Project Submission to the College of Physicians and Surgeons of Saskatchewan

Re: Conscientious Refusal

Abstract

The policy Conscientious Refusal requires all physicians who object to a procedure for reasons of conscience to facilitate the procedure by referring patients to a colleague who will provide it, even if it is homicide or suicide.  No evidence was provided to justify the policy.  None of the arguments provided to Council justify the policy, nor do the principles included in the text.

Conscientious Refusal fails to recognize that the practice of medicine is a moral enterprise, that morality is a human enterprise, and that physicians, no less than patients, are moral agents.

The original text virtually copied by Conscientious Refusal was written by believers: by people who believe that whatever is “legally permissible and publicly-funded” is morally acceptable- including euthanasia, assisted suicide and abortion. It is an assertion of those beliefs and an authoritarian attempt to compel others to conform to them. It is a partisan document that is profoundly disrespectful of the moral agency of physicians, not a compromise.

Conscientious Refusal advances the dangerous idea that a learned or privileged class, a profession or state institutions can legitimately compel people to do what they believe to be wrong and punish them if they refuse. This is not a limitation of fundamental freedoms, but a serious violation of human dignity. It is also incoherent, because it posits the existence of a moral or ethical duty to do what one believes to be wrong.

The Associate Registrar has made it clear that those who refuse to do what the policy demands will be disciplined by the College or forced out of the medical profession. This clashes seriously with the approach taken by the Supreme Court of Canada, which has affirmed that public policy must make room for physicians whose “concept of the good life” precludes their participation in abortion, euthanasia, assisted suicide or other morally contested procedures.

The burden of proof was on the Associate Registrar and the appointed committee to prove beyond doubt that Conscientious Refusal is justified and that no less authoritarian alternatives are available.  They failed to discharge that burden; neither has College Council discharged it. The policy should be withdrawn.

Contents

I.    Origin of the draft policy, Conscientious Refusal

II.    Content of the proposed policy

III.    Focus of this submission

IV.    Justification for the proposed policy

V.    The issues

VI.    Response to the issues

VII.    Discussion

VIII.    Conclusions

Appendix “A”: Origin of the CPSS Draft Policy

Appendix “B”:  Development of the CPSS Draft Policy

Appendix “C”: Interview of CPSS Associate Registrar

Appendix “D”:  Ontario, Alberta, Manitoba and Saskatchewan College Policies

Appendix “E”:  College of Physicians and Surgeons of Saskatchewan Re: Guideline: Unplanned Pregnancy

Appendix “F”:  Morally Significant Participation

Appendix “G”:  Notes on Referral, Abandonment and Fiduciary Duty

Wake up to the war on Catholic doctors

From midwifery to geriatrics, Catholics are being driven out of vast areas of the medical profession. We need to fight back now.

Catholic Herald (UK)

John Duddington

Imagine you are a Catholic who has just finished general medical training and is now seeking experience in the field of obstetrics and gynaecology.

At the interview for a training post you are not asked “Are you a Catholic?” That would be discrimination on grounds of religion. Instead, you are asked: “Are there any procedures that you would not be able to do?” You answer: “Yes. Abortion.”

Shortly afterwards, you hear you haven’t been chosen for the position. The letter doesn’t mention your conscientious objection to abortion. That is the reason for your rejection, but the letter covers that up by saying the job was given to a “better” candidate. This actually means “more suitable”, as the candidate will be willing to perform the abortions that the post demands. You will now have to change specialties.

Evidence is naturally anecdotal, but my research suggests that virtually all Catholic obstetricians and gynaecologists in Britain have trained abroad and it is virtually impossible not only for Catholics but also for others with strong religious convictions to train here in these areas. . . [Full Text]

Unacceptable to force doctors to participate in assisted dying against their conscience: CMA head

National Post

Sharon Kirkey

No physician in the country should be forced to play a role in any aspect of assisted dying against their moral or religious beliefs — including referring patients to another doctor willing to help them die, the Canadian Medical Association says.

Legalized physician-assisted death will usher in such a fundamental change in practice “we simply cannot accept a system that compels physicians to go against their conscience as individuals on something so profound as this,” CMA president Chris Simpson said in an exclusive interview.

The unanimous Supreme Court of Canada ruling legalizing assisted dying would not compel doctors to help patients end their lives when the historic decision takes effect next year.

But the justices were more guarded on the issue of mandatory referral, saying the Charter rights of both patients and doctors will need to be reconciled.

Dr. Simpson said that many doctors who conscientiously object to assisted dying feel the very act of referral “is contrary to their personal ethics or moral or religious beliefs.” . . . [Full text]

Giving doctors a choice on assisted suicide

National Post

The following is an open letter written by medical professionals to the College of Physicians and Surgeons of Ontario.

Should Ontario’s doctors be forced to violate their consciences? On Feb. 6, the Supreme Court of Canada struck down the Criminal Code provisions against euthanasia and physician-assisted suicide. Concurrently, the College of Physicians and Surgeons of Ontario (CPSO) is proposing to oblige physicians, at the risk of professional discipline, to refer patients for procedures that a physician has refused for reasons of conscience, to a willing physician or agency established for such referrals.

This is a major shift in policy for the CPSO. Aside from Quebec, this position is not held by any other medical regulatory college in Canada and is inconsistent with the position of the Canadian Medical Association, the American Medical Association and similar bodies in Commonwealth countries. . . [Full Text]

Woman acted as surrogate mother for son’s IVF baby, court hears

Man in his 20s told he may adopt his biological son after court is told how he embarked on ‘process of becoming a father’ with assistance from his own mother

The Guardian

A woman acted as a surrogate mother for a baby whose biological father is her adult son, a family court judge has been told.

The man, who is in his mid-20s and lives alone, had taken advice from specialist lawyers before embarking on the “process of becoming a father”, Mrs Justice Theis heard. He had looked after the little boy – now seven months old – since birth. Theis has ruled that he can adopt.

Detail of the case emerged in a written ruling by Theis following a family court hearing in London. The judge said she had never encountered such a surrogacy arrangement before.