Ontario College of Physicians approves policy compelling doctors to abort, euthanize in some cases

LifeSite News

Steve Weatherbe

TORONTO, March 6, 2015 (LifeSiteNews.com) – Ontario doctors could be compelled to perform abortions and euthanasia after the professional regulator’s ruling council approved its controversial new policy Friday morning in a 21-3 vote.

The College announced today in a news release that its new Professional Obligations and Human Rights policy “requires physicians to provide their patients with an effective referral to another health-care provider for those services the physician chooses not to provide for reasons of conscience or religion.”

But it does more, and requires doctors not only to refer but to provide service if required to alleviate “suffering.”

Commented one of the policy’s severest critics, Sean Murphy of the Protection of Conscience Project: “The Ontario College of Physicians has decided they are prepared to compel physicians to do what they consider is wrong, even homicide or suicide and punish them if they refuse. If institutions can order citizens to do what they believe is evil, what can they not do?” . . . [Full text]

UPDATED: Ontario doctors must refer for abortions, says College of Physicians

The Catholic Register

Michael Swan

TORONTO – Despite an overwhelmingly negative response from members of the public, physicians and organizations during a three-month online consultation, the Ontario College of Physicians and Surgeons voted 21-3 to force doctors to refer for abortions, contraception and other legal treatments or procedures even if they have moral or religious objections.

A last-minute submission from the Ontario Medical Association urging the college not to force doctors to act directly against their moral or religious convictions failed to sway the governing council of the college to reconsider wording that demands doctors provide “an effective referral to another health-care provider” despite personal convictions, whether religious or moral.

The college did not provide a statistical breakdown of the 16,000 submissions it received online, other than to say that 90 per cent were from members of the public and most were against the policy. . . [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]

American Medical Association provides details of new freedom of conscience policy

AMA submission to Ontario College of Physicians an improvement on quality of briefing by College working group

Sean Murphy*

The American Medical Association has made a submission to the public consultation on physician freedom of conscience being conducted by the College of Physicians and Surgeons of Ontario (CPSO). The AMA letter provides important details about a policy on physician freedom of conscience adopted by the AMA House of Delegates in November, 2014, but not due to be formally published until June of this year.

The current consultation on a controversial draft policy, Professional Obligations and Human Rights (POHR), was approved by College Council in December, 2014. Briefing materials provided to Council members by the College working group at that time included the American Medical Association as one of the organizations selected for international comparison of policies.

However, the single sentence offered by the working group as representative of AMA policy was taken from an on-line source of short essays about medical ethics, not an authoritative source of information about AMA policy. In fact, the article was about conscientious objection among pharmacists, not about the policies of the American Medical Association concerning freedom of conscience in health care.

The letter from the AMA is a substantial improvement upon what the Protection of Conscience Project submission characterizes as the “deficient and superficial” briefing materials concerning the United States supplied to College Council in December.

. . .In the Council’s view, an account of the nature and scope of a physician’s duty to inform or to refer when a patient seeks treatment that is in tension with the physician’s deeply held personal beliefs must address in a nuanced way the question of moral complicity. The Council concurs that physicians must provide information a patient needs to make a well-considered decision about care, including informing the patient about options the physician sincerely believes are morally objectionable. However, the Council sought to clarify that requirement, holding that before initiating a patient-physician relationship the physician should “make clear any specific interventions or services the physician cannot in good conscience provide because they are contrary to the physician’s deeply held personal beliefs, focusing on interventions or services that a patient might otherwise reasonably expect the practice to offer.”

The Council also reached a somewhat different conclusion than the College with respect to a duty to refer.

The College’s draft policy provides that, when a physician is “unwilling to provide certain elements of care on moral or religious grounds,” the physician must provide “an effective referral” to “a nonobjecting, available, and accessible physician or other health care provider.”

This seems to us to overstate a duty to refer, risk making the physician morally complicit in violation of deeply held personal beliefs, and falls short of according appropriate respect to the physician as a moral agent. On our view, a somewhat less stringent formulation of a duty to refer better serves the goals of non-abandonment, continuity of care, and respect for physicians’ moral agency. The council concluded that:

In general, physicians should refer a patient to another physician or institution to provide treatment the physician declines to offer. When a deeply held, well-considered personal belief leads a physician also to decline to refer, the physician should offer impartial guidance to patients about how to inform themselves regarding access to desired services.

On the Council’s analysis, the degree or depth of moral complicity is defined in part by ones “‘moral distance’ from the wrongdoer or the act, including the degree to which one shares the wrongful intent.”

Other factors also influence complicity, including “the severity of the immoral act, whether one was under duress in participating in the immoral act, the likelihood that one’s conduct will induce others to act immorally, and the extent to which one’s participation is needed to facilitate the wrongdoing.” . . .

Project Submission to the College of Physicians and Surgeons of Ontario

Re: Professional Obligations and Human Rights

Abstract

The focus of this submission about Professional Obligations and Human Rights (POHR) is its demand for “effective referral” – the demand that physicians do what they believe to be wrong – even gravely wrong – even arranging homicide or suicide – and the implied threat that they will be punished if they refuse.

This is a dangerous and extraordinarily authoritarian policy, completely at odds with liberal democratic aspirations and our national traditions. The burden of proof is on the working group to prove beyond doubt that it is justified and that no reasonable alternatives are available. The working group has not done so.

The working group provided no evidence that such a policy is necessary, and there is evidence that it is not. The briefing materials supplied to Council in support of POHR were not only seriously deficient, but erroneous and seriously misleading. “Public sentiment” captured by a random poll does not justify the suppression of fundamental freedoms, and the results of consultation, when carefully considered, suggest that a policy of “effective referral” is highly controversial.

An example of a reasonable alternative is available from the Australian Medical Association – an example not offered to Council members by the working group, which, instead, completely misrepresented AMA policy.

This submission, supported by detailed analysis in the appendices, provides good reason for Council members to doubt that the requirement for effective referral in POHR is necessary or justifiable, or prudent policy. It also provides reason for them to believe that reasonable alternatives can be developed.

Council members unpersuaded by the working group or left in doubt about POHR should give the benefit of doubt to freedom of conscience and refuse to approve the draft policy in its present form. They should direct the working group to collaborate with those opposed to the present draft to produce a broadly acceptable text. 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 College’s real goal is to ensure access to services – not to punish objecting physicians, or drive them out of family practice, or out of the profession – that goal is best served by connecting patients with physicians willing to help them.