Tony Gosgnach
The Interim

A proposal explicitly to deny pharmacists in Ontario a right to refuse to provide services on the basis of religious belief or personal conviction has implications beyond the matters of simply abortifacient medications and birth control. Some pharmacists fear that, under such a stricture, they may eventually be called on to dispense medications for the purposes of euthanasia, assisted suicide or capital punishment.

The Ontario College of Pharmacists, by way of a questionable procedure, has filed recommendations with the Ontario Health Professions Regulatory Advisory Council regarding a code of ethics for the province’s pharmacists and pharmacy technicians. Among them is “Principle 4,” which states: “The pharmacist and pharmacy technician respects the autonomy, individuality and dignity of each patient and provides care with respect for human rights and without discrimination.” Then comes the clincher: “No patient shall be deprived of pharmaceuticals services because of the personal convictions or religious beliefs of a pharmacist or pharmacy technician.”

The clause seems to have been included as a response to cases where pharmacists have refused to dispense abortifacient or birth control medications. Whatever the reason, observers have expressed concern with the underhanded and surreptitious way that the recommendation was not only put forth, but is being considered by members of the pharmaceutical profession.

“This draft anti-conscience provision, if you will, was prepared without any consultation with, or input from, the people who would be most interested in, and affected by, it,” said Sean Murphy, administrator of the Protection of Conscience Project, based in B.C. “The college (of pharmacists) must be aware there would be some pharmacists who would object to that kind of position and, in fact, I’m sure they also know how to get a hold of them … I want to find out how that happened.”

In addition, a series of “focus group” sessions were called in various parts of Ontario to obtain input on the draft code of ethics. The problem is, the groups were by invitation only and, once again, shut out democratic input and negated the people who would be most affected by the adoption of such a code. Murphy said he is investigating the running of the focus groups, because it appears they included discussion of the draft code of ethics. He’d also like to know what was said there.

“One would hope to see a lot more transparency in the process so that whole groups are not excluded at the outset by virtue of their known opinions,” he said. “You can hardly claim a code of ethics is a matter of consensus by excluding anyone who disagrees with the provisions of it from all discussions leading to it.”

Iain Benson, executive director of the Centre for Cultural Renewal in Ottawa, suggested that Principle 4 suspends the guarantees of freedom of conscience and religious belief contained in Section 2 of the Canadian Charter of Rights and Freedoms.

“This is not the approach taken by doctors and the Canadian Medical Association would not endorse this blunt and unfair kind of principle,” he said in a Sept. 13 statement. “Why are pharmacists deemed to be so different as citizens or professionals that they cannot exercise the full rights of other citizens and professionals? Why, indeed.”

Benson concluded by characterizing the situation as a “narrow and, frankly, totalitarian view of professional practice.”

More alarming, said Murphy, is what the adoption of the proposed code of ethics may mean for pharmacists and pharmacy technicians down the line. “One of the things to keep in mind is we now have this bill before Parliament that suggests euthanasia should be legalized … If it is legalized and becomes what may be termed an accepted medical procedure, if you refuse to accept the principle of freedom of conscience, then conceivably, pharmacists could be compelled to provide and facilitate euthanasia …

When you establish a principle that one is not entitled to refuse one of these things for reasons of conscience, then logically it ought to apply to any procedure – and that would include euthanasia, capital punishment and assisted suicide.”

Such a situation basically exists in B.C. already. The Code of Ethics of the College of Pharmacists of British Columbia subordinates freedom of conscience to the delivery of pharmacy products and services. Worse still, according to the Protection of Conscience Project, that college has published statements that have impugned the integrity of conscientious objectors within the pharmacy profession. When challenged on the matter, the college has acknowledged it has no evidence to back up such charges, but refuses to retract or apologize for them.

Murphy and conscientious objectors hope a similar situation will not arise in Ontario. He is encouraging the province’s citizens at large, not just pharmacists and pharmacy technicians, to contact the college and object to the iron-fisted provisions contained in its proposed code of ethics. There is no known timeline for when a code might be enacted.

Ideally, the Protection of Conscience Project would like to see anyone who has a conscientious conviction concerning a product be permitted to exercise that conviction. “There’s nothing to prevent the pharmacy college, employers or other groups, for that matter, from arranging for the provision of services that some pharmacists might find objectionable.”

There is a distance to go before such a situation is secured for medical personnel everywhere. An overview by Greg J. Edwards, writing in the B.C. Catholic newspaper, summed up the situation in Canada as one in which “ a customer’s convenience trumps a pharmacist’s freedoms of conscience and religion. Pharmacists are free to object, but in the end, they must refer, or otherwise help, customers get the objectionable product.”

Edwards noted Manitoba is the only province that recognizes its pharmacists’ right to object without having to refer customers elsewhere. However, the registrar of the Manitoba Pharmaceutical Association “dodged and weaved when asked whether his association would stand by pharmacists fired or refused employment because of their conscientious objection.

In fact, not one Canadian licensing body contacted said that it would support a member in trouble for taking a pro-life stand.  The associations’ representatives say that any conflicts are the fault of owners or management … Again, however, not one licensing body said it would stand by a pharmacist in trouble with management or owners.”