Submission to the College of Physicians and Surgeons of Ontario

Re: Professional Obligations and Human Rights

A threat to the supremacy of conscience

Catholic Organization for Life and Family

The College of Physicians and Surgeons of Ontario has proposed a modification in its operational principles which, if adopted, would severely restrict the rights of conscience of medical practitioners in Ontario. The implications of the proposed policy change would be devastating for Ontario doctors who seek to inform their consciences by their faith – and not only by College policy – and who, as a consequence, may be forced to leave the province or the practice of medicine in order to maintain their integrity. These implications would also be disturbing for many patients who want to be treated by physicians who share their vision of the human person.

Freedom of conscience and of religion are guaranteed by Canada’s Charter of Rights and Freedoms (section 2a). These rights, inalienable and universal, derive from the unique dignity of the human person, which constitutes the bedrock on which all human rights rest. Moral discernment demands the right use of reason, which impels us always to seek that which is right and good in order to do what we must and thus cultivate integrity and remain true to ourselves. The human person must always obey the certain judgment of his or her conscience.[1]

By requiring Ontario doctors to provide information about and to facilitate access to procedures which they judge to be gravely immoral – and not in the best interest of their patients – the CPSO’s proposed policy would replace the supremacy of conscience with that of a self-appointed authority functioning outside the sphere of its competence. Let us recall that the medical establishment has often proposed practices which it subsequently repudiated – lobotomy and electric shock treatment to name two of many. The humanization of medicine has come about largely as the result of the efforts of doctors who have found themselves unable, as a matter of conscience, to uphold the medical orthodoxy du jour.

To suggest that any particular practitioner should be compelled to act in a way which contradicts his or her conscience, is to call into question the collective rights of conscience of medical practitioners in general. Taken to its logical conclusion, this position would negate any role the medical establishment itself might legitimately play in determining the ethical acceptability of a given medical procedure.

The Catholic Church articulates the necessity of upholding this universally recognized right of freedom of conscience and religion as follows: “. . . the freedom of conscience of all people, whatever their religion or philosophy of life” is to be defended; “no person [is to be] forced to act against conscience or be prevented from acting according to conscience”.[2] Requiring medical doctors to bracket concerns informed by their particular religious or ethical views violates this fundamental principle. Furthermore, in the context of healthcare, it also risks turning them into mere dispensers of medical services whose good in a given situation is determined by persons other than themselves.

Human experience clearly demonstrates that “the effective recognition of the right to freedom of conscience and religious freedom is one of the highest goods and one of the most serious duties of every people that truly wishes to ensure the good of the individual and of society.”3[3] For all of these reasons we ask the College of Physicians and Surgeons of Ontario to reject the draft policy “Professional Obligations and Human Rights”.


COLF is co-sponsored by the Canadian Conference of Catholic Bishops and the Supreme Council of the Knights of Columbus.

[1]Catechism of the Catholic Church, no. 1800

[2]Dignitatis Humanae (On the Right of the Person and of Communities to Social and Civil Freedom in Matters Religious, Promulgated by His Holiness Pope Paul VI, 7 December 1965), no. 3.

[3]Compendium of the Social Doctrine of the Catholic Church, no. 553.

 

Helping suffering patients die may be doctor’s most humane option, Canadian Medical Association says

National Post

Sharon Kirkley

For the first time, the Canadian Medical Association has said helping a suffering patient die may be a doctor’s most humane option.

In a new position statement approved by its board, the CMA – once firmly opposed to any form of doctor-hastened killing – now states “there are rare occasions where patients have such a degree of suffering, even with access to palliative and end of life care, that they request medical aid in dying. In such a case, and within legal constraints, medical aid in dying may be appropriate.”

The policy change comes as the powerful doctors’ lobby prepares for a possible lifting of the federal ban on assisted suicide when the Supreme Court of Canada releases its historic ruling Friday morning in Ottawa.

If the top court strikes down laws making it a criminal offence to “counsel, aid or abet” another person to commit suicide,  “we’re going to need to hit the ground running if we want to lead and do this well,” said CMA president Dr. Chris Simpson. . . . [Full Text]

If Supreme Court decriminalizes physician-assisted suicide, doctors may be obligated to help with euthanasia

National Post

Shanifa Nasser

Doctors may be forced to support euthanasia over their own religious objections if the Supreme Court of Canada decides to decriminalize physician-assisted suicide in a landmark ruling expected Friday.

The court announced Monday it is set to rule on the Carter case launched on behalf of B.C. women Kathleen Carter and Gloria Taylor, who have since died.

Ahead of the ruling, the College of Physicians and Surgeons of Ontario, which regulates medical doctors in Ontario, has been seeking public input on a draft policy that would force the province’s doctors to help patients access any services to which they are legally entitled. It will finalize the policy after the comment period ends on Feb. 20.

Whatever its policy ultimately looks like, the college is clear: a patient’s right to access services outweighs a doctor’s right to refuse them. “We prioritize the interests of our patients in facilitating access,” says Dr. Marc Gabel, past president of the college and chair of the policy’s working group. . . . [Full Text]

A watchdog in need of a leash

Ontario College of Physicians manipulates consultation process

New Release

For immediate release

Protection of Conscience Project

It appears that the College of Physicians and Surgeons of Ontario is manipulating its consultation process to support a controversial draft policy intended to force doctors to do what they believe to be wrong.

The College is intervening in a Discussion Forum about Professional Obligations and Human Rights (POHR), apparently to discredit critics and defend the policy. The Forum is supposed to be used by the public to provide feedback on the policy, and to post emails and written submissions the College receives from the public.

But on 29 January the College posted a comment accusing Professor Margaret Somerville of misrepresenting its policy in a National Post column. The comment included a link to a letter to the National Post from College President, Dr. Carol Leet.

Not content with interfering in the consultation by posting its own statement, the College impersonated anonymous forum participants and used its statement to reply to comments supporting Professor Somerville’s “modest proposal.”

Someone at the College seems to have had second thoughts about impersonating participants, because the replies were revised a couple of days later to identify the College as the author. But the purported correction of participant responses still violates College policy.

Sean Murphy, Administrator of the Protection of Conscience Project, thinks College officials are interfering in the consultation because they are afraid that more people will begin to realize what the draft policy really means.

“In her National Post column, Professor Somerville succinctly critiqued the draft policy, and offered a reasonable alternative,” he said. “If Dr. Leet disagreed, she was within her rights to write a letter to the editor.”

“But,” he added, “interfering in the consultation process is unacceptable.”

Murphy observed that the College is supposed to be the watchdog protecting the public and profession from unethical conduct.

“It seems this watchdog needs a leash.”

For details, see A watchdog in need of a leash: Ontario College of Physicians manipulates consultation process

Results of the first consultation on Physicians and the Human Rights Code

Sean Murphy*

In February, 2008, the  Ontario Human Rights Commission responded to a draft policy of the College of Physicians and Surgeons of Ontario with a submission recommending that physicians “must essentially ‘check their personal views at the door’ in providing medical care.”1

The College, in response, released a draft policy, Physicians and the Ontario Human Rights Code, stating, “there will be times when it may be necessary for physicians to set aside their personal beliefs in order to ensure that patients or potential patients are provided with the medical treatment and services they require.”2

As a result of the subsequent controversy and public pressure the demand that physicians abandon their moral or religious beliefs was dropped before Physicians and the Ontario Human Rights Code was adopted. The policy was slated for review by September, 2013, but a public announcement of the review was not made until June, 2014.  The first stage of a public consultation about the policy closed on 5 August, 2014.

In December, 2014, a working group at the College released a new policy draft called Professional Obligations and Human Rights (POHR)  for a second stage of consultation ending on 20 February, 2015. The most contentious element in POHR is a requirement that physicians who object to a procedure for reasons of conscience must help the patient find a colleague who will provide it.3

According to the College, POHR takes into account feedback received during the first consultation. When the new draft policy was released in December, Dr. Marc Gabel, then President of the College, stated that “public polling” by the College had demonstrated that “the vast majority of Ontarians believe that [objecting physicians] should be required to identify another physician who will provide the treatment, and make and/or coordinate a referral.”4

The “public polling” to which Dr. Gabel referred appears to be an on-line random survey of 800 Ontario residents conducted by the College in May, 2014. The participants were randomly selected “using a Voice Response system,” and College Council was told that the results can be generalized to the online population of the province (80% of adults), with an accuracy of +3.5% and a 95% level of confidence.5 Beyond that, the College has not disclosed details of the poll that would permit an independent assessment of its validity. Particularly on such an important question, this seems inconsistent with its commitment to greater transparency.6

An analysis of consultation feedback posted on the College website produces quite a different result.

College Council was told that the consultation produced 6,710 responses7 – an “unprecedented volume.”8 However, an unknown number of respondents contributed both to the On-line Survey and Discussion Forum, so the number of unduplicated consultation responses actually available for analysis may have been far less than 6,700. Less than half that number responded to a question about the extremely contentious issue of mandatory referral, and only 50% of that group supported it.9

In any case, an overwhelming majority of responses in a Discussion Forum supported freedom of conscience for physicians, but only about 2% advocated a policy of mandatory referral. Nor were On-line Survey responses supportive of a policy of mandatory referral, suggesting, instead, that such a policy is controversial.

A detailed analysis of the results of the consultation is available here.

[PDF Text]

Notes

1.  Submission of the Ontario Human Rights Commission to the College of Physicians and Surgeons of Ontario regarding the draft policies relating to establishing and ending physician-patient relationships. 14 February, 2008. (Accessed 2018-03-07)

2.  College of Physicians and Surgeons of Ontario, Physicians and the Ontario Human Rights Code, p. 4

3.  College of Physicians and Surgeons of Ontario, Professional Obligations and Human Rights (Draft, December, 2014)

4.  Gabel, M. “Dear Colleagues.” College of Physicians and Surgeons of Ontario, Dialogue, Vol. 10, Issue 4, 2014, p. 6. (Accessed 2018-03-07)

5.  College of Physicians and Surgeons of Ontario, Annual Meeting of Council, December 4-5, 2014, p. 330 (Accessed 2018-03-07)

6.College of Physicians and Surgeons of Ontario, Appendix 2, Transparency Principles (2013-09) Accessed 2018-03-07).

7.  College of Physicians and Surgeons of Ontario, Annual Meeting of Council, December 4-5, 2014, p. 328 (Accessed 2018-03-07)

8.  “Balancing MD and patient rights: Human rights draft policy open for consultation.”  Dialogue, Vol. 10, Issue 4, 2014, p. 49.  (Accessed 2018-03-07)

9.  3,104 responses. College of Physicians and Surgeons of Ontario, Physicians and the Ontario Human Rights Code Consultation: Online Survey Report and Analysis, Figure 4 (Accessed 2018-03-07)