Protection of Conscience Project News
Service, not Servitude
Toronto Sun
The Ontario government has quietly amended its proposed Patients First Act with wording that appears to strengthen the rights of faith-based hospitals to opt out of assisted death.
The proposed amendment, which was not originally in the act, appeared when it was re-tabled last month after the legislature was prorogued. The act, according to the province, is aimed at improving health care for patients and their families. . . [Full text]
Michigan Radio
WUOM FM: All Things Considered
Physicians in Ontario are facing a dilemma: What can you do when asked to perform an action that is legal, but violates your moral code or religious beliefs?
In 2015, the Supreme Court of Canada struck down the federal law that prohibited medically-assisted suicide.
In Ontario, the service is now covered by the Ontario Health Insurance Plan, and any drugs required to help a patient die will be available at no cost.
Dr. Brad Burke is a physician in Windsor who says assisted dying goes against his conscience. He’s making plans for the day when a patient asks him for help in dying.
He joined us today. Listen to our conversation with him . . . [Full audio interview]
Globe and Mail
Groups representing more than 4,700 Christian doctors across the country have launched a court challenge to Ontario regulations that require them to refer patients to physicians willing to provide an assisted death, arguing the referrals are morally equivalent to participating in the procedure.
The College of Physicians and Surgeons of Ontario, however, takes issue with the faith groups’ position. “An effective referral does not foreshadow or guarantee an outcome,” college spokeswoman Tracey Sobers said in an e-mail.
Ewan Goligher, a doctor who works in the intensive care unit at Mount Sinai Hospital in Toronto, said he considers himself a conscientious objector to doctor-assisted dying and supports the court challenge. “I think the patient is of greater value than their preference, and I cannot lift my hand to destroy that which is of fundamental value,” he said in an interview. . . [Full Text]
National Post
Ontario will allow hospitals to opt out of providing assisted death within their walls, provoking charges from ethicists that conscientious accommodation has gone too far.
Elsewhere in the country, a divide is already shaping up, with half of voluntary euthanasia cases in Quebec reportedly occurring in Quebec City hospitals — and few in Montreal.
The situation highlights the messy state of the emotionally charged debate as the provinces wrestle with the new reality of doctor-assisted death, and as the Senate takes a proposed new law further than the governing Liberals are prepared to go. . . [Full Text]
Abstract
Virtually all of what is proposed in Interim Guidance on Physician-Assisted Death (IGPAD) is satisfactory, requiring only clarifications to avoid misunderstanding and appropriate warnings concerning the continuing effects of criminal law.
The College has no basis to proceed against physicians who refuse to do anything that would entail complicity in homicide or suicide, including “effective referral,” because they believe that a patient does not fit the criteria specified by Carter. College policies and expectations are of no force and effect to the extent that they are inconsistent with criminal prohibitions.
Proposals about respect for patients, access to services, and providing information are acceptable, subject to some clarifications and limitations with respect to offering the option of suicide. Simple and uncontroversial recommendations are offered to avoid problems associated with failed assisted suicide and euthanasia attempts, and in urgent situations.
However, the requirement for “effective referral “is completely unacceptable. It is ludicrous to assert that the reasoning that underpins the law on criminal complicity and culpability, civil liability and the College policy that prohibits referral for Female Genital Cutting can be dismissed as legally irrelevant to the exercise and protection of fundamental freedoms of conscience and religion.
The College cannot justify a demand for “effective referral” on the grounds that it cannot be understood to involve morally significant complicity in killing patients or helping them to commit suicide, nor can it be justified as a reasonable limitation on fundamental freedom.
The only apparent basis for the College’s demand for effective referral is that it has decided what the Supreme Court of Canada did not decide: that euthanasia and assisted suicide in circumstances defined by Carter are morally/ethically acceptable. College officials seem to consider the College justified in using force – the force of law – to compel dissenting physicians to conform to their moral/ethical views.
This is not a reasonable limitation of freedom but a reprehensible attack on them. It is a paradigmatic example of the authoritarian suppression of freedom of conscience and religion and a serious violation of human dignity. Examples of alternative acceptable policies demonstrate that access to assisted suicide and euthanasia can be ensured without suppressing freedom of conscience and religion.
II. Avoiding foreseeable conflicts
II.1 Failed assisted suicide and euthanasia II.2 Urgent situations
II.3 Project recommendations
IV. IGPAD on respect, access, notification and providing information
IV.1 Treat patients respectfully; do not impede access
IV.2 Notification of objections
IV.3 Providing information
V.1 IGPAD and “effective referral”
V.2 “Effective referral” and criminal law
V.3 Legal vs. ethical/moral evaluation of euthanasia, assisted suicide
V.4 The College position: “error has no rights”
VI.1 Previous submissions
VI.2 Making freedom easy – or impossible
VII. Alternative acceptable policies
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” Carter in theTrial Court, Part VII: A Judicial Soliloquy on Ethics
B1. A note of caution
B2. The questions addressed in Part VII
B3. Plaintiffs’ claim shapes and limits the analysis
B4. Ethics: which one?
B5. Medical ethics
B5.1 Ethics and the willingness of physicians
B5.2 Ethics and the positions of medical associations
B5.3 Ethics and the opinions of ethicists
B5.4 Ethics and current end-of-life practices
B6. Ethics of society
B6.2 Ethics and public opinion
B6.3 Ethics and public committees
B6.4 Ethics and prosecution policies
B7. Summary of the ethical debate
B8. Conclusions about the ethical debate
B8.2 Would Canadian physicians provide the services?
B8.3 Current medical practice with respect to end-of-life care?
B8.4 Does the law attempt to uphold a conception of morality?
B9. Carter Part VII: in brief
B9.1 Unanswered questions
B9.2 Meaningless findings
B9.3 Inconclusiveness
B9.4 Neglected evidence
B9.5 Deficient review of end-of-life decision-making
B10. On appeal to the Supreme Court of Canada
Appendix “C” Physician Exercise of Freedom of Conscience and Religion
C1. Introduction
C2. Providing information to patients
C3. Exercising freedom of conscience or religion
C4. Reminder: treatments in emergencies