A man of science, or a child of God. Can a person be both?
Perhaps, but apparently not if you’re a doctor.
The salty issue has been raised by a Christian doctor from Barrie Ont. who refuses to prescribe the birth control pill or the sex-enhancement drug Viagra to unmarried patients because he believes it would promote immoral activity.
Dr. Stephen Dawson, a family practitioner who operates a clinic in Barrie and has an office in Toronto, vows he will risk losing his licence rather than sacrifice his religious and moral beliefs. “There is no compromise here,” said the soft-spoken, born-again Christian as he sat in his white lab/coat with a Bible in one hand at his Family Medical Clinic, while a long line of patients waited in the reception room. “I will stand firm to the end – even if it means losing my licence.”
The Ontario College of Physicians and Surgeons has charged Dawson with committing an act of professional misconduct by denying standard medical care to his patients.
The charges stem from complaints made by four women who weren’t given a prescription for birth control pills. Now Dawson must face a disciplinary hearing in April. If found guilty of the charges, he faces punishments ranging from a severe reprimand to revocation of his licence.
“This is excessive and a waste of time and resources,” Dawson told The Interim, adding the action taken against him goes against the Charter of Rights and Freedoms. “I believe every physician has the right to practise according to his beliefs and convictions.”
In a letter Dawson sent out to his patients, he explained he was not judging them by refusing to prescribe the drugs. “Not one of us should piously claim to have a perfectly moral track record”, it stated, along with several passages from the Bible that chastises sexual relations outside of marriage.
“The intention of this most intimate relationship was that it was to be shared only by the husband and his wife, joined together in marriage by God.”
Spokesperson for the college, Kathryn Clarke, refused to discuss the case but said charges of this nature are the first she has come across. Dawson says he finds that hard to believe.
“It astounds me that this is the first case,” said Dawson. “There are many physicians of various faiths that will not prescribe the birth control pill.”
He says he is offended that the College has already suggested he take courses on ethics. “I am simply going by what the Bible tells me,” he said. “I can’t just tear out select pages of the Bible to suit my patients.”
He adds the charges also violate the Hippocratic Oath (part of the physician’s code of ethics).
“We are not supposed to do anything that is deemed harmful to our patients,” he said. “Sex without marriage and commitment often leads to the harmful sexual exploitation of women.”
If found guilty, Dawson says it will open up a hornet’s nest of other complicated issues, such as abortion, reproductive technology, euthanasia, and even experimentation on human subjects.
His plight has made headlines across the country and has triggered reactions from several organizations, such as the Protection of Conscience Project, a non-profit initiative that advocates for protection of conscience legislation. Such laws ensure people cannot be forced to participate in medical procedures to which they object for reasons of conscience.
“If the College of Physicians and Surgeons can steamroller Dr. Dawson’s conscientious convictions and force him to dispense or refer patients for contraceptives, the College can also force him and other physicians to participate in assisted suicide, euthanasia, abortion, artificial reproduction and any other morally controversial procedure that is deemed to be legal,” project administrator, Sean Murphy, of B.C. told The Interim. He has raised the issue with the Canadian federal government since 1988. He says the single exception would involve a situation in which the drug or procedure is immediately necessary to save the life of the patient or prevent grave physical injury.
However, Murphy points out that doctors must be careful not to pass judgement on the patient while standing up for what they believe in.
“It should not be an attempt to change the behaviour of the patient.”
One of the complainants in Dawson’s case, who has asked to remain anonymous, insists that is what happened in her case. The 29-year-old patient says she was living with her boyfriend for two years when she went to the doctor to get a prescription for the pill, but what she got instead was a lecture on how to stop her immoral ways by insisting she get married before continuing her sexual relationship. “I was flabbergasted,” said the woman who said she left his office in tears. “I didn’t expect a lecture on how I should run my life. He told me that if he referred me to another doctor then the three of us would be damned to hell.”
In retrospect, Dawson now admits that he may have come across to patients too strongly. “I have since learned to become more tactful when relaying my position to my patients.”
But he stands by his Christian principles and insists that he must refuse to refer his patients to another doctor, which is a secondary charge against him.
“If I did that, I would just be passing the buck so I could wash my own hands of the problem, and that is wrong,” he said.
Professor of philosophy at the University of Toronto, James Robert Brown, argues that Dawson should resign from his position as a doctor, end of argument.
“His duty is to the healthy and physical well-being of his patients,” Brown told The Interim. “Doctors cannot pick and choose what medical services they will offer on the basis of their private beliefs.”
Brown sites a similar case involving a Toronto police officer who refused to do protective duty if it involved anyone who performed abortions. He was disciplined on the grounds that a police officer cannot pick and choose whom he will protect.
“Similarly, as a teacher, I can not let my religious views affect the way I teach. I can’t go into a biology class and tell my students the earth was created in six days. It’s not acceptable. And what if a doctor refused to treat black people because he has racist views … or if he refused to treat homosexual patients with AIDS on the grounds that the sexual behaviour is immoral? Would we find that acceptable behaviour? I should hope not.”
But Murphy points out that denying birth control is not denying a patient anything that is essential to their health.
“One of the problems faced by conscientious objectors in communicating their position is that morally controversial drugs or procedures are often not medicines or treatments in the usual sense,” he says. “The birth control pill and the morning-after-pill do not cure diseases or promote healing, unless you believe that the proper functioning of a woman’s natural fertility is a disease.”
Dr. John Williams, the director of Ethics and International Health with the Canadian Medical Association, which sets out the Physicians Code of Ethics, says part of the problem is that nothing is written in stone and the guidelines are ambiguous. “There are no easy answers, no right and wrong, no Ten Commandments written out in the code,” he told The Interim.
“Whatever you do, you’re going to get caught up in ethical principals. There are a lot of demons that people of faith face. Sometimes it has to boil down to what is the lesser of two evils … this is not a perfect world and these issues will be around for a long, long, time.”
But choosing the lesser of two evils is simply not acceptable, says Dawson.
“I can’t compromise my faith like that,” he says. “This is nothing less than religious persecution.”