Three family doctors at an Ottawa health clinic are being criticized for refusing to prescribe birth control to their patients.

The controversy started when Kate D. went to CareMedics Elmvale Acres walk-in clinic to get a prescription. She was surprised when the receptionist handed her a letter by the attending physician, Dr. Edmond Kyrillos, stating that he only provides Natural Family Planning due to “medical judgment as well as professional ethical concerns and religious values.” The note also states that Dr. Kyrillos would not refer for vasectomies and abortions. Dr. Agnes Tanguay and Dr. Rene Leiva are the other two doctors at the clinic not prescribing birth control.

On Jan. 29, Kate posted an image of the letter to a Facebook group belonging to the Radical Handmaids, a pro-abortion organization famous for sending knitted wombs to politicians. Kate commented, “so yes – this is real. Yes, this is a real doctor. No, you are not in a time warp.” The Facebook comments in response to Kate’s post shared her judgment. “There is no respect in that letter. Just male chauvinism and a deep disrespect for all women,” wrote Bika B. “When you become a doctor, you take an oath to do not (sic) harm. Impeding someone’s ability to receive the care they need is doing harm and should not be legal,” commented Kate Suppa. 

On Feb. 4, Kate wrote a post for feminist website XOJane.com about her experience. She reports that she had gone to the clinic for over two years and was never denied the prescription before. Dr. Kyrillos was the only doctor on call at the moment, but Kate had the option of coming back the next day when there would be a different physician. Because she had to go to work the next day, Kate was forced to get her prescription at another clinic nearby. She claims that the owner of the clinic never approved Kyrillos’ letter and that it would have been better if Kyrillos had talked to patients instead.

“I almost felt like I was doing something wrong. I felt truly embarrassed having to leave in front of a group of people because of something that someone thinks is shameful and not right,” writes Kate. “I just hope that the message gets out enough for people to realize that when you’re in a professional position, you have to leave you morals at home… yes, we do have radicals that are against such things as abortions and birth control, but before this happened, I’ve never met one personally.”

Some of the doctors’ own patients, however, have defended them. Andrea Pawlowsky, a Catholic 27-year-old patient told the Ottawa Citizen that she goes to the clinic for health and not religious reasons. While other doctors simply prescribed her the birth control pill for her painful menstrual cycles, her doctor at the Ottawa Clinic discovered she had polycystic ovary syndrome and gave her appropriate treatment. She also practices NFP. “Our mothers took (the pill)… maybe a generation ago we thought it was sort of a fix-all magic pill, but now we know it is not for everyone and it is fallible,” said Pawlowsky.

Faye Sonier of the Evangelical Fellowship of Canada also revealed on ProWomanProLife website that her family doctor is one of the three Ottawa physicians. She wrote that she chose that doctor because of his or her “perspective on fertility and hormonal care and because I knew that subscribing to that philosophy, that physician wouldn’t simply give me a pill for my problems and send me on my way.” She also states that she is a patient of the physician’s colleague in Toronto, who uses the same approach and “found two significant medical problems that 19 other physicians missed in the preceding years.”

Jeff Blackmer of the Canadian Medical Association told the Ottawa Citizen that “we don’t expect (doctors) to check their morals at the door; we recognize they will continue to hold personal views.”

However, the refusal to prescribe birth control is still a grey area and the practice of personal values should not interfere with patients’ access to so-called medical care. 

Blackmer was criticized for his comments by Carolyn McLeod, associate philosophy professor at the University of Western Ontario and principle investigator for the Canadian Institutes of Health Research-funded project Let Conscience Be Their Guide? Conscientious Refusals in Reproductive Health Care. McLeod said in a blog post for impactethics.ca that physicians do not have an “absolute” freedom to turn down patients, “for if it were absolute, then a Muslim physician could refuse to accept female patients, a Catholic physician could deny care to women who have had previous abortions.”

Sean Murphy, administrator of the Protection of Conscience Project (PCP), called Suppa’s comment a revelation of “a complete lack if intellectual engagement with Islamic medical ethics and with Catholic moral theology” on the Project’s web site.

Murphy wrote in an email to The Interim that freedom of conscience is important in living a “fully human life,” which includes “life lived in the workplace or the practice of a profession.” It is only the profession of medicine, however, that seems to demand that members must violate their conscience. “Law professors who demand that physicians act against their consciences in medical practice do not demand that lawyers act against their consciences in legal practice,” he states.

Furthermore, NFP “is recognized by the Society of Obstetricians and Gynaecologists as an effective form of birth control when it is used consistently and correctly. Hence, none of the physicians… have refused to provide ‘medical care.’”

“It is true that freedom to hold beliefs is wider than that freedom to act on them,” states Murphy.

The focus of the Project is to protect the “preservative freedom of conscience,” defined as “the principle that health care workers should not be forced to do what they believe to be wrong.” This is distinct from “perfective freedom of conscience,” the freedom to actively choose to do a perceived moral good.