Nurses Cannot be Good Catholics

BMJ Blogs

John Olusegun Adenitire

It seems that if you are a nurse you cannot be a good Catholic.  Or, better: if you want to work as a nurse then you might have to give up some of your religious beliefs.  A relatively recent decision of the UK Supreme Court, the highest court in the country, seems to suggest so.  In a legal decision that made it into the general press (see here), the Supreme Court decided that two Catholic midwives could not refuse to undertake administrative and supervisory tasks connected to the provision of abortions.

To be sure, no one asked the nurses to directly assist in the provision of abortions.  The Abortion Act 1967 says that “No person shall be under any duty … to participate in any treatment authorised by this Act to which he has a conscientious objection.”  The Nurses argued that this provision of the Act should be understood widely.  Not only should they be allowed to refuse to directly assist in abortion services: they should also be entitled to refuse to undertake managerial and supervisory tasks if those were linked to abortion services.  The nurses’ employer was not impressed; neither was the Supreme Court which ruled that the possibility to conscientiously object only related to a ‘hands-on’ capacity in the provision of abortion services. . . [Full text]


UN Special Rapporteur Favours of a Right to Conscientious Objection

News Release 

European Centre for Law and Justice

On the occasion of a conference organized by the ECLJ at UN headquarters in Geneva, Professor Heiner Bielefeldt, the UN Special Rapporteur on Freedom of Religion or Belief, spoke in favor of the right of medical staff to refuse to participate in performing an abortion or euthanasia. He mentioned the case of a midwife who was harshly sentenced in Sweden for having refused to participate in an abortion and was forced into “professional exile.”

He considers that this right, based on freedom of conscience, should extend to the medical staff directly involved in the matter, as long as their objection is well-founded on a strong and deep conviction. . . [Full text]


A modest proposal for respecting physicians’ freedom of conscience

National Post

Margaret Somerville

The Ontario College of Physicians and Surgeons is consulting on whether patients’ right of access to certain procedures, such as abortion, should trump the rights of those physicians who refuse, for reasons of conscience, to provide them. Dr. Marc Gabel, a College official, chairs the working group looking at this issue, which is drafting a new policy on “Professional Obligations and Human Rights.”

Dr. Gabel has been reported as saying that “physicians unwilling to provide or facilitate abortion for reasons of conscience should not be family physicians” and it seems wants the College to approve that stance. Sean Murphy, of the Protection of Conscience Project, argues that “if it does, ethical cleansing of Ontario’s medical profession will begin this year, ridding it of practitioners unwilling to do what they believe to be wrong.”

Freedom of conscience, like the other fundamental freedoms enshrined in the Canadian Charter of Rights and Freedoms, is a fundamental pillar of democracy. So how could breaching this right be, as Dr Gabel claims, “required by professional practice and human rights legislation”? . . . [Full text]


Proposed policy of Ontario College of Physicians “appalling”


Reproduced with permission of the author

Dr. Terence McQuiston, M.D.

Dr. Gabel is not alone in this opinion, but I find it nevertheless appalling. Ever since Hippocrates medical ethics were determined by our profession independently of government legislation (including human rights tribunals). We Canadians stood in judgement at Nuremberg over the German physicians of the Nazi period.

Their defense was that they had done nothing outside of the law (true). However, we took the view that ethics transcend and should inform legislation, not the other way around, and therefore we could hold them to account for their deeds.

Such transcendence of ethics is only possible by the exercise of conscience by all physicians. Granted there may be differences arising from this exercise, but we should do our best to accommodate these differences.

That’s why we permit conscientious objection in wartime. Individual conscience is too precious a part of our social fabric to be casually overridden. The policy defended by Dr. Gabel in effect puts conscience on ice. If euthanasia becomes legal, I for one still won’t do it.

This comment responds to the Medscape article “Doctors opposing draft abortion policy may need to rethink whether family practice is right for them, says CPSO official: Direct referrals a sticking point in Ontario’s human rights policy (17 December, 2014)  Dr. Marc Gabel was quoted to the effect that physicians unwilling to provide or facilitate abortion and contraception should not practice family medicine. Administrator



Ontario College of Physicians’ new policy violates basic tenets of law

Larry J. Worthen, Albertos Polizogopoulos

The College of Physicians and Surgeons of Ontario (CPSO) recently released a draft policy on professional obligations and human rights that has deeply disturbed health service providers and patients.  The draft policy forces physicians to do certain procedures or prescribe certain pharmaceuticals against their own moral or religious convictions in some cases, or to make a formal referral to another doctor in others. In doing so the CPSO has drafted a policy that violates Canadian law. This matter has taken on an even more serious tone given the possibility that assisted suicide and euthanasia may be legalized at some point in the future.

There is no human right in Canada to demand and receive particular services from a specific physician. The Ontario Human Rights Code prohibits discrimination against the public on a number of grounds that include among others, race, ethnicity, sex, sexual orientation, age or disability. This means that one must not deprive one group of services one provides to others. However, the Code does not dictate what services must be delivered. So, if a restaurant chooses not to serve pork because of the owner’s religious beliefs, there is no violation of the Code. If the restaurant choses to exclude people of a particular ethnic group however, that would amount to discrimination and a violation of the Code. In the same way, a physician who is unable to participate in a procedure or prescribe a pharmaceutical for moral or religious reasons is not discriminating against his or her patient provided all patients are treated the same.  Unfortunately, the draft policy suggests that a physician’s objection to a specific procedure or pharmaceutical may result in the violation of a patient’s rights under the Charter or the Code. This reference makes clear that those who prepared this policy misunderstand the application and function of Ontario and Canadian law.

Physicians do have the right to be protected from state coercion to act against their moral or religious convictions, guaranteed by the Charter of Rights and Freedoms. Provided the services are delivered in a respectful way there are no competing rights. In such a case, the only human rights present are the physician’s human rights to freedom of religion and freedom of conscience. Furthermore, when the physician is an employee they have the additional right to be accommodated by their employer.

Referrals are as morally problematic as doing the procedure itself. This concept is supported in Canadian law. For instance, if an accused person refers an acquaintance to a drug dealer, the accused person is guilty of the crime of trafficking in narcotics. If a physician has the moral or religious conviction that abortion or euthanasia is the taking of an innocent human life, then the physician who formally refers a patient to the abortionist or euthanist has contributed to the taking of that life.

Physicians who rely on these protections want to serve all patients in an open and inclusive manner, providing all relevant information in a fair and unbiased way, striving to be non judgemental and supportive in their approach. In a multicultural society, doctors relate with patients with widely divergent worldviews every day. The physician’s primary concern is for their patient’s health. Even when the physician is not able to participate in the implementation of the patient’s ultimate decision, the professional relationship between them can be maintained and may even be enhanced. Physicians in these circumstances are up front with their patients about what services they will or will not provide from the beginning of the relationship. Physicians simply request that their rights be respected just as they respect the rights and feelings of their patients.

Unfortunately, the purpose of this draft policy appears to be clear. It was not designed to ensure that physicians understand and comply with their legal obligations under the Code, but rather, it appears to have been designed with the goal of either compelling physicians who object to specific procedures and pharmaceuticals to act against their moral and religious convictions or, alternatively, to drive those who object to these procedures and pharmaceuticals out of the medical profession.

If the CPSO passes this policy, it will do great damage to many well-qualified physicians who are currently making significant contributions to health care in Canada. The CPSO will be alienating these physicians from their heart and soul that is their primary motivator for excellent patient care. And the CPSO will be depriving many members of the public of the type of doctor they would prefer to be treated by. This is discrimination.  It is the systematic disqualification of perfectly acceptable practitioners because of their religious beliefs.

This policy cannot withstand Charter scrutiny as it results in a clear violation of physician’s conscience and religious rights. The CPSO perhaps assumes that physicians will not defend their Charter rights to freedom of religion and conscience. They are wrong.

Larry Worthen is a lawyer and the Executive Director of the Christian Medical and Dental Society of Canada, an association that represents 1600 physicians across Canada. The CMDS presented submissions to the CPSO in relation to the draft policy.

Albertos Polizogopoulos is a Partner with the firm Vincent Dagenais Gibson LLP/s.r.l. in Ottawa, Ontario. He regularly appears before courts and appellate courts including the Supreme Court of Canada to advocate for his clients’ rights to freedom of religion, freedom of conscience and other civil liberties. He also frequently appears in media interviews and on panels to discuss constitutional law. Albertos was counsel to the CMDS in making submissions to the CPSO on the draft policy. @CharterLaw