Submission to the College of Physicians and Surgeons of Ontario

Gift of Life Fertility Care Centre

Dear CPSO Members,

I teach women and couples how to understand and track their fertility using the Creighton Model FertilityCare™ System. I am writing in response to the review of your policy about Physicians and the Ontario Human Rights Code.

Several articles by major news outlets have documented the inconvenience experienced by a woman who wanted to get the birth-control pill only to find that the doctor on staff did not prescribe it. Despite attempts by these outlets to make it more than this, ultimately “inconvenience” is the right word for what this woman experienced. She lost, maybe, 30 minutes of her time going to another clinic.

What has been played up by these news outlets as an inconceivable travesty is common fare for the women who are my clients. I work with women who, in contrast to women who use the Pill, believe their fertility to be health, not disease, and therefore use methods of family planning based on their natural cycle. These women want to work with doctors who will treat their reproductive and gynaecological issues in accord with this mindset. Many of the women I have worked with would be glad if the worst thing that happened to them in their attempt to find such a doctor was a 30 minute detour to a different clinic. A significant number of my clients make regular 3 to 6 hour trips, each way, to see a doctor who will respect their decision to work with their fertility versus seeing it as a disease. Some have even travelled from other provinces, paying not only for travel but also hotel rooms and lost days of work.

To my knowledge, the woman in the above mentioned news articles never even interacted with a doctor. She was never judged for wanting the Pill, never pressured to get off of it, or never told she should be doing something else. In contrast, here are some of the things that women using natural methods have dealt with:

  1. More than once, a woman’s physician has pressured her to go on the Pill, despite her clearly telling her physician that she does not want that, after she has chosen to get pregnant and given birth. [Please note: “chosen” is the best word, as my experience in practice matches with the published method effectiveness for the Creighton Model of 99.5% to avoid pregnancy.)
  2. In one instance, an OBGYN was so insistent that a women use non-natural methods of family planning that she felt the need to get a letter from her lawyer before her scheduled C-section as she feared the OBGYN would tie her tubes.

In addition, clients have experienced ignorance, scorn, and downright rudeness from physicians who, horribly informed about modern methods of Natural Family Planning, chastise them for using the “Rhythm” method or no method at all.

This lack of respect for my clients’ desires is seen not only with their choice for family planning but also with their approach to pregnancy:

  1. A woman struggling from multiple miscarriages shared with me how callous her physician was in response to her distress regarding her most recent miscarriage; for him, loosing multiple unborn children was no big deal and he felt it should also be for her.
  2. A couple, given a potential negative prenatal diagnosis was repeatedly pressured by their physician to abort despite the couple telling the physician that they were morally opposed to abortion.

Finally women who are looking for real answers to their reproductive and gynaecological health issues, as opposed to suppressive/destructive approaches like the Pill, have sometimes found Pill-prescribing physicians more “dogmatic” than any of the physicians the media decided to highlight who do not prescribe the Pill. A number of my clients have been told by these Pill-prescribing physicians that the Pill was the only option to their problems. In case you were wondering, the Pill was not the only medical answer, as all of them have subsequently found out.

I find it ironic that, given the ubiquitous presence of the Pill and the ease at which hormonal contraception can be found – not only in private medical practice, but at any Public Health Unit or Family Planning Clinic – that the story of one woman’s inconvenience became national news. Meanwhile, the women that I work with continue to quietly accept the difficult and costly efforts they go to to find physicians who will work with them. These women are equally deserving of having physicians, such as those who only prescribe natural methods for family planning. Any attempt by the CPSO to change its referral policy and thus force such physicians out of practice is a clear statement by the CPSO that some women – particularly those who take the Pill – are more equal than others.

Gift of Life FertilityCare TM Centre,
Ottawa, Ontario

Submission to the College of Physicians and Surgeons of Ontario

Dr. Marc Gabel
President
College of Physicians and Surgeons of Ontario
80 College Street
Toronto, Ontario
MSG 2E2

Dear Dr. Gabel:

Re: Policy Review ‘Physicians and the Ontario Human Rights Code’

As the College of Physicians and Surgeons of Ontario prepares to review its policy on physicians and the human rights code, we are deeply disturbed by the many negative voices that have been urging the College to force doctors to “check their ethics at the door”. It should be obvious that now, only weeks after Quebec legalized euthanasia, we have arrived at the worst possible time in Canadian history to turn doctors into mere mechanics whose duty is to blindly do the bidding of their clients.

With euthanasia legal in Canada’s second-largest province, the debate about euthanasia and assisted suicide on the national level and in other provinces will only intensify. It is crucial that we preserve the right of our doctors to refuse to participate in such services even if they are legal.

Euthanasia and assisted suicide continue to be regarded as deeply unethical by many world religions, including Christianity, Judaism and Islam.

What is legal is no longer necessarily moral, and we would be unwise to place all our trust in the law as our shield, or to train our doctors to disregard their own ethical limits. Indeed, the properly formed conscience of our physicians may sometimes be the last moral and ethical boundary that protects us and provides us with life-affirming options and alternatives that respect our human dignity.

Canadians pride themselves on being a society made up of many cultures, religions and ethnicities. The freedom and democracy that underpin our pluralist society lead us to affirm the right of all citizens to participate fully in roles of leadership and the professional life, including the medical profession.  Any policy that would require doctors to contravene their consciences and to breach their most deeply held values would be outrageously exclusionary and unacceptable, as it would chase out of medicine those principled physicians who refuse to violate the central teachings of many of our largest and most ancient religions. For such doctors, referral for actions that they believe to be contrary to their medical judgement, ethical principles and religious beliefs would be as unacceptable as providing them, as it would be tantamount to outright cooperation with the action in question.

We refuse to believe that this is the kind of Canada that any of us would want to live in. The freedom of conscience is a basic human right recognized by many international agreements and protected by the Canadian Charter of Rights and Freedoms. It is essential to a truly democratic society and foundational for the protection of all other human rights, including the freedom of religion.

As such, we strongly encourage the College, as it reviews its policy on this matter, to continue to protect an authentic freedom of conscience for all physicians. No Canadian citizen, including any physician, should ever be disciplined or risk losing their professional standing for conducting their work in conformity with their most deeply held ethical or religious convictions.

Sincerely yours,

Rabbi Reuben Bulka
Congregation Machzikei Hadas, Ottawa

Terrence Prendergast, S.J.
Archbishop of Ottawa

Imam Sarni Metwally
Ottawa Main Mosque

CC:
President of the Ontario Medical Association
President of the Canadian Medical Association
President of the College of Family Physicians of Canada

Policy allowing doctors to deny treatment on moral or religious grounds under review

Globe and Mail

Kelly Grant

Doctors who refuse to provide certain treatments on religious or moral grounds must tread delicately or risk trampling human-rights laws, according to the chief commissioner of the Ontario Human Rights Commission, which is expected to weigh in soon on a review of professional guidelines for physicians practising in Canada’s largest province.

“First and foremost their job is to provide health-care services to people who require them,” Barbara Hall said. “If [doctors] wish to put forward their own human rights as a barrier to doing that then they may come up against the fact that their rights are not absolute.”

In an interview, Ms. Hall said doctors generally do not enjoy the same legal protections as religious officials – a point her commission underlined to the College of Physicians and Surgeons of Ontario (CPSO) when the medical regulator last updated its policy on doctors and the human-rights code in 2008. . . [Full text]

Professor argues for a profound rethinking of conscience rights

Mary Anne Waldron offers three solutions for legal quagmires

The B.C. Catholic

Alistair Burns

An argument in favour of changing how citizens approach freedom of conscience and religion was presented May 2. Mary Anne Waldron, a professor of law at the University of Victoria, spoke to an audience of 80 in Holy Name of Jesus Parish Hall in Vancouver.

Her lecture was the first event co-hosted by the Catholic Physicians’ Guild of the Archdiocese of Vancouver and the St. Thomas More Catholic Lawyers Guild.

She asked the crowd to ponder why “we protect conscientious and religious freedom, when it is so often inconvenient, may seem unfair, and often offends others.”

The law professor declared perhaps many would prefer a world “in which our (specific) view prevailed” on major legal problems: abortion, euthanasia, and sexual moral codes.

Freedom of conscience and religion rights, she asserted, should allow the participation of all citizens in debates on social policies and norms, “protecting the minority against tyranny by the majority.” [Full Text]

Swedish midwives must provide abortions even if they object

Smålandsnytt

Caution: machine assisted translation

Ellinor Grimmark denied job – was not discriminated against

It was not discriminatory of Jönköping County Council to deny Ellinor Grimmark the job of midwife when she refused to perform abortions. Thus says the Equality Ombudsman in dismissing the case.

The midwife Ellinor Grimmark felt discriminated against because of her faith, but after investigation the Discrimination Ombudsman (DO) felt that not to be the case.

“It was quite expected, I did not think the Swedish Equality Ombudsman would dare bring it up,”  Ellinor Grimmark told Smålandsnytt.

According to the DO, the County Council of Jönköping did not deny Ellinor Grimmark employment because of her beliefs in themselves, but because she was not prepared to carry out a task which is part of midwifery.

Although this had serious consequences for Ellinor Grimmark, this was proportionate to the aim of guaranteeing the rights and freedoms of others, thought the DO.

Today,  Ellinor Grimmark is working as a nurse in California, but will soon start working as a midwife in Norway, where it is possible for a midwife to refrain from participating in abortions.

But I intend to pursue this further.  We are just a short way down this  road,” she says.

However, the DO’s decision cannot be appealed, and the case is closed. [Original Swedish text]