.

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For further information and comment, call (613) 992-1966 or (613) 297-2249; email: maurice.vellacott.a1@parl.gc.ca

Notes

[i] http://policyconsult.cpso.on.ca/wp-content/uploads/2014/12/Draft-Professional-Obligations-and-Human-Rights.pdf

[ii]http://laws-lois.justice.gc.ca/eng/acts/C-46/FullText.html

  1. (1) Every one is a party to an offence who
  • (a) actually commits it;
  • (b) does or omits to do anything for the purpose of aiding any person to commit it; or
  • (c) abets any person in committing it.

[iii] “Medical Association vows to protect conscience rights,” by Michael Swain, The Catholic Register, August 27, 2014, http://www.catholicregister.org/item/18703-medical-association-vows-to-protect-conscience-rights;  and Resolution adopted by General Council at 2014 AGM: “The Canadian Medical Association (CMA) supports the right of all physicians, within the bounds of existing legislation, to follow their conscience when deciding whether to provide medical aid in dying as defined in CMA’s policy on euthanasia and assisted suicide.” (https://www.cma.ca/Assets/assets-library/document/en/GC/Final-Resolutions-GC-2014-Confirmed-Nov-2014.pdf )

CBC interviewer fails to ask tough questions

Sean Murphy*

A bill has been introduced in the Canadian Senate by Conservative Senator Nancy Ruth to legalize physician assisted suicide and euthanasia.  Bill S-225’s definition of of “assist”  is of particular interest.  It means  “to provide the person with the knowledge or means to commit suicide, or to perform an act with the intent to cause the person’s death.”   Consistent with this, an “assisting physician” is one “who provides assistance” to a patient seeking euthanasia or physician-assisted suicide.

This indicates that indirectly facilitating suicide even by providing information for that purpose is equivalent to more direct forms of assistance, like providing a lethal prescription.  Further, it implies that both providing information to facilitate suicide and actually killing someone are of comparable legal or moral significance.  Many physicians and health care workers who object to assisted suicide and euthanasia would agree, and, for that reason, would refuse to refer or otherwise help a patient find someone willing to kill him or assist him in committing suicide.

The point was overlooked during an interview of Senator Ruth by Evan Solomon on CBC Television’s Power and Politics (2 December, 2014).  After discussing the contents of the bill in general terms and asking Senator Ruth about her reasons for introducing it, Solomon raised the issue of conscientious objection:

Evan Solomon:  A doctor might be watching this, and say, you know, “Great piece of legislation. What do you do if, what will you do to me if I don’t want to do this?”

Senator Ruth:  Nothing.  No doctor is coerced to do this, no patient is coerced to do this.  This is about choice.  The choice of doctors who want to assist in it and their protection . . .

Solomon failed to ask the tough questions.  Among them:

  1. If physicians will not be forced to kill patients, will they, nonetheless, be forced to help patients find someone who will?
  2. Why is it that the bill is about the choice and the protection of doctors who want to help to kill patients, and not about the choice and protection of those who refuse?
  3. When abortion was legalized, politicians and activists promised that no physician would be forced to provide abortions, but refused to include a protection of conscience provision in the law.1  Now the College of Physicians of Ontario is proposing a policy that would compel physicians to provide abortions or help  patients obtain them.2  Dr. Marc Gabel, chair of the working group that produced the draft policy, warns that physicians who refuse to do this should get out of family practice.3  As written, the policy could be applied equally to euthanasia and assisted suicide.  Why does Senator Ruth think that objecting physicians will not be coerced – if not sooner, then later?

Notes:

1. Murphy, S.  “Promises, promises.  Canadian law reformers promise tolerance, freedom of conscience:What happens after the law is changed is another story.” Protection of Conscience Project

2. “Ontario physicians to be forced to do what they believe to be wrong:  Draft policy demands that objectors provide or refer.  Policy would apply to euthanasia, if legalized.”  Protection of Conscience Project news release, 10 December, 2014

3.  Swan, M.   “Catholics doctors who reject abortion told to get out of family medicine.” The Catholic Register, 17 December, 2014.  (Accessed 2014-12-19)

 

 

Doctors who oppose abortion should leave family medicine: Ontario College of Physicians

LifeSite News

Steve Weatherbe

Family doctors who object to referring patients for abortions should think about switching specialties, the man overseeing the Ontario College of Physicians and Surgeons’ revision of its ethics policy said this week.

Dr. Marc Gabel, a Toronto psychotherapist and past president of the college, told LifeSiteNews on Thursday that if his committee’s proposed revision of the college’s “Professional Obligations and Human Rights” is adopted, then if doctors refuse to refer patients to abortionists, or to doctors willing to prescribe contraceptives, they could face disciplinary action.

“If there were a complaint, every complaint is investigated by the complaint committee,” Dr. Gabel said. The complaint committee could deliver a mild private rebuke or turn over the matter to the disciplinary committee, which Gabel chaired for several years.

According to Dr. Carol Leet, the new president of the college, a doctor found guilty of professional misconduct by the disciplinary committee could face anything from remedial instruction to loss of his or her medical licence. . . [Full text]

 

Proposed policy of Ontario College of Physicians “appalling”

Medscape

Reproduced with permission of the author

Dr. Terence McQuiston, M.D.

Dr. Gabel is not alone in this opinion, but I find it nevertheless appalling. Ever since Hippocrates medical ethics were determined by our profession independently of government legislation (including human rights tribunals). We Canadians stood in judgement at Nuremberg over the German physicians of the Nazi period.

Their defense was that they had done nothing outside of the law (true). However, we took the view that ethics transcend and should inform legislation, not the other way around, and therefore we could hold them to account for their deeds.

Such transcendence of ethics is only possible by the exercise of conscience by all physicians. Granted there may be differences arising from this exercise, but we should do our best to accommodate these differences.

That’s why we permit conscientious objection in wartime. Individual conscience is too precious a part of our social fabric to be casually overridden. The policy defended by Dr. Gabel in effect puts conscience on ice. If euthanasia becomes legal, I for one still won’t do it.

This comment responds to the Medscape article “Doctors opposing draft abortion policy may need to rethink whether family practice is right for them, says CPSO official: Direct referrals a sticking point in Ontario’s human rights policy (17 December, 2014)  Dr. Marc Gabel was quoted to the effect that physicians unwilling to provide or facilitate abortion and contraception should not practice family medicine. Administrator

 

 

Catholics doctors who reject abortion told to get out of family medicine

The Catholic Register

Michael Swan

Catholic doctors who won’t perform abortions or provide abortion referrals should leave family medicine, says an official of the College of Physicians and Surgeons of Ontario.

“It may well be that you would have to think about whether you can practice family medicine as it is defined in Canada and in most of the Western countries,” said Dr. Marc Gabel, chair of the college’s policy working group reviewing “Professional Obligations and Human Rights.”

The Ontario doctor’s organization released a draft policy Dec. 11 that would require all doctors to provide referrals for abortions, morning-after pills and contraception. The revised policy is in response to evolving obligations under the Ontario Human Rights Code, Gabel said.

There have been no Ontario Human Rights Tribunal decisions against doctors for failing to refer for abortion or contraception.

Gabel said there’s plenty of room for conscientious Catholics in various medical specialties, but a moral objection to abortion and contraception will put family doctors on the wrong side of human rights legislation and current professional practice. . . [Full text]