The College Council of the Ontario College of Physicians and Surgeons is seeking input during an “external consultation” on a draft policy that would force doctors to do abortions and vasectomies and prescribe contraception, even if it violated their moral or religious beliefs.
The OCPS is seeking public input until Feb. 20, which is a continuation of the consultation process that began last year as the College sought to update its Practice Guide to comply with the Ontario Human Rights Commission and provincial human rights code. It was reported last summer that during the initial phases of the “Professional Obligations and Human Rights” consultation there was widespread support among the public and medical profession for a doctor’s right to conscientious objection, which is not reflected in the new proposed draft.
If passed the new policy would force doctors who are “unwilling to provide certain elements of care due to their moral or religious beliefs” – such as abortion – to refer the patient “in good faith” to another doctor who would provide the service. If there is nobody to whom the patient can be referred, then the doctor “must provide care that is urgent or otherwise necessary to prevent imminent harm, suffering, and/or deterioration, even where that care conflicts with their religious or moral beliefs. “
The draft, which has been tentatively accepted by the College Council, also states, “physicians, who choose to limit the health services they provide on moral or religious grounds, to do so in a manner that respects patient dignity, ensures access to care, and protects patient safety.”
The draft policy admits, “although physicians have (freedom of conscience and religion) under the Charter, the Supreme Court of Canada has determined that no rights are absolute,” and the “right to freedom of conscience and religion can be limited. “
Sean Murphy from the Protection of Conscience Project called the draft policy “dangerous” “and “an affront to the best traditions of liberal democracy.” In a press release, Murphy said it is part of a “strident campaign to suppress freedom of conscience among physicians,” and that the draft policy reflects the influence of activists.
He also said that if a doctor is morally opposed to a particular procedure such as abortion or euthanasia because they consider it killing, the physician would likely not want to be implicated in the illicit activity by referring patients to those who have no moral qualms with abortion or euthanasia.
Although the draft does not mention euthanasia, Murphy said that with euthanasia and doctor-assisted suicide on the political agenda at both the federal and provincial levels, the loss of conscience rights could mean physicians will be forced to honour requests by patients who want medical assistance dying. “It is not a coincidence that activists who would force objecting physicians to facilitate abortion and contraception also intend to force objectors to refer for euthanasia, “ he said.
Indeed, the OCPS is also undertaking a consultation on end-of-life care that will conclude on Feb. 20. In its “Planning for and Providing Quality End-of-Life Care” draft policy, the OCPS “requires physicians to sensitively respond to a patient’s wishes or requests to hasten death and to engage patients in a discussion to understand the reasons for their wish or request and to resolve any underlying issues that may be motivating the request.”
Marc Gabel, a former president of the college, told the Globe and Mail that if doctors fail to comply with the proposed regulations, they could face disciplinary action. Gabel said, “what we’re trying to do, I think, is set a tone to remind physicians and the public we will act professionally in ensuring their access to care and their safety.”
But some ethicists do not think the proposed draft goes far enough. Arthur Schafer, director of the Centre for Professional and Applied Ethics at the University of Manitoba, said doctors who allow their personal convictions to affect their professional duties are not serving their patients. “The doctor is not supposed to be a priest or a religious figure, “ he said.
Murphy disagrees. He said it is “incoherent and contrary to sound public policy” to force doctors to perform “what one believes to be wrong in a professional code of ethics.”
