To ensure transparency and encourage open dialogue, the feedback we receive is posted on our website in accordance with our posting guidelines.
Current month [email protected] day *
Leave this field empty *
Denial of freedom of conscience for physicians is yet another step we would be taking towards soviet-style medicine. I have been in practice for over 40 years, and can see the slow but progressive trend in medicine: increasing government/bureaucratic control, stifling of creativity, increasing ethical and spiritual poverty. It used to be that medicine was a calling. Things are different now, and for many, medicine has become a business.
I had a question about your post and would like to get some clarification on how you see the medical system.
First of all you say: “Denial of freedom of conscience for physicians is yet another step we would be taking towards soviet-style medicine.” So, communism.
And then you end with: “Things are different now, and for many, medicine has become a business.” Capitalism.
My question: Is the system trending towards communism or capitalism?
Capitalism or communism trending is typical demagogic question.I recommend you the answer dated June 11, 2014 at 5:25 pm.
The trend is Medicine is to manage the dollars as Healthcare is big business
Along with this the freedom of conscience can be done away with, no matter what personal beliefs sre held. The Code is good
the way it is and does not need to be fine tuned. Non emergency situations can be handled without forcing someone to go against their belief and conscience. This would contravene one’s Human Civil Rights under the Constitution.
Talk about discrimination, if one cannot practise their chosen field of Medicine
because they are NOT ALLOWED a conscience on Freedom of Religion. That’s Soviet style or Islamic Extremists.
We must keep our freedom of religion and be able to practice it. Once lost we will not get it back. There are other doctors who can fill in in a non emergency situation. Our freedoms were won on the backs of our Canadian solders who died for our freedoms. In life we do not always get what we ask for just because we would like it.
very well said. The Rights under Constitution (hopefully not recent changed)should be superior over Ontario codes
There is no contradiction in his/her comment. Communism isn’t merely an economic system. “Soviet-Style” can simply mean the denial of an individual’s freedom of conscience. The way I read the comment he/she is complaining about the separation of the practice of medicine from one own moral/conscience/ethical beliefs, whether this is State imposed (soviet-style) or chosen by the individual for “business reasons.”
There is not necessarily a dichotomy between freedom of conscience for physicians and respect for patients rights. There are certainly more options than just “doctors need to give standardized advice and care” and “doctors can do whatever their conscience dictates”.
That said, doctors should not have the right to not refer patients to physicians who offer family planning, and they should be obliged to seek out, refer, and arrange for standard levels of care that they themselves won’t provide.
If you feel “called” to medicine but you can’t offer competent medical advice because of spiritual concerns- perhaps you were called to Ministry instead of Medicine.
This comment does not enhance the dialogue. If anyone disagrees with you, they shouldn’t be physician?
If a professional disagrees with the CPSO’s standards of practice, they should not be a publicly funded physician. They are perfectly free to go into private practice in alternative healthcare, consultation, publishing, etc.
“They are perfectly free to go into private practice…”–that will be true when OHIP is abolished and health care is privatized. Right now it isn’t, so don’t put the cart before the horse.
People say that for every industry: “If you don’t want to violate your conscience, you can always choose to work somewhere else.” Choice is only choice when there ARE choices.
People love putting the rights of the doctor, the professional in front of the patient. A simple referral, it is just so minor, anything less should be considered failure to provide care. In fact it can do great harm in the cases of refusing family planning. This world does not need more unwanted children, and abortions are only minimized if you allow women to control their own bodies.
In the case of doctors morals vs woman right to bodily autonomy, I think it clear that a doctor can’t take a patients blood or kidney, why should they be allowed to control a persons uterus? Even if it is indirect.
“Simple referral”–you would advocate referring a murderer (whether very disturbed or not) to another hitman? You cannot be serious!
“Right to bodily autonomy”–you would deny the pre-born child the right to his own body? the right to life itself? You cannot be serious!
And why should a woman be able to make a doctor violate his conscience? If you are so concerned about a woman being able to get the pills, why not lobby for them to be over the counter if they are so safe? Why force a doctor to prescribe them against his will?
re “abortions are only minimized if you allow women to control their own bodies.” is an oxymoron… the fetus, or baby inside of the woman’s body is fact not her body.. scientifically, it is someone else’s body.. as the little person has different genetic code, its own mind, its own beating heart, its own blood type, its own kidneys… and at a surprisingly early stage, they just keeping maturing for the rest of their life. This is for those who are unaware of the scientific reality, which exposes the imploding logic of the previous comment.
Do not claim to understand logic or scientific when you don’t have much background in the matter.
The fact of the matter and it’s well researched is this: Abortions will happen, they always have, (they are in the bible too, in fact according to that book it’s how you can tell your wife is cheating on you) What happens in places where abortions are illegal? Women do them in back alleys harm them selves use coat hangers… No everyone want to have children, or more children. Other it’s for very good reasons, such as being unable to afford to feed another mouth.
Abortions will happen, so if you can teach women and men about effective birth control you lower the numbers of unwanted pregnancies, and from there you lower the number of abortions. And it you allow abortions to be legal (under sensible guide lines obviously)then you keep the women seriously injured by botched abortions out of the hospital saving us tax payers a lot of money.
Also the problem with Anti-choice activists (pro-lifers) is they don’t put children or women first they put the unborn before the born. Do anti-choice people adopt more often, I doubt it, as least not very much. No anti-choice people was babies to be born no matter what life they will lead, given up for adoption, living in foster care, having limited to no opportunities. Living of the street. Stuck in neglectful or abusive families.
Unwanted pregnancies that come to term will often be unwanted babies, and there is not nearly high enough adoption rates.
I think Doctors should not be allowed to withhold information unless there is a good medical reason for it. A doctors moral stance should not allow them to obfuscate perfectly legal medical procedures. Regardless if it has to do with reproduction, or not.
This pro-life nonsense is morally vacuous, it puts one life above others to the horrid extent. When anti-choice measures are inflicted on any given area only thing brought about is suffering.
“…if you can teach women and men about effective birth control you lower the numbers of unwanted pregnancies, and from there you lower the number of abortions.”
No, this is wrong, because it assumes that sexual behaviour will be exactly the same with or without birth control. Nothing could be further from the truth. See for example:
“No anti-choice people was [sic] babies to be born no matter what life they will lead, given up for adoption, living in foster care, having limited to no opportunities. Living of [sic] the street.”
So, in your view, they would be better off dead? Why don’t you go find some of those people living in the street and ask them if they think it would have been better for them to have been killed in their mother’s womb? Then you can report back here and let us know what they said.
People who think like you do see everything in a negative light, you are so grievously wrong , and it is regretful that you live through such darkened lenses
Murders will happen so if you make murder illegal people will just do it anyway so we should help the murderers do what they feel so inclined to do. Insert any crime where the word murder is and you will realize how completely asinine your statement is. wrong is wrong no matter how legal or illegal it is. lastly, pro lifers put LIFE first because life comes first. everything else is secondary. you really need to re think things!
And so you become guilty by association right? And hence violate your conscience right? Tell me a man who doesn’t commit murder but provides the murderer opportunities to such an end is he not guilty of murder too? I don’t know whether to you it is but to any practicing Catholic it is one and the same. That Judas did not murder Jesus did not make him innocent for his deeds lead to such an end indirectly. For all your eloquent lingo you can’t ask a man to go against his conscience directly or indirectly or else lose his job, if you do such a thing it is nothing less than religious persecution
The doctor shouldn’t “control” a woman’s uterus. The woman should. If she is so concerned with keeping “unwanted children” out of the world, she should keep unwanted baby making anatomy out of her world/uterus.
The physician didn’t judge the woman on her morals or force the woman to conceive so she/he should not be forced to provide assistance contradictory to their (now be questioned) morals.
any pills are harmful to women’s body, abortion is a murder and terrible shock to woman physically emotionally and spiritually.
It is possible to choose a specialty that will not challenge one’s personal or religious beliefs.Example: pathology , radiology anesthesiology, dermatology. It is important to think of these things before one chooses an area of practice.One should not work at a sexual health centre if one cannot practice according to current standards of medical practice.
Your comment does not enhance dialog either this is a public forum try not to science others. I only bring this up to further to attempt to stop this sort of thing further. Quantity is a valid form of showing support, those advocating “physicians rights” (or more likely anti-choice) here are doing the same.
“Anti-choice”? “Choice” is a code word for giving life to the child in the womb or killing it. Why won’t you say it like it is?
Depending on the advice or care needed (if a referral is required) that patient can go online and find enough resources for physicians to consult. There’s no need for a physician to compromise themselves. As far as family planning, there’s all kinds of clinics etc.
Canadian Association for Spiritual CareNot every member of the public has computer access or computer literacy. But one of the biggest problems with doctors refusing prescribing or treatment via their own rights to conscience is for patients in remote areas of the province or within very closed communities. In these cases doctors need to uphold their professional standards of practice and code of ethics re. referring to actually accessible options.
What “prescribing” or “treatment” do you have in mind? I ask because the debate is too often framed in evasive language. Most pro-life doctors became doctors because they wanted to HEAL people, NOT KILL them.
The prescriptions to which some pro-life doctors object are contraceptives because (1) most of these are abortifacient, (2) many are carcinogenic, and (3) in popular use they detrimentally separate two purposes of sexual intercourse. In other words, if contraceptives are medicine, then so is poison.
Some other treatments which all pro-life doctors reject are abortions and euthanasia. Abortion is killing a young person; euthanasia is killing an elderly person. In other words, if abortion and euthanasia are the practice of medicine, then so is the electric chair or gas chamber.
Murder is not a professional standard of medicine doctors became doctors to heal not to play God please get your facts right
I agree. This is just another assault on religion.
There should be a distinction made between freedom to practice one’s own religion and a license to practice one’s faith upon others.
The first is a critical right.
The second is an serious misunderstanding and in most cases a willful misunderstanding of both professional and personal moral and ethical duties to others.
It should also be mentioned that the moral and ethical choices of the patient are the ones that rule here – because their choices affect them and are therefore legitimate and to be respected.
“License to practice one’s faith upon others”–like telling them to kill one’s child?
re “the moral and ethical choices of the patient are the ones that rule here…” not according to the Canadian Charter of Rights and Freedoms, the highest law in our land actually. If you take all the faulty logic away, the core of this issue is really about the bullying and discrimination by organizations trying to intimidate those with religious beliefs and facistly force them to comply. If Mother Teresa were taking care of people who needed basic medical care in ONTARIO today, she wouldn’t be afraid to call them out on this assault of religious freedom..
There is no such precedence when you go to a doctor you are actually confident in his ideas on medicine that is why people seek out different doctors who specialise in the same sector of medicine due to their well known ideas of the medical field. So no the patient’s view of medicine has no precedence over the doctor’s.
Religion is not under assault, it is not assault when some one tell you that you can not force your beliefs on others. And a horrid number of cases on this public forum, people are claiming it is a physicians should have right to refuse care even to withhold basic information. And it all seem to be because some people think that sex is bad unless your trying to reproduce. Well you can think what you will, but do not try to force my daughters to conform to your ill conceived notions, by restricting medical care.
These tactics are shameful and back handed, and physicians should care more about the health of their patients than the particular morals they hold. It is their job to care for others, not themselves.
“It is their job to care for others”–pre-born children and their aging grandparents are others, and pro-life physicians want to care for them, too, not kill them. Certainly they care about them.
Yes, it is a physician’s job to care for others, but not at the expense of compromising their own moral beliefs. No professional organization can propose for its members to do so and remain “professional”.
Right on ! …member of the Public.
WRONG!!!! Doctors should not be forced to be murderers or accomplices to murder!
Religion is, in fact, under assault. A religion whose adherents must confine their beliefs to attending religious services but cannot put them into practice in their work, within their family circles, or in their political choices, is no religion at all.
“Pro-choice” people have, now, the freedom to have abortions. People also have the right to engage in casual sexual relations, to employ contraceptives, to manipulate and abuse each other in the name of sexual enjoyment and freedom. What more do you want from those of us who dissent? Does it occur to you that you may ultimately DECREASE the supply of doctors in our society because many would prefer not to bow down to the compulsory requirement that they become abortionists, eugenicists, and euthanists?
“Competent medical advice”–no doubt there were many competent Nazi doctors at Auschwitz. Were they any worse than one of their intended victims? Nazis believed that a Jew is not a person; abortionists believe that a child in the womb is not a person.
We are talking about beliefs. To use your words, they are “spiritual concerns” that are dealt with in a code of ethics. Obviously the Nazi code of ethics had weaknesses, to say the least. It should be obvious that the code of ethics for Ontario’s doctors has weaknesses just as serious.
I wrote the above comment at 10:17 am, and “one of their intended victims” was meant to refer to a famous abortionist.
re Nazi comparison, well said.
this is supposed to be a FREE country – and it used to be. NO one should be “obliged” (forced, on pain of losing ones livleyhood) to participate in providing contraception, or referral for the murder of an unborn child.
Referral = Complicity
I chose the profession of medicine
to enhance patients lives to the best of my ability.
The Hippocratic oath forbade us from assisting
or ending a patients life. It certainly did not encourage
abortion except if a women’s life was endangered.
Early in my medical career I realized the obvious
humanity of the foetus and I vowed that I would
never encourage or assist in the destruction of
a young human life. Since when is pregnancy
a disease? It is a normal human physiological process.
Half of the foetus’s destroyed are female. So to
me it is a human rights issue and I vehemently
oppose any rule forcing me to assist in the destruction
of another human being. “Human” is of the species
Homo sapiens and “being” is an entity with an existence.
The human foetus fits all the medico- biologic definition.
I see many women patients who regret the day
that they allowed a physician to invade their womb
and kill their unborn child.
i feel the docters should have the right ex ersice there religious beliefs at all times
In all professions people MUST be have a conscience!!! Having a conscience (which is now dead in a lot of people) is not limited to only Ministry. It should be alive in ALL people. No wonder there are so many people who are MURDERERS!!!
Ethics and spirituality are not synonyms. Spirituality can just as easily lead to ethical poverty as to ethical enhancement.
While I agree with you that the business of medicine should not supercede a patient’s right to the best possible treatment, neither should a physician’s spiritual beliefs.
Shoe on the other foot. If you were sick and you felt that there was a chance that your doctor was holding out on the best possible health outcome for you because of his spiritual beliefs, what faith would you have in that physician?
A lot–if he had told me so himself and he was a Christian. After all, the Christian physician is motivated by love to his neighbour. Remove the freedom of conscience, drive his religion underground, and you will get a whole lot more suspicion of him–i.e. less faith in him.
Should the Christian physician then get paid via the public purse, or work for free, as Christ did, and not have to render to Caesar? I ask this with all respect, and am not being sarcastic.
There are so many wrong assumptions in your question:
(1) The Lord Jesus’ mission was not to be a physician. He came to save sinners (1 Tim. 1:15).
(2) He Himself said, “The labourer is worthy of his wages” (Luke 10:7).
(3) His statement about “rendering to Caesar” (Mark 12:13-17) referred to paying taxes.
(4) Physicians should not necessarily be paid from the public purse or work for free. There are more alternatives. The origins of Western medicine have much more to do with the church than the state. I do believe that the state has a role to play, but it has now assumed too much responsibility. The state’s job is to execute justice and punish evil-doers; the church is Christ’s agent of mercy.
I presume that since you feel you feel that you should have the freedom of conscience to refuse to serve a patient or recommend a procedure, you would also be fine with other professionals who want to do the same? If for example someone was breaking into your home at night and the first RCMP officer to respond was to decide that he objected to something about you for religious or ethical reasons and told you to wait for the next cop, you would be ok with that? Hopefully the next officer will have the the same beliefs that you have and will be willing to save your life like he agreed to do when he signed up to be a police officer.
Don’t worry though, as long as he has a piece of paper that explains that he has certain convictions and will not be able to serve you on account of them everything will be fine.
If the police are expected to serve and protect everyone, including those who they may not agree with ethically, why shouldn’t physicians?
WeNeedaLAW.caThe situation you outline is entirely different. It is not a normal occurrence for a physician to have to engage in a procedure that would be objectionable to his/her conscience in an emergency situation.
Perhaps a more apt situation would be that of certain RCMP members objecting to the traditional uniform as it violated their religious beliefs.
I seem to recall a charitable approach to those requests for an alternative.
Not when you’re the only Dr available as is too often the case especially in smaller cities and towns.
Healthcare is always about the patient’s well being not the Dr’s belief in some iron age myth. I support people’s freedom to believe whatever they want right up to the point it impacts on someone else. If you’re a Dr refusing to follow sound scientific medical practice because of your personal beliefs you have crossed that line and are forcing your own personal beliefs onto the patient. It might be practically tolerable if there is another Dr who won’t force their personal beliefs onto patients available at the same time so the patient can get the same care without having to travel for hours and wait for weeks or months but it is still morally and ethically wrong.
Even if you’re a Dr who thinks its a sin to use birth control, which is nowhere mentioned in the bible btw, you’re not the one using it are you. Its you’re patient who will be using it and you should never be allowed to force your own beliefs onto anyone else. That is never acceptable under any circumstances.
Maybe you should research contraceptives. See what the pill actually does.
People do, and even though it might not be right for your others disagree. Perhaps your sources are not as reliable as you think.
“Forcing your beliefs on someone else”? Why is this wrong? Society “forces” its beliefs on us because it has declared murder illegal, there are many other prohibitions of the law which “force” our compliance.
“I support people’s freedom to believe whatever they want right up to the point it impacts on someone else.” Sorry, but this is hilarious. I think the someone who never got to be born would consider herself somewhat impacted. Oh, and Christ didn’t live in the Iron Age.
You support freedom of religion until someone actually tries to practice it you mean. To obligate a person to perform a service for you is nothing short of slavery. You don’t believe a doctor should have the right to refuse to perform a procedure they find wrong. So in your opinion if you wanted the doctor to remove your arm because you didn’t want it anymore, and they felt that what a terrible idea, they should not be able to deny you the amputation. Those who object to things like abortion, sex change operations, euthanasia, etc, may do so not just out of moral reasons, but because they know them to be harmful.
As to you ham fisted example of a dr objecting to birth control for sinful reasons (here’s a hint – the bible isn’t the be all end all in Catholic faith) would be JUST as sinful to condone, suggest, or be complicit in it’s use. It is actually a sin for a Catholic doctor NOT to refuse to prescribe it. And in Canada we have a right, called freedom of religion. There is no right to birth control, no right to abortion, and no right EVEN TO HEALTH CARE. Because you can’t have a right to someone else’s time or skill.
your comment “..you should never be allowed to force your own beliefs onto anyone else.”… am I the only one who sees the total contradiction in that statement? So what you’re saying is that you think it’s acceptable to force the DR. to prescribe contraceptives against his or her own beliefs! Fascist bullying logic at it’s best..
It is actually very frequent in emergency situations. What about a doctor over-riding the beliefs of a Jehovah’s Witness patient in proceeding with blood transfusion? What if that patient is a child or a patient with dementia who no longer has consent and capacity but whose family insists on no transfusing? What about the rights of a patient needing immediate critical care bed space which could be easily provided if a long term coma patient is terminated, without their prior consent or that of the substitute decision maker?
The policy is clear for emergency situations. We are discussing non-emergency. If you need a transfusion, you are most likely in a hospital where other doctors are present. Have your paperwork and personal wishes ready at all times and make them known.
If i were pregnant, would i want my baby delivered by an abortionist or a christian doctor? Do you think the abortionist would be as careful as a family oriented doctor? There should not be a one size fits all medicine just like there are different banks, grocery stores. Do YOUR research when it comes to a doctor and ask questions. Some physicians have a conscience.
Or RCMP deciding to seize guns during a natural emergency (High River anyone?) which was based on nothing more that a preference that individuals shouldn’t have guns.
The RCMP example given above is a poor analogy. It states the officer objecting something about the PERSON as a reason for denying service. It is very important to make the distinction for the question “Should a physician be allowed to refuse to provide a patient with a treatment or procedure because it conflicts with the physician’s religious or moral beliefs?”, that it is something inherent about the SERVICE to be provided that are moral grounds for refusing to provide, not anything about the PATIENT (age, sex, gender,religion etc.)
If a physician decides not to write prescriptions for oral contraceptive pills (OCPs), it may be erroneously interpreted as the doctor saying; “OCPs are wrong, therefore you cannot have them”; no, that is not the question at stake here and is a completely different argument. More correctly it would be the physician saying “I believe this is wrong, therefore I cannot be involved in writing prescriptions for OCPs as my participation would be going against my moral values”.
This is well described. Thank you.
And this is the crux of it, I think, as well. As a person who has had to learn how to navigate our medical system for much of my life, it boils down to whose needs supersedes?
In my view, it’s the patient’s as their concerns are what brings them to the doctor. Be it a mere bump, yearly physical, desire to plans one’s family and life, or something more life and death, the patient’s needs are the only reason this dynamic exists.
The Greeks knew this, they developed an oath to keep those curious of the health and healing of human system in check. Let’s get real, there are odd people in the word (I am not calling the religious odd.), who are curious about the human body and that can be anywhere on the continuum from enlightened to malevolent.
Without an oath to bind, without this value above all other values, to do no harm and to help in every way, this very personal relationship is merely an exercise of the empirical method played out in society — the patients become not subjects of study, but objects — to be discarded for “my work.”
Ultimately the relationship is one-sided, it is about the patient’s needs. More to the hope (because.. life needs it), teaching that the role of doctor to be one of the two coming together to help the one.
Do no harm speaks to the need for a tipping of the balance in favour of the patient. Otherwise the relationship will not function well, and how is this good use of our tax dollar?
The patient is always the more vulnerable, whether we have just nearly lost the battle that is life, we’ve been changed by maiming, or needing to discus our life choices for ourselves. We need objective compassion, and any morality or religion that does not include this, is an excuse to be unethically selfish.
And who is deciding what is harm? You ask a doctor to prescribe contraceptives, and they believe them to be harmful for you. They must uphold their oath, and not give you them. You cannot oblige another person to do something for you. It makes them your slave.
It shouldn’t be about “the doctor believes them to be harmful for you”.
Health Canada and the law have said that they are not harmful to me and have instead made oral contraceptives (or blood transfusions or whatever else a doctor might object to) a legal and approved treatment for specific conditions and situations. Therefore when seeking treatment for such a condition or situation, my doctor should not be permitted to refuse that treatment based on his or her own morals.
Medical contraidications, yes. His or her own morals, no.
And yet there are birth control pills listed as a class 1 carcinogen. The “birth control shot” has horrible side effects and I personally know a few people that suffered horribly after taking it, but drug companies successfully lobbied to get it approved. Your infallible “health Canada” is not above error. If you feel the pill is so incredibly safe, and should be available to any woman wanting it, why not lobby instead for it to be OTC instead? Then no doctor need prescribe it, and no need to violate their conscience? If the law is passed saying that euthanasia is legal in Canada, should doctors then be FORCED to perform THAT on their patients as well? How about “gender reassignment” surgery? A parent asks for their 3 year old to be changed from a boy to a girl, because they played with their sisters doll, and prefer the pink blanket (actual case!) should a doctor not be allowed to disagree?
And what if the pendulum swings the other way? Say for example female circumcision becomes legal after pressure from immigrant groups wanting it? Should a doctor be forced to perform barbaric actions like this simply because “health Canada” (meaning some politician or bureaucrat with greased palm) says it is ok?
The oral contraceptives are not safe for many reasons:
The World Health Organization’s International Agency for Research on Cancer (IARC) has in their listings for their Group 1 Carcinogens (carcinogenic to humans) several forms of oral contraceptives and estrogen replacement therapy.
Group 1 Carcinogenic to humans (107 agents)
One can obtain the actual list of all agents, (IN Group number order) beginning with the following known (Group 1) carcinogens containing:
Estrogen therapy, postmenopausal
Estrogen-progestogen menopausal therapy (combined)
Estrogen-progestogen oral contraceptives
Aside from the cancer risk of oral contraceptives, I saw much devastation from oral contraceptives…..strokes( I think the most common cause of stroke in a young female); pulmonary embolus, and leg clots; huge numbers of STDs from “safe sex”, some resulting in permanent sterility; unwanted pregnancies from failed contraception; devastated young teens from failed sexual relationships.
With great regret, for many years, I did prescribe, (against my better judgement, and conscience), until the evidence of the disastrous side effects became too overwhelming, and I stopped.
Interesting that you bring up the Hippocratic Oath, considering it contained the following:
“I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.
I will give no deadly medicine to any one if asked, nor suggest any such counsel; and similarly I will not give a woman a pessary to cause an abortion.
But I will preserve the purity of my life and my arts.”
This has been eliminated from the modern oath, more’s the pity.
I think the analogy is quite apt. If a physician believes that contraception violates his or her values then that physician should not choose an area of practice (family medicine) where the probability of encountering issues of contraception is high. Would we countenance an emergency physician who refused to provide blood transfusions because of his or her moral values? I think not – because it is patently ridiculous.
You are actually equating the necessity of a blood tranfusion with the inconveniance of have to look elsewhere for contraceptives.
Inconvenience becomes life-changing when you live in Ontario and access to doctors in many cases requires long wait times or seeing a different doctor each time (eg. no continuity of care.) As a woman of child-bearing age, I know that not only is birth control a health care service that enhances my quality of life (physically and mentally), but it also requires a doctor’s expertise, and having a good family doctor who knows my history and is willing to explore different options for the best choice for me is very important. If I didn’t have a family doctor and relied on one-time visits to a walk-in clinic and had to supply each new doctor with all the intricacies of my past history (which I may not even understand), the care I would get would not be the same. Therefore, I’m glad that my family doctor went into a branch of his profession that didn’t require him to send me and an estimated 30+% of his female patients away because they were requesting health care in the form of birth control.
Birth control is health care.
As a husband and father, I don’t see your pressing need for birth control. No chaste single woman needs it for preventing pregnancy. My wife has had C-sections, so we have had to be careful to leave sufficient healing time between pregnancies. However, we have been able to accomplish the interval without contraceptives and significant hardship. We know that many contraceptives are abortifacient, carcinogenic, and otherwise detrimental and unethical, so we do not want to use them.
I thought that the possible policy change was referring to non-emergency cases. Obviously, in an emergency case the physician would work to save the patient.
I am sorry to say that your analogy is weak the police have a code the swore to and they must observe all that that code entails then use his apply his religious belief in line with that code. For example he coming to the said house knows that he must arrest the offending party what his religious conviction should do on that respect will be to affect whether he patiently determines who the offending party is or not.
In the case of doctors the code the swore was the hippocratic oath where the swore to use their skills to protect life and this they must do how the do this must be in line with their training and knowledge. The conscience clause comes in in the choice of which of the methods to apply or whether or not to follow the code sworn to. In the case of doctors of the Christian or Catholic origin they choose to live by the code whole by healing/saving lives and they choose also to neglect any methods tagged as medicine that go contrary to their conscience for if it is against their conscience they never learned in the first place and it is dead to them it is like asking a psychiatric doctor to perform a surgery on a patient because as you have observed he is a doctor. But then again he is not obliged because he doesn’t perform such procedure to refer to another who does if he feels that such procedure is not medicine in any good standing and face it abortion like euthanasia is not medicine but we’ll decorated murder because it takes the live of a living human being.
you don’t compare physicians and police
Very good point We will stand behind our doctors and their rights
If I come to you for medical care, I expect to get the scientifically determined best care for my condition. If you can’t or won’t provide it because of your beliefs, find a new job.
My doctor has a note posted in his office stating that he will not provide contraceptives or referrals for abortions. If I had an issue with his stand, I would seek out another family physician who better suited my needs, not force him into doing something against his conscience. I appreciate the “social” medicine we have here in Canada however, I certainly don’t want it at the cost of someone’s freedom of conscience. Come on Canada, there’s room for all of us here!
Then the squeamish need not apply.
Refusing to kill someone is a kind of squeamish I can live with. Especially in a doctor. Question: why on earth would you trust your own life to them otherwise?
This might be fine if all members of the public had equal access to physicians – but they don’t. If you are well educated and live in an urban centre your chances of having options are high. If you are young, less well educated, and/or live in a rural setting with few doctors these options might not be open to you. Moreover, most of us believe that a young person who intents to have sex and also plans ahead to use contraception is behaving responsibly. What is the message to that young person when her doctor refuses to support her decision?
A person’s age and education level in no way influences their ability to access a physician. Where are you getting this from?
Furthermore, stating that “most of us believe” something is by no means a reason that that particular BELIEF should be propagated by the medical community. If a physician is part of a community where most of its members believe she should not prescribe OCP, should she then be punished for counselling patients on something other than abstinence. Where is your logic?
Canada’s strength as a country lies in its diversity of culture and religion. We should do everything to protect the rights of the individual, whether physician or patient, to act in accordance with their own conscience. Someone should never be forced to act in objection to his own morality. The unique position of a physician or other professional that acts in the service of the public, makes it necessary for them to be clear about their own biases so as to ensure that they do not infringe on the rights of the people they service – hence onwards referrals should be readily available.
Your above comment appropriately identifies access to rural physicians as an important problem that needs to be addressed.
Age and education are entirely relevant here. Abstinence as a realistic alternative to birth control for the majority of teens? Meanwhile there are many elderly and isolated people, many of whom may not be literate, who do not have access to computers for researching their conditions or finding alternate providers. It physicians’ ethical duty of practice to provide directly or through realistic, accessible referral for their patients’ healthcare needs.
If age is “entirely relevant” here for access to doctors, then how about considering pre-born children and their access?
Abstinence is the ethical alternative to birth control for the majority of teens. God did not make us sexual so that we could fornicate. I did not, and neither did my peers in my church. Thankfully, we also had parents who did not. Perhaps the culture is too permissive?
You speak of elderly people and the doctor’s ethical duty to provide for their health care needs. What specific polarizing need do you have in mind here? We may not kill each other or ourselves.
And what do you think is “behaving responsibly” when a person that is to young to deal with a pregnancy is having sex anyway? Every birth control method has a failure rate. Maybe the doctor is doing what is best by denying them the false confidence that birth control will always work, and without access to it, they might consider NOT jumping into a sexual relationship before they are able to deal with the potential consequences.
Medical care is, and always should be, about the rights and needs of the patient, not the physician. Your comment about “Soviet-style medicine is both irrelevant and inaccurate. If a doctor feels that a given procedure or medication somehow violates his/her religious views, and it is the best or most appropriate – or most desired – treatment for the patient, it is their responsibility to either refer to another provider or, where no other provider is easily available, to give the patient what they need or want. That’s the doctor’s job. It is most emphatically NOT the doctor’s job to decide treatment options based on his/her own religious beliefs.
The problem that you apparently do not acknowledge is that current secular humanist beliefs are not only wrong but also downright dangerous. Annually thousands of Ontario residents die as these beliefs are acted upon. Get a sense of proportion, please.
As a patient I think I should should have the privilege of selecting a physician with a belief system consistent with my own.
When decisions are removed from the doctor/patient relationship, they are more likely to infringe on both. The further they are removed, the more likely they will infringe.
This particular discussion is not so much whether the doctor’s ethic’s or the patient’s ethics should prevail, though it is framed as such, but rather whether we value the patient/doctor relationship and have the decisions made at this level, or whether the decisions will be imposed by a group of distant people that do not have an intimate knowledge of the decision at hand.
A simple ethic, like the Hippocratic oath, and decisions made within the patient/doctor relationship will always be superior.
And it will be less costly and easier to administer.
I agree with this physician’s posting that physicians should not have the right to deny or refuse treatment quashed. With the diversity there is in public practice, there are doctors who may choose to perform procedures that some find against their religious beliefs. I struggle with the inconsistency of logic that demands a doctor who entered the profession as a person with rights to forfeit them at the door. Function does not trump humanity. There are ways to ensure people get the services they want without demanding the doctor change who s/he is. We expect doctors to be ethical, compassionate and skillfull. Those traits are about who they are as people as much as it is about who they are as professionals. So also are their moral and religious selves.
Agreed. A doctor must retain the ability to make decisions about what they prescribe and what procedures they will undertake on the basis of their morality, religion, experience, personality and knowledge. We do not force a doctor who has chosen family practice to do heart surgery, even though she can, if that is not in her comfort zone. No more should we force a doctor to perform or recommend abortion when that is not in their (moral) comfort zone. As long as a doctor is clear about what is outside their practice, they should not be forced by the state to operate outside. If the state is so concerned about access to particular services they should focus on training more doctors and providing better access, not forcing doctors to abandon their morality that is often the foundation for why they became doctors in the first place.
I couldn’t agree more. As a patient, you would be the type of doctor that i would be searching for.
Agree !00% with Dr opinion. Some minority groups tray manipulate and push their agenda include some politicians.They like control everything possible.still I believe we can say NO to them.
I go to a pro-life doctor here in Ottawa. I have chosen to go to him because of the moral stance that we share on issues like abortion and euthanasia. Please don’t change the laws in denying the right for Physicians to practice medicine the way it should be, protecting the born, the pre-born, the disabled (like me) and the healthy.
I do not understand how your comment is relevant. Your pro-life family doctor would not have to perform any abortions if a woman needed or wanted one. I doubt your family doctor is qualified to perform the procedure. However, their personal beliefs should not be dictated or forced upon another person. If I needed or wanted an abortion for whatever reason, I legally have the right to do so no matter your personal opinion.
Good point! We must be vigilant to prevent the degradation of medicine we see all around us. A pro-life midwife in Sweden cannot get a job (2014). A pro-life hospital director in much more pro-life Poland loses his job when he frankly refuses to refer (2014). A pro-life medical student in neighbouring Manitoba cannot graduate (2004). The culture of death is so pervasive now in the West.
So it is okay for a doctor to refuse to properly treat women?
Of course not. And when he properly treats a woman who is a mother, he must also properly treat her child. Of course.
Denial of freedom of patients to make their own health choices is a better option?
To allow physicians to impose their religious decisions on their patients?
No-one is saying doctors will be required to make their own healthcare decisions against their religious and or moral views. Only that they cannot dictate this to others.
….taking offence at having your religious privilege stopped causing you to cry offense.
EVERYONE has the right to make healthcare decisions free from authorities dictating options. This includes Doctors.
Doctors have a responsibility to provide and safeguard those rights in their patients.
If for example, a doctor has a religious problem with birth control, and a patient wants birth control. At no point, ever, will the doctor be required to take birth control. However to deny the patient control of their own medical decisions is entirely unprofessional and oppressing.
Anyone who has the ‘calling’ of medicine should understand that it is about the patient – NOT the doctor. To make it about the doctor is to turn it into a business.
I believe you are missing the point. Doctors would be obligated, if the rules change, to prescribe birth control even if according to their own morality they must not prescribe birth control. It is not the taking that is against the doctor’s morality, it is leading the mother to abort. The ‘calling of medicine’ should not mean abandoning your own morality for the state’s. The doctor should have the freedom to practice the areas of medicine he/she is comfortable with. If that means avoiding birth control and abortions, that is fine – they need not be part of every doctor’s practice any more than obstetrics or arthritis or pediatrics.
Denial of freedom of conscience is indeed denial of religious freedom as is done in communist countries. Please don’t allow this to happen to Ontario.
What is with all this communist fear mongering, it’s like we live in the states.
We living in a regulated capitalist society, some things like health care and utilities do not work well under the realm of the private market since there is rarely enough real competition to create good outcomes for the consumer. Look at cable and phone, we get to pay more of less because we have telecommunication cartels which don’t directly compete with one another.
Just because people don’t want to have their health choices dictated by a doctor whom they might disagree with on important related issues, does not mean we are going to become a communist state. That’s a slippery slope fallacy at its finest.
July 29 commenter, you missed July 27 commenter’s point of comparison, the absence of religious freedom. Communist countries continue to be officially atheist and brutally totalitarian even as they, in some notable cases, become more capitalist.
Religious beliefs is not something one can leave at home when going off to work. Physicians (and other professionals as well) should be able to live their lives (which work is a part of) according to their beliefs.
Even though, the issue is worded in a general way, it is mostly about physicians refusing to perform a murder on the unborn (so called abortion), or about physicians refusing to refer such “patients” to an institution that will do it. The latter would equal to being an accomplice in crime.
The timing of the issue of Physicians’ right to refuse to provide non-emergency care that does not conform to their moral or religious beliefs is surprisingly well synchronized around the globe. Same issues are now being discussed all around the globe.
I vote for giving Physicians (and other professionals) freedom to follow their own religious beliefs at work as well as after work especially that in only refers to non-emergency care. Freedom of religion is a basic right free countries should protect.
Patients will only benefit from having doctors who can follow their conscience.
I believe in religious freedom for all citizens including physicians. Our community has had a shortage of family doctors and many of us have no choice but to accept the doctor which is available. We should not be limited in the treatment available to us by the doctor’s religious beliefs, whatever their religion may be. As an example, consider birth control.As an individual the physician should be free to practice (or not) whatever form of birth control dictated by their religious beliefs. That does not give them the right to impose directly of indirectly those same beliefs on their patients. I am Roman Catholic but I have no more right to impose my religious beliefs on others than my Muslim counterparts have to impose their beliefs on me. Physicians have no right to expect an exception to this basic concept of freedom of religion. Let them practice their religion personally but it must not be imposed on their patients. This should not be construed as government interference, but merely clarification of the basic concept of the Hippocratic oath.
With all due respect, I find the “rural/ underserviced area” argument to be misguided. Instead of focusing on the one service these physicians are not providing (i.e. contraception), physicians in those areas should be celebrated for all the other services that they do provide. If the CPSO changes their rules and forces physicians to act against their conscience you will see these physicians move out of underserved communities and move to places where they are free to practice conscientiously (i.e. America). Rural Canadians will then have no doctor present to provide any care.
Furthermore, please consider this key point. In the majority of communities a patient has the option of going to at least one other doctor. Since we are discussing nonemergent cases the patient has the luxury of time to “shop around”. In these cases no one is imposing any values on another– both the physician and patient are living according to their values. If the CPSO changes their rules then the doctor will be forced to provide contraception against their conscience and now the patient will be imposing their values on the doctor. For these reasons I see more harm than good arising from any change to the policy.
I am most relieved that physicians are starting to make known that they will always give us the best of care and would not take any measure whatsoever to take our lives. May you be steadfast in your position and not let the Euthanasia people lead you astray…..!
I am slightly confused here. To make sure we’re talking about the same thing here … “Euthanasia (from Greek: εὐθανασία; “good death”: εὖ, eu; “well” or “good” – θάνατος, thanatos; “death”) refers to the practice of intentionally ending a life in order to relieve pain and suffering.” – Wikipedia. If a physician were to take your life against your will … would that not be murder (the unlawful killing of a human being)?
On another point, since we do not criminalize suicide, would it not be ethical to allow those who are in pain and suffering to choose to end their own lives in as painless a process as possible? And would not physicians be in a position to provide that service? Because the argument against seems to be that one would rather see people experience pain and suffering than not … and I’m not sure it’s ethical to just let people suffer.
You’re right, it is not ethical to just let people suffer. However, we do not need euthanasia to relieve suffering. We need to provide holistic palliative care that addresses physical and psychological suffering with a true commitment to journeying with patients. Euthanasia kills the patient without providing the care they deserve.
Even worse, euthanasia compels a physician to be complicit in that killing.
This is a good point. Many responders have focused on issues such as contraception or abortion services, but if euthanasia becomes legalized, what is to stop a patient or family from requesting it, and the physician then be forced to provide it?
Awesome and very well said and stated.
I totally agree with you..
God Bless you!!
If a patient doesn’t agree with a doctor’s professional judgement about what is the best course of treatment they can always get a second opinion or pursue other treatment options. Other professionals are given the opportunity to make these calls – why not physicians?
Physicians provide a public service. Public health care should not be designed to protect the physician at the expense of the patient. The health of the public should come before the morality of the physician.
And to address the other part of your comment, from my comment below: “For many reasons Ontario residents do not always have the luxury to pick a physician and as a result have to rely on walk-in clinics or have a limited choice in physicians. This limitation is not exclusive to family practices and can extend to other specializations. Here are a few reasons Ontario residents may not have a regular family doctor or not have access to the care they need:
- Rural area with very few physicians
- Discrimination based on gender, sexuality, religion, race, etc.
- Limited physicians in a specialization
- Recently re-located and have not found a family physician
- On a waiting list to get a family physician
- Due to work schedules may have to rely on after hour clinics
- Vacationing in Ontario
I am going to add to that list here:
- Economical restraints limiting travel (relying on public transit)
- Waiting lists to get in to see specialists are long and getting a second opinion is not always a viable option when health matters are time-sensitive.
- Youth (under 18) limited by parental choice. Not everyone has a healthy home life and a parent may not make choices in the best interest of the child.
I hope this helps you understand why some may not have the option of seeking a second opinion and may be limited in regards to physician choice.
I can understand that there might be difficulties finding a second opinion. However, I would not want to be a physician FORCED to act against my conscience. If your boss/manager came to you and asked you to do something you felt was wrong – you would just do it? Probably not.
Most of the time we are not asked to do things that involve matters of life and death.
Physicians are though. For some physicians, respecting life from the moment of conception until death is of vital concern to them. They take their age old admonishment of “do no harm” seriously.
Physicians, like other members of society must have the right to act according to their conscience. One cannot separate one’s conscience from actions – even professional ones. We risk repeating the terrible crimes of the Nazis if we insist doctors, nurses and pharmacists must sanction every action of the state.
If your conscience cannot allow you to provide scientifically sound medical care you are not fit to be a Dr. I find it terrifying that any medical professional should be allowed to deny anyone medical care because they put their belief in some iron age myth above science, medicine, and most importantly their patient’s well being.
Who are you to dictate who is and is not fit to be a doctor? Clearly, a physician who objects to the performance of abortions should not become an gynecologist. This does not mean that they cannot be an oncologist, a geriatrician, a pediatrician or any other speciality where they can provide excellent care without infringing on their personal morality.
Having a code of ethics (whether it is one that you personally subscribe to or not) is essential in a good doctor.
I work in an area of medicine that deals daily with matters of life and death and must work hard to ensure that the decisions being made about a patient’s care are in accordance with their and their family’s sense of value. Science cannot answer some of the difficult questions we must answer everyday – for example is it right to make a end-stage Alzheimer’s patient undergo a surgical procedure to continue to feed them once they have lost the ability to eat on their own? How does one scientifically study that? These decisions come down to the individual patient’s values and the wishes of their families. Doctors are merely here to guide patients and to sometimes make the difficult decisions when asked to by families seeking guidance.
I would never ask my patient to act against her own conscience when making difficult choices about treatment. Who do you think you are to make me, because I have chosen a profession in the service of others, to make me act against mine?
You as a physician are accountable to the public via your regulatory college as well as the provincial and federal courts. That’s why this consultation process must be open to the public as we are stake holders in publicly funded healthcare. It is far different in privatized healthcare, as formerly so in the U.S. Though I firmly believe in the rights of conscience for all healthcare workers, including those who have very little professional voice in ethically questionable procedures, you are in a regulated profession. Maybe privatized healthcare somewhere else is a better fit for physicians who want to adhere to their own beliefs over the needs of their patients.
“Needs of their patients”–such as killing their children (abortion)? or the patients themselves (euthanasia)? Is pregnancy a disease and killing a cure?
Freedom of conscience is absolutely necessary for such a perversely regulated profession as Ontario’s publicly funded health care. It should be privatized.
“Is pregnancy a disease and killing a cure?”
In some cases, it can be. An ectopic pregnancy, for example, can be a life-threatening condition. I have heard of cases of twin pregnancies where one is unlikely to survive and risking the death of both twins by causing blood pressure fluctuation.
Things are not always as cut-and-dried as many people like to make it seem. There are legitimate medical reasons for which abortion may be the best choice.
“In some cases”–already you are conceding that the vast majority are not.
An ectopic pregnancy is only a disease because it is ectopic; the child is growing outside of the womb. If the ectopic pregnancy is left to continue, both mother and child will die.
My understand is that the same procedure as in abortion is used by pro-life doctors to end an ectopic pregnancy, but they do not call it “abortion”. The goal is not to kill the child but save the mother as neither child nor mother will otherwise survive.
As for “twin pregnancies”, even if one is likely to die and also endanger the life the other, then it seems to me that God has so ordained. The doctor should not kill one to save the other. It’s worthwhile to note here, however, that because of IVF there have been many more twin pregnancies that would naturally have never occurred. I believe IVF is wrong.
I believe that abortion (as I’ve qualified it above) is NEVER a valid choice. While there are rare occasions which are not “cut-and-dried”, Christian ethics can still be brought to bear so that the physician knows what to do. I’m not Roman Catholic, but I’m aware of the existence of a large body of rules and considerations for Roman Catholic physicians to follow.
“Who are you to dictate who is and is not fit to be a doctor?”
cannot be followed by
“Clearly, a physician who objects to the performance of abortions should not become a gynecologist.”
No, it’s not clear. Clearly, a person who objects to the performance of abortions should not become an abortionist. This person may choose to become a gynecologist. This gynecologist may even perform D&C to end an ectopic pregnancy, a true disease. I’ve been told that pro-life doctors don’t call this surgery “abortion”: its purpose is quite different. The intent is not to kill the baby but save the mother; if the pregnancy is left to continue, both mother and child will die.
A normal pregnancy is not a disease. Also, sex is not frivolous, so pre-born children should not be punished for the sins of their parents. Abortion is violence and has no place in medicine, not even in gynecology.
Actually sex can be frivolous. And guess what? That’s fine. People are within their rights to do that and they are within their rights to use contraception to prevent pregnancy.
Your comment demonstrates what this debate is really about. A back-door option for restricting how and why people have sex.
1. given to undue levity.
2. of little or no worth or importance.
Perhaps you have definition 1 in mind, but I believe the poster above has definition 2 in mind. Sex is always has worth and importance because it is inherently procreative, i.e. a new human being is a natural and expected outcome of sexual intercourse. Therefore, sex has worth and importance because every human being has worth and importance.
What about contraception? Well, every method of contraception has a failure rate (you can look these up), so sexual intercourse remains an inherently procreative act, even if you use contraception. You can alter the probabilities, but not the range of possible outcomes.
No, this debate is about whether physicians should be required to KILL people.
I’m all for restrictions on sex that promote marriage and the family–these have been present in every continuing civilization–but they’re not what this debate is about.
This debate is about whether physicians should be required to KILL people.
In what universe is killing a patient SOUND MEDICAL CARE? It what way is poisoning a patient SOUND MEDICAL CARE? Just because some doctors have no problem murdering a child, or giving lethal injections, or prescribing drugs that are devastating to health (how depo got approved I will NEVER understand) doesn’t make is sound medical care, it makes it immoral business practices. Some doctors are concerned with ACTUAL health care, not murder. I find it terrifying that you ignore scientific fact about when life begins.
Not to mention the fact that you completely ignore freedom of religion, an ACTUAL right that we have, in favour of an imagined one that you pretend you have.
At one time, thalidomide was considered a sound prescription for women suffering excessive “morning sickness” during pregnancy. At one time, it was considered best for parents to institutionalize disabled children. What is considered good medicine is a dynamic concept as we learn more about what’s best for health and how different people react to different treatments. It’s imperative to allow physicians to use their judgement and act within their conscience. I would not want to be treated by a doctor who will willingly go against their own conscience. Such a doctor cannot be trusted to treat my health as important, nor to follow the oath “to do no harm”. Pre-natal care is what’s needed more of, especially in rural areas where women are still forced to travel long distances to deliver their babies in a health facility.
GOD’s COMMANDMENT: Thou Shall NOT Kill!
Morality is merely the beliefs that guide our actions. If the health of the public comes before the morality of the doctor,what belief system should control the doctor’s actions? The States? The Public? And who determines what this ‘morality” is?
So you are saying that the patient’s belief system should control the doctor’s actions. OK… that means doctors are really slaves who gave up their basic human rights when they entered medical school.
God. He has communicated His will to us in the Bible. It results in Judeo-Christian morality. Research the history of Western civilization–and of modern medicine and hospitals–to see its effects.
In all cases? Can you imagine any scenario in which enabling a patient’s request should not be done?
If the patient is not morally infallible, then how is it then to be determined what morals the physician should be made to follow?
Can you generate any other ways to solve those problems other than making all physicians conform to your morals?
You are absolutely correct that morals are a moving target and for that reason my preference would be that the problem would be solved by conforming to neither the physicians morals, or my own.
I would like the solution to be based on the most sound medical information at the time and the best possible health outcome for myself. If there are multiple options then I would like to be presented with all of those options, rather than just a certain subset that meet with the moral convictions of either party.
The health of the public DEPENDS on the morality of the physician.
Define morality. Are you talking about ethics or spirituality? If a physician tries to put his or her spiritual/mystical beliefs over the best posible outcome for the patient, then that physician should not be allowed to practice.
The health of the public depends on physicians basing their treatments on sound scientifically supported health studies, not some personal code of behaviour that they feel they should force on others.
If by morality you mean the physician has to stand up to those who would have them prescribe a certain medicine for the sake of profit then I agree with you, however if you mean the physician should be allowed to let their spiritual beliefs supercede the client’s right to the best possible treatment, then you are dead wrong. And by dead, I mean your patients.
I have read a number of the comments here and yours is one of the very few that makes complete sense to me.
The physician who states that “the health of the public DEPENDS on the morality of the physician is wrong, in my opinion. It should read “the health of the public DEPENDS on the competence of the physician”.
I agree with you completely. It is delusional to believe that medical practice can be separated from sound moral reasoning.
Morality differs from group to group and individual to individual and for many of us, from situation to situation. Professional ethical codes are standardized practices among regulated medical professionals or else they cannot work at their self-chosen profession.
It would be a grave injustice to physicians (and a disservice to patients) to demand that a physician’s capacity for reasoning be replaced by standard “professional ethical codes”.
I agree that there are times when the access to physicians can be quite limited; however, I think it is much better to have a physician who is willing to provide good quality care of all the services they can than to have no physician at all. If we say that physicians must provide all services regardless of their conscience, the first consequence would be to stop many physicians from practicing. This does not actually help the situation at all.
So your premise is that a bad doctor is better than no doctor?
Well I challenge your mediocrity. The better outcome would be to keep bad doctors out of medical schools in the first place and let those seats go to someone who will place their “faith” in sound health practices and research. If it is clear in the college’s policies that physicians will not be allowed to let their spiritual beliefs trump the best possible outcome for the patient, then the doctors that we have will not be required to choose between their morals and their patient’s health.
I have every confidence that medical schools will be able to find sufficient numbers of qualified applicants, even if it is clear up front that conscientious objectors should not be applying to medical school.
It seems to me that a physician who refuses to provide a service because of their conscience may not be able ‘to provide good quality care’, and if they are the only available physician, than the patient would be denied that care because of the physician. The physician may have, or make up, a ridiculous moral code that allows them to deny treatment to patients they do not wish to see have care. The idea that it is better to have more physicians who are allowed to arbitrarily cut back on their level of care is a worse scenario than fewer physicians who would provide the best care they can.
“If your boss/manager came to you and asked you to do something you felt was wrong – you would just do it? Probably not.” … what if you felt that the actual tasks of your job were wrong, but didn’t want to be fired? Consider if your job was to drive a taxi, but you had a deep felt moral sense that the operation of motor vehicles was a sin. You might be able to get hired, than claim that you can’t be fired, because to insist that you drive a taxi would violate your conscience. If someone signs up for a job, they have to be willing to do all aspects of it, not pick and choose the things they would like to do.
Ridiculous comparative (argument). How many taxi drivers are providing health services?
Not ridiculous at all. If you consider driving a sin then choosing to work as a cab driver is a poor career choice. Similarly, if you consider birth control a sin then choosing family practice is a poor career choice – pick anesthesia or some specialty where the moral dilemma is unlikely to arise.
Oh, seriously. Doesn’t common sense have to play a role here? Doctors should be able to go into family care to help families, without having to add on items that they know will be harmful to families. If you don’t believe in abortion, you don’t go in for an ABORTIONIST. It shouldn’t keep you out of family medicine altogether.
Then why is a Swedish midwife suing in local court after being denied employment at three separate maternity centers because she is unwilling to assist with abortions?
Why has a renowned pro-life doctor in Poland and head of the gynecology and obstetrics department at Holy Family Hospital been sacked and fined after he refused to participate in abortion?
There are plenty more examples. Abortions were already being performed in the Ontario hospital in which I was born some decades ago. Now I’m living in Asia. The doctor who delivered my first child and the doctor who will deliver my second next week (C-section) almost certainly also perform abortions. I doubt it’s possible to get a pro-life doctor here.
Those cases are very clearly abuses of the legal system in the US. They where not denied employment, they ask to be employed in clinic which do family planning (in the case your referring it might ever be the case that none of them are even doing abortions) She was interviewed and she was unwilling to do some of the work required for the available position (offer family planning in the form of contraceptives and giving certain type of support to patients) So they hired a more appropriate person. She just keeps applying to underfunded clinic that offer services she unwilling to provide.
July 29 commenter, what are you talking about? July 26 commenter referred to situations in Sweden, Poland, Ontario, and Asia. None of them are in the U.S. LifeSiteNews reported on the recent, distinct cases from Sweden and Poland.
A decade ago, LifeSiteNews reported on another instance of totalitarian abortionist ideology being used to violate the physician’s conscience, this one in neighbouring Manitoba. There a medical student was not permitted to graduate despite good academic performance and recommendations from supervisors. The reason given was that he had failed a course in gynecology and obstetrics because he refused to perform abortions or to refer for them.
It would free up the limited spaces in medical schools so that we get Dr’s making decisions on the basis of science and best medical practices instead of iron age myths.
“Iron age myths”–like the magical transformation of a non-person into a person by the process of birth?
Very well said. A public service paid for with public monies.
“The health of the public should come before the morality of the physician”
It is a dangerous claim to ask health care professionals to set aside morals. In a profession that deals with life and death and countless issues in between, acting ethically and with moral integrity is vital.
Here are some examples of what could happen if the “The health of the public should come before the morality of the physician”
1) Nazi physicians completely unethical medical research studies (quick google search and you’ll find many). Based on the above statement the Nazi physicians very well could be putting away their moral values and justify medically torturing a few patients in these grosteque experiments to benefit “overall public health” with the knowledge gained from such experiments.
2) 3 sick patients need an organ transplant ( ie one needs a new kidney, another a liver, another a lung) putting aside morality and aiming for the goal “best health of the public” could justify killing 1 person to harvest organs to save 3 sick people
In addition to all of the situations that put patients in difficulty with regards to finding a doctor, I would also add that many doctors now threaten to remove patients from their roster for going to walk-in clinics, because OHIP deducts money from the rates paid to that doctor for every visit someone on his roster makes to a walk-in.
This makes patients wary of walk-ins, even when their doctor’s office is closed, as they fear losing access to their family physician for the services that doctor IS willing to provide.
A patient may find themselves removed from their physician’s roster for going to walk-in, seeking only the services the regular doctor is unwilling to provide, which puts that patient at risk.
What services are you thinking of? The “services” that are included in this discussion are only a handful: “contraceptives”, abortion, and euthanasia. They involve serious ethical considerations related to the Sixth and Seventh Commandments (Protestant numbering).
Anyway, I’ve heard that it was socialism that drove doctors into the U.S. for higher wages. The solution is not more of the same. To increase doctor availability, let’s get rid of OHIP and privatize health care or put it more meaningfully under the supervision of the church (as it once was).
I think the Hipocratic oath has been adequate for centuries. Trying to over-regulate can often backfire.
The intent of the Ontario Human Rights code initially was noble, however it has resulted in some bad outcomes, that can only be called persecution.
You are best off totally ignoring legislation that has bad outcomes.
“The intent of the Ontario Human Rights code initially was noble, however it has resulted in some bad outcomes, that can only be called persecution.”
Could you elaborate or, preferably, provide cited examples of this being the case?
The following example is from a newspaper article from February 2008:
A printer was hauled before a Human Rights Commission in 1998 for refusing to print promotional material for a group he was morally opposed to serving. The printer had done business with similar clients before, but never for jobs that promoted their political causes, which would violate his Christian belief. By politely declining the job, he set into motion a series of events that cost him time and treasure – more than $100,000 and a half-decade defending himself first before the tribunal and then in the courts. In the end, he lost, had to pay a $5,000 fine and pledge to never refuse work from the group or another similar activist group again. The printer refused to abide by the decision and challenged it in court – where he lost.
Because advocacy of homosexuality has always been a wrong in Christian morality but has become a right in Canadian society, there are more examples of similar scenarios.
Another man spent years of his life defending himself in three different human rights tribunals. One was national and the other two provincial, one of them Ontario’s. As many have noted, the tribunals are inherently unfair, inviting frivolous complaints, paying all expenses for the complainant, and avoiding the rigor of real courts. The process is the punishment.
The Hipocratic oath was always taken by every person who was destined to became a doctor. A doctor was a person who saved a person’s life whether in the womb or outside. According to a PhD recipient – “A person is complete in the sense that each has every attribute, ‘IN EMBRYO’, that everyone else has, every attribute that is needed”. How can we then permit a single embryo of a person that has the potential already of a person with unique attributes, be allowed to be destroyed? What about the “right” of that unborn person, who is not even capable of fighting for his/her own rights to live! How sad it would have been if we who are writing would have been destroyed ‘m embryo’. All the good that we are doing today would have been snuffed out of us. Abortion is never a a good or right choice. It snuffs out the life of a future noble king, doctor, teacher, PSW, social worker, religious person or even a poor person and besides it offends the Creator.
As I teach ethics to medical students the question of physicians declining to provide certain treatments based on conscience often comes up. I point out that there is a tension when medicine is delivered by physicians from various world views to a multi-cultural population. We want patients to be able to access all treatments that are legal and considered part of standard care by at least a significant minority of doctors. Yet we also want physicians whose moral integrity is solid. No one wants to be cared for by a physician who has become accustomed to violating her moral integrity.
Generally, the solution has been to ensure the system allows patients to easily access controversial treatments without needing their physician to be involved. Patients get the care they desire and physicians continue to practice with moral integrity intact.
There may be situations where this approach is not possible and the current policy address that. The last item in the list of College expectations states that “in some circumstances” physicians must help patients access services that the physician finds morally objectionable.
The current policy seems to strike a good balance and I would recommend minimal change.
You mentioned that you teach ethics. I would love to hear your opinion on the following issue and how the CPSO policy could ensure that this sort of thing doesn’t happen again:
“In January 2014 a female Ottawa resident, after waiting at a walk in clinic, was provided with a letter from the attending physician outlining the type of care he would and wouldn’t be willing to provide. The letter cited religious values indicating that he would only prescribe “Natural Family Planning.” The letter also misinformed the patients, implying that a patient required a referral for an abortion (a referral is not required) and that a prescription is required to obtain the morning after pill (the morning after pill is an over the counter medication).
Looking forward to your insight.
Thank you for the link. This letter is perfect! and in no way “implies” that patient needs a referral for abortion, or prescription for the “morning after pill.” It simply says that he will not provide them (and doctors do give “referrals” for abortions and “prescribe” over the counter drugs). Not sure why this particular lady felt shamed. I note the doctor doesn’t just cite religion either – he makes it clear that he understands these things to be harmful to the patient.
I would question the physician’s “own medical judgement” … when, as far as I am aware, the established view is that there is no expected harm in “vasectomies, abortions nor the morning after pill or any artificial contraception”.
If the patient in question wanted or needed a morning after pill, and this was her only chance to get one, having to come back the next day puts an undo burden on them.
This is not true. There have been many recent published cases of deaths and serious injury from blood clots (DVT) on hormonal contraception. There is an established risk between breast cancer and abortion, as well as psychological consequences well known, but often down played, in the media post-abortion.
As is the case with beta-blockers, blood pressure medication, antidepressants and, oh yes, advil and every pharmaceutical ever.
Side effects are a risk that come with any prescription – how, as a physician, do you make the distinction between medications? Which side effects constitute an acceptable risk to your patients?
Side effects are not a valid reason to not prescribe. I have informed consent as a patient – tell me what the risks are and I will decide whether those risks are worth it regarding my own quality of life. My physician should not get to make that decision for me, unless it violates professional ethics – not personal ones. Your personal ethics have no place in my treatment.
Translating what you said:
“personal ethics” = your doctor’s ethics
“professional ethics” = your ethics
That is an awfully convenient way for you to claim the right to dictate your ethics to everyone else.
“Your personal ethics have no place in my treatment.”
You can make it so, but only by finding another doctor.
Thank-you for your interest in this question. Two thoughts:
1. If the letter could be worded better then it should be. It would be even better if the patient had been informed further in advance that she wouldn’t be able to get the birth control pill that day.
2. It sounds like the matter caused the patient inconvenience but she was never at risk of harm. She obtained her script easily from another source and could have returned the next day to the same clinic. Cases where the choice is between patient harm and violating a physician’s morality are of ethical interest and concerning. Such cases are rare and this case is not one of them. Are you suggesting that we diminish physicians as persons and risk the well-being of the public by demanding physicians grow accustomed to violating their moral integrity simply for patient convenience?
“Are you suggesting that we diminish physicians as persons and risk the well-being of the public by demanding physicians grow accustomed to violating their moral integrity simply for patient convenience?”
By your logic Rosa Parks should have moved to the back of the bus, since the only thing at risk was a matter of convenience. Why should the moral convictions of the white folk in the front be challengeed every day, when all she has to do is move a few steps farther to the next seat?
What right do physicians have to diminish their patients as persons, just so that they are not diminished themselves? Respecting human rights over religious/moral rights is not a matter of convenience. Who is to say what impact the emotional damage to a teenage girl is when a doctor tells her to go somewhere else for a morning after pill, because he would feel morally diminished if he were to prescribe it to her? What impact does that have on the well being of the public?
If a physician’s moral convictions are such that giving the absolute best possible health outcome for the patient will diminish him as a person, then he is in the wrong profession. Doctors are professionals and should behave as such, and it is egotistical to believe they are the only profession to live with ethical dilemas. A public school teacher can have any religious/moral beliefs in their personal life that they want, but they cannot pick and choose what or who they teach based on those.
Thank-you for your response.
The policy as currently worded explicitly forbids discriminating against a patient on the grounds of race (and several other criteria). Any physician who would provide a treatment to one group of patients but both another on anything other than medical grounds is in violation of the policy and guilty of conduct unbecoming a physician. SO I don’t believe your comparison to racism applies.
I thought that freedom of conscience is a basic human right upon which many other freedoms rest. Aren’t religious/moral rights one aspect of human rights? I am confused.
One solution to respecting physician freedom of conscience and patient access to care is to ensure that patients can access that care without requiring a specific physicians involvement. We have done that with the morning after pill by making it available without a doctor.
I have not heard any physician argue that giving “the absolute best possible health outcome” is in violation of her conscience. i have only heard certain doctors articulate that what the patient is seeking and some other doctors would provide they believe to be morally unacceptable and therefore harmful to the patient. i have no encountered anyone in this debate who does not want the best for the patient. the question is what happens when doctor and patient disagree about what is best.
Freedom of conscience is a personal right, but not a professional right. When you project your conscience into your profession, you infringe on the freedom of conscience of those you serve professionally. Religious and moral rights apply only to the person who owns them and they give no authority for that person to project their morality onto others.
“i have no encountered anyone in this debate who does not want the best for the patient. the question is what happens when doctor and patient disagree about what is best.”
Well I have and here is a link to an example. http://www.calgaryherald.com/health/Calgary+doctor+refuses+prescribe+birth+control+over+moral+beliefs/9978442/story.html?__federated=1
Birth control pills are one of the most highly requested prescriptions and are widely accepted as an appropriate treatment option to prevent unwanted pregnancies across reputable health bodies worldwide. When a doctor and patient disagree about what is best, the doctor should not be able to cite “personal preferance” as a valid reason to refuse to provide what is widely accepted as best practice. A doctor having valid medical reasons to counsel against it is one thing, but to simply refuse to provide it for religious reasons is something different altogether.
The question of what happens when doctor and patient disagree about what is best has a simply answer. You default to the practices widely accepted as appropriate by the relevant health bodies, not the religious biases of the doctor.
Thank-you for the response. I reviewed the article. This debate is not about “personal preference” but about actions that violate a physician’s moral integrity. So I am not sure whether the article is relevant.
Your first paragraph confused me. How does one’s freedom of conscience not impact everyone else in society? The concept was created to deal with conscription during time of war. The citizen whose conscience dictated that they not take a life even in self-defence reduced the nation’s war effort and thus endangered everyone in society. And yet society felt it important that freedom of conscience be protected. If freedom of conscience is important enough to die for, how is it not important enough to wait a day for a prescription renewal?
Freedom of individual conscience was not recently “created to deal with conscription”. It is the heart of many religious but also secular ethical systems. However, working for the public good does include adherence to common standards of practice, or else set up your own alternative health system, as in the many alternatives to public schooling. Since the current issue applies to non-emergency situations, perhaps it will force healthcare in Ontario to de-regulate and privatize. And do remember all healthcare workers, including those not regulated nor with the huge income of doctors – should they not be able to freely exercise their rights of conscience, with no fear of job loss or reprisal?
If a Dr believes that abortion or contraception is a sin they are well within their religious rights not to have abortions or use contraception. If their patient requires these sorts of medical treatments the Dr is not the one using them or having them done so are not the one sinning. What they are doing is forcing their own personal beliefs onto their patients.
Should a patient be able to require a Dr to perform rituals to a god they don’t believe in before treating them if the patient believed a Dr who doesn’t perform those rituals is sinful? If not why not and how is that any different than a Dr forcing a patient to avoid doing something the Dr considers sinful? Across most of Canada there is no chance for a person to choose which Dr they see since there is, outside of large cities, usually only one Dr available, permitting Dr’s to force patients to behave the way they personally would is intolerable and leads to patients’ health and well being suffering.
Besides which why is it control over women’s bodies that cause Dr’s to have religious issues? Considering how every mainstream religion treats women allowing such beliefs to be forced onto female patients by Dr’s, is perpetuating the second class status of women in our society.
Thank-you for your response. The question not what constitutes sin, but to what degree we accommodate differing moral positions and people acting on those positions. If the doctor believes that writing a prescription or a referral letter is immoral then they violate their conscience if they are forced to write the script or referral. Training doctors to violate their moral integrity seems like a dangerous thing to do.
If you live in a community with only one physician then the problem is much larger that freedom of conscience. Very few communities exist like yours and medical care in your community is very precarious. One doctor in a community will quickly burn out and then there will be no doctor. And she will certainly burn out faster if forced to regularly violate her moral integrity.
“Very few communities exist like yours and medical care in your community is very precarious?” That is simply not true. but is an unaware, urban-centric response. Yes, medical care in most rural communities, let alone in more remote areas, is highly precarious! Even finding a doctor in urban areas is difficult.
Excuse me, I can’t tell by your post what your credentials are, but please tell me where it is you are the final arbiter on what is sin? You are actually incorrect about what you said. A doctor performing an abortion is indeed sinning, as well as a doctor that forwards you on to someone else knowing it is for an abortion. Until you are a priest, I would suggest you not decide what it is a sin and what isn’t .
Physicians have the right and sometimes the obligation to refuse patients who want pills. This is not just the case with contraceptive pills but with that sector of the populace who go their doctors demanding antibiotics on the slightest provocation. As a doctor, he does have to make certain decisions about what is best for that person. Ultimately it is the patient’s decision if they wish to continue seeking a treatment their doctor thinks will harm them, but that’s no reason for him to be forced to give them anything they ask for.
The young lady felt embarrassed. I think people sometimes misunderstand – the physician refuses to provide such services because he/she believes it is morally wrong and cannot act against his/her conscience. It is not done as a statement of shaming, or condemning.
On a side note, she mentions “It 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. “if what you are doing is morally right, do you feel shame?
Intent isn’t magic.
She felt shamed because the health care she was seeking is often stigmatized by society. People often feel shame for things they know are morally acceptable because of self-consciousness about other people’s negative judgments of them. A physician who expresses moral condemnation of certain medical procedures to patients shames the patients who need those procedures.
For that reason, physicians should be required to simply state that they don’t provide a given type of care, without giving a reason, and refer to another physician, or, if the patient can’t go elsewhere, provide all care that is medically appropriate in the circumstance. Patients’ welfare needs to come first. I do not want to deal with doctors who prioritize religious beliefs above good medicine or whose perspective on good medicine is distorted by their religious beliefs.
“We want patients to be able to access all treatments that are legal and considered part of standard care by at least a significant minority of doctors.”
I have a problem with this. As a licensing body for physicians you should want patients to be able to access all treatments that are legal and considered part of standard care, by ALL doctors. A significant minority of doctors? What possible justification could you have for setting the bar so low, that is not self-serving?
“Yet we also want physicians whose moral integrity is solid. No one wants to be cared for by a physician who has become accustomed to violating her moral integrity.”
You are confusing spiritual dogma with moral integrity. The bedrock of a physician’s moral integrity should be based on their serving the best possible health outcomes for all of their patients based on currently accepted best health practices. For you to say “No one wants to be cared for by a physician…” implies that you are speaking for everyone and you do not speak for me. I guarantee that I would rather not have a doctor who bases their moral integrity on spiritual dogma and uses that to justify delivering a poorer standard of health care, then what modern heath care practices should require.
“The current policy seems to strike a good balance and I would recommend minimal change.”
Actually the current policy seems to be heavily weighted toward allowing physicians to pick and choose what level of health care they deliver and forcing the public to go find service elsewhere if they don’t like it, even if the patient’s goal is simply to receive the best possible health care without the influence from the doctor’s personal religious, cultural, or ethical bias. I can’t think of any profession that allows people to deliver lower quality service to those whose personal views they disagree with. In contrast to your position, I would recommend a significant change to the wording of the policy is in order.
You indicate in your reply that a doctor who believes they cannot council an abortion is doing so not because of ‘moral integrity’ but because of ‘spiritual dogma’, implying that a doctor must REALLY feel morally obliged to do whatever the patient wants but is otherwise enslaved by an external dogma. Some people do actually feel abortion to be morally wrong, a belief that is formed with their freedom of conscience. That may or may not be informed by spiritual dogma or religious belief, but that is not for you or me to judge the source of their morality. But in our society, we must not let the state dictate the morality of the individual.
I am very grateful that Canada continues to have physicians of high integrity. If this integrity means that the occasional patient will be inconvenienced, this is a small price to pay. Please do not let small but vocal groups dictate how medical care should be delivered to the rest of us. Supporting our doctors and their freedom of conscience will benefit all Canadians in the long run.
“Public opinion can harm minority populations. The decision to allow physicians to exercise religious freedoms that discriminate or infringe on the rights of others should not be left up to public opinion if the public opinion is discriminatory towards minorities and vulnerable populations. It is the responsibility of the CPSO to ensure that their policies protect the rights of minorities and vulnerable populations. The current CPSO policy does not protect minorities and vulnerable populations.”
Public opinion can harm minority populations. The decision to allow physicians to PROVIDE TREATMENTS OR PROCEDURES that discriminate or infringe on the rights of others should not be left up to public opinion if the public opinion is discriminatory towards minorities and vulnerable populations. It is the responsibility of the CPSO to ensure that their policies protect the rights of minorities and vulnerable populations. The current CPSO policy does not protect minorities and vulnerable populations.
Well said! I totally agree!
It seems that it is in some cases necessary for physicians to be required to provide some services that may conflict with ones religious or moral belief. For instance it is difficult to see how someone whose religion prohibits blood transfusions could practice in an emergency room where it may be a life saving procedure. I would hope that we could agree that these instances are fairly rare and should be confined to circumstances which are urgent in which there is no time to make alternate arrangements. Surely if there are procedures with which significant majorities or even minorities of physicians object to providing physicians should be able to honestly say , “for reasons of conscience I don’t provide or refer for this service” Abortions are an example and euthanasia may become one. The reasoning behind the decision to prohibit the laws against abortion seemed to be no woman should be forced to carry a pregnancy they do not want. Should not doctors have a similiar right not to carry out or refer for procedures that offend their consciences.. If there is broad public support for certain things we should not have trouble putting in place mechanisms to make them happen. If we cannot maybe we should rethink if we are doin g the right thing. Doctors should not be forced to violate their conscience to practice medicine.
Forcing doctors to refer for services with which they disagree may have unintended consequences. For instance many doctors who provide palliative care do so out of a felt obligation to the vulnerable. It is often work that involves low pay and it involves housecalls and time away from family. It takes sacrifice that often only comes because of a felt commitment. Which doctors are most often going to be called upon to refer a patient for euthanasia if this becomes a requirement if a patient so asks? Those doctors who provide palliative care. For many of those doctors the very thing that animates their desire to help the vulnerable (their consciences) may be the thing that causes them to have to turn away from providing that care. I personally provide care for a large number of nursing home patients in an underserviced area. I don’t see anyone would replace me if I stopped doing it. I really don’t have the time to do it as I already have a full practice and a young family. Everytime my pager goes off at 1 am because someone needs pain medication or some other measure to meet a need I wonder why am I doing this. The answer is it is the right thing to do and fewer and fewer of us are doing it. If it became the accepted practice that I would have to refer a nursing home patient for euthanasia the very thing that makes me say it is the right thing to do will be the thing that makes me walk away from providing nursing home care.
Nope. If you refuse to do your job correctly, then you need to find a different job.
Who gets to decide what “doing your job correctly” means? Just because something is legal doesn’t mean that it should be the job of a doctor. It doesn’t take a doctor to kill a person. Why not have a specially trained group of lawyers administer euthanasia instead?
Many thanks to the physician who made post #7. The work you do is invaluable!
Agreed. Who gets to decide what “doing your job correctly” means? And who decides “the absolute best possible health outcome” for each individual? Don’t we all rely on the professionalism and “moral integrity” of a well-trained doctor when it comes to health issues? Or, would you rather count on public opinion, media pressure, or even human rights, that we think we are “entitled” to a medical procedure, we should get it and disregard or even deny the freedom of physicians to have their own stand? Doctors are not production line workers. Just as we respect judges to have their discretion in “doing their job correctly”, we should continue to allow doctors to do the same. I thought I came to a free and democratic country when I emigrated to Canada twenty years ago??
Well, I think it’s pretty clear that for a woman who does not want to become pregnant the best possible health outcome would be to not become pregnant.
No one here is questioning access to therapeutic abortion.
I am–if “therapeutic abortion” includes killing the child because of its severely abnormal development and if “mother’s health” means anything more than her biological survival. The Ontario Humans Rights Code requires that physicians provide medical services without discrimination on the basis of age.
There are lots of ways for her to not become pregnant. She doesn’t need 100% of doctors to agree with her to accomplish her goal.
There’s a great way for her not to become pregnant. It’s called not having sex. Outside of that, there are no guarantees. I can’t throw myself in a river and then demand that someone else jeopardize themselves to come and pull me out.
You don’t get it there is no one who will replace me. At one point we advertised for two years to get someone to take my position at the nursing home I serve. No one even replied. In my area there are five doctors providing 90 percent of the nursing home care to about 500 nursing home residents. I am the youngest. The other four are all hanging in because they have to.
Freedom of conscience needs to be protected if physicians are to continue providing excellent care with moral integrity.
This can be done compassionately and respectfully, without discrimination on the basis of “race, ancestry, place of origin, colour, ethnic origin, citizenship, creed, sex, sexual orientation, age, marital status, family status, and/or disability”
However, it appears that some medical professionals are not able to do so without discrimination. Who should the CPSO protect: the doctors or the patients the public health care system is supposed to care for?
http://www.xojane.com/it-happened-to-me/it-happened-to-me-my-doctor-refused-to-refill-my-birth-control (Location: Ottawa, Ontario)
There is a difference between deciding not to provide a particular service, and deciding not to provide a regular service to a specific person. The first situation is a professional choice (for example I might run a restaurant but not serve fries to anyone b/c I think they are unhealthy). The second is true discrimination (for example I am fine with selling fries in general, but I won’t sell them to people with red hair).
i want a doctor with moral integrity. Not too much to ask.
as a young physician in my first 5 years of practice I have been discriminated against on the basis of my religion, nationality and level of experience. for example, a family from a cultural background frequently at war with my own, refused to remain my patients after discovering my heritage. where are my human rights here? my issue with the college, as a body made up of fellow physicians, is that it protects the interests of the public while ignoring the interests of its own members. doctors are members of the public too. it’s like being a resident; our superiors drive us to borderline insanity requiring 24 hour plus work shifts and then expect us to look after the mental health of our patients. Hypocrisy? bullying? demoralization? over-regulation can have a hence have a deleterious effect creating a generation of paranoid and stressed doctors thereby compromising patient safety.
IT’S A BIT OF A LAUGH THAT THE COLLEGE, COMPRISED ALMOST ENTIRELY OF WHITE MALE MIDDLE AGED MEN, HAS A DISCUSSION ABOUT HUMAN RIGHTS. ITHINK MAINLY THEY WANT TO PRESERVE THE STATUS QUO, AND THESE SO CALLED DISCUSSIONS ARE NONSENSE, AND THEY DO WHAT THEY WANT.
While perhaps upsetting as your experience was, physicians do not have a right to keep patients within their practices. Patients are free to leave an individual’s practice for whatever reason provided they do not infringe on your right to work (i.e. attempt to slander your ability to practice medicine based on their religious beliefs).
This is my point; patients rights are honoured while physicians rights are left by the wayside.
While I do not condone any form of discrimination, I am a victim of it and there’s nothing I can do because I am a physician and somehow this means that I have the right to act as a doormat and humbly accept anybody that walks all over me. Not only discrimination, but abuse and frivolous college complaints with intent to injure. Somehow the public has gained such ascendancy over doctors so as to almost make a mockery of the profession. I feel like I’m playing Dr. Google everyday, and if I refuse and unreasonable request I’m liable to abuse, either directly or in the form of a College complaint. Sad state of affairs when doctors have been relegated to the position of public slaves without freedom of speech or conscience. Moreover, we are regulated by an unpredictable dictatorship lacking transparency and logic. I am not sure how long I can endure this and I think about leaving the country everyday.
Your example of you being discriminated against by a bigoted patient makes no sense to me. If someone refuses to buy their Big Mac from a black cashier at McDonalds, that means they lose out on a good meal that would have been just as tasty as if the Big Mac had been served by a white person. It is their loss, not the cashier’s. By the same token if a bigot is not interested in you being their doctor, you should not consider it to be a slight on you. They are the ones who lose out on quality health care. Beliefs of that nature originate with the bigot, not their target.
You seem to have an axe to grind about the respect that you get from your patients in general though. Your religion, nationality or age do not define the level of care that you can give. The question being asked here though is whether your religion, nationality or age also should allow you to define the level of care you are willing to give.
As soon as you (or the college) say that your religion or something else about you allows you to recommend anything other than the best possible medical outcome for your patients, then the bigots will be justified in judging you by the way you look.
Yes the beliefs originate in the bigot but they can manifest as acts of discrimination. To me, refusing to buy the Big Mac from the black cashier, as in your example, is an act of discrimination and the cashier a victim of discrimination. Just as I feel I have been the victim of discrimination with the patients that left my practice because of my cultural background.
As I said before, I do not condone any form of discrimination and I certainly do not consciously let it affect the quality of care I give. The point I’m trying to make is that there is an imbalance with regards to the rights accorded to patients versus doctors.
If I were for example to dismiss patients from my practice or refuse to accept them in the first place or provide them with inferior care because of their cultural background I would be liable to face severe consequences as I should. But, if a patient discriminates against a doctor on those grounds, they can get away scot-free.
Similarly, when it comes to respect (or a lack thereof), a patient can get away scot-free where a doctor could potentially lose their licence.
To give a real world example, a drug seeking patient comes into an urgent-care clinic seeking a narcotic prescription. The doctor recognizes the scam and refuses to provide the prescription. The patient verbally abuses the doctor, insults their family, and then lodges a college complaint (free of charge) making up a bogus story and accusing the doctor of lacking compassion.
The investigation and decision take 9 months costing the doctor tremendous stress not to mention hours of wasted time and lost income. In the end, the doctor faces a consequence which is unfair and punishing. The patient has injured the doctor over and over but the doctor has no recourse for justice.
In a similar situation, if a doctor insulted a patient, what would be the consequences to the doctor?
So, where are the doctors rights? There are none and this is my point.
Again here, we are talking about “best possible medical outcome”. Since when do we make that call in place of doctors and think we can dictate what is a “good level of care”? Just because we don’t get what we want, or think we are entitled to, we say it is a poor level of care? If you think you don’t get the level of care you want, simply visit another one whom you “trust”. I would rather not trust a doctor who does not value and uphold their moral integrity or religious or personal beliefs to find the “best medical outcome” for me.
The best possible medical outcomes are based on the findings of health boards and scientific research, not the religious beliefs of any one individual. This isn’t about getting what we want, it is about providing patients with the alternatives that are approved by a licensed health board instead of those approved by the doctor’s minister.
Playing semantics with questions like what qualifies as a good level of care vs a poor level of care is a red herring. The question is whether there is a reduction in care when the physician refuses to provide some of the most widely accepted alternatives for health care due to their personal religious bias. Clearly refusing to provide a prescription for birth control is a reduction in care, it has the potential to negatively impact the woman’s physical and mental health. In that light the physician is not providing the best possible medical outcome, they are providing a reduced subset of what is widely accepted as the best options for their patients to choose from.
I would rather not trust a doctor who does not have the moral integrity to put their patient’s health above their own personal religious biases.
I appreciate your point of view.
It used to be that doctors were the authority, their word and judgment final and that was the end of it. Now you have a situation where the profession is over-regulated, doctors left questioning their word and judgment, and the power balance in the hands of patients. ‘Patient-centered’ care rules the roost. While it is good in theory, it creates hosts of problems.
For example, it breeds ‘Google hypochondriacs’; patients that look up their symptoms on google, are convinced they know more than the doctor, and then come to the doctor expecting this or that test will be ordered or a referral be made to such and such a specialist.
Their understanding is often superficial lacking the background knowledge that years of medical school and experience brings. It is futile trying to argue with such a patient as they are convinced they are right. The current system empowers them because if the doctor refuses their request they are liable to a complaint which the college is mandated to investigate and ends up costing the doctor months of stress and lost time.
This puts pressure on doctors to accede to inappropriate requests, doing more harm than good. For example, the ordering unnecessary x-rays causes potentially harmful radiation exposure, creates worry and taxes the public purse needlessly.
I believe it’s time for the pendulum to swing the other way and give back doctors at least some power. Protect them from frivolous complaints and put some of the onus on the public to pay (based on ability) a small co-payment for visits and tests. This will help deter unnecessary visits and tests, and help keep our healthcare system sustainable.
Taking away conscience protection would be taking away the right of a physician to be human. We innately have opinions and a conscience regarding various issues. Please do not take this right away from us. Other professions are allowed to have a conscience and so should we.
“The freedom of religion is not protected if it infringes on the rights of others:
According to the Constitution Act of 1982 (http://laws-lois.justice.gc.ca/eng/const/page-15.html)
Rights and Freedoms in Canada:
1. The Canadian Charter of Rights and Freedoms guarantees the rights and freedoms set out in it subject only to such reasonable limits prescribed by law as can be demonstrably justified in a free and democratic society.
This means that where a violation of a right exists, the law will not necessarily grant protection of that right.
2. Everyone has the following fundamental freedoms:
(a) freedom of conscience and religion
15. (1) Every individual is equal before and under the law and has the right to the equal protection and equal benefit of the law without discrimination and, in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age or mental or physical disability.
(2) Subsection (1) does not preclude any law, program or activity that has as its object the amelioration of conditions of disadvantaged individuals or groups including those that are disadvantaged because of race, national or ethnic origin, colour, religion, sex, age or mental or physical disability.
Therefore, if a Canadian’s religious freedom infringes on a citizen’s right then their religious freedom is not protected.”
Here is a case in Ontario where a Ottawa resident was discriminated against based on the fact that she was a woman:
(According to the World Health Organization (WHO), access to contraception is required to ensure the protection of human rights. Reference: http://apps.who.int/iris/bitstream/10665/102539/1/9789241506748_eng.pdf?ua=1).
It isn’t the physician’s humanity that could be removed but the protection of the patient’s humanity that should be protected.
Nonsense. She was not “discriminated against based on the fact that she was a woman”. (That would mean that the physician only provides contraceptives to men.)
Furthermore, she *had* access to birth control. He did not have medical judgement issues or ethical concerns about NFP, and she, by her own admission, got birth control same day through a nearby clinic. She was merely inconvenienced.
A physician is not a pez dispenser or a puppet that you can force to provide whatever you think you want. Coercing a physician to violate her/his conscience and act in a manner that, in her/his professional judgement, causes harm is a dangerous practice.
The physician in question provides the same level of care to anyone who seeks it from him. Your quotes are irrelevant.
The above post was meant as a reply to post # 11, not #10.
No, the idea that refusing to provide basic women’s health care to a woman isn’t discrimination is nonsense! Not providing women’s health care to men also is ridiculous and not a logical statement. Of course you can’t provide birth control pills to men. Just because you refuse both men and women doesn’t make it any less of an act of discrimination.
Not all women have access to “nearby clinics”. Many women live in rural areas where they must drive some distance in order to seek medical aid. If the only doctor in the area were to systematically discriminate against the women in that district by refusing to provide birth control, there would be terrible repercussions for that entire population.
Women are not pez dispensers either, they are people and citizens with rights that supersede religious freedom. By refusing a woman birth control, a doctor is essentially forcing her to conform to his or her religious beliefs. That is illegal, immoral, and against the mandate of the CPSO.
Men and women do not need or receive the same care. Men and women are not the same, biologically. Your comment is irrelevant.
Since you are quite familiar with the constitution and charter, please tell me where I can find the right to birth control. Or for that matter, the right to an abortion, or even the right to health care.
In January 2014 a female Ottawa resident, after waiting at a walk in clinic, was provided with a letter from the attending physician outlining the type of care he would and wouldn’t be willing to provide. The letter cited religious values indicating that he would only prescribe “Natural Family Planning.” The letter also misinformed the patients, implying that a patient required a referral for an abortion (a referral is not required) and that a prescription is required to obtain the morning after pill (the morning after pill is an over the counter medication).
Currently the CPSO’s Physicians and the Ontario Human Rights Code states the following:
“ii) Moral or Religious Beliefs
If physicians have moral or religious beliefs which affect or may affect the provision of medical services, the College advises physicians to proceed cautiously with an understanding of the implications related to human rights.
Personal beliefs and values and cultural and religious practices are central to the lives of physicians and their patients.
Physicians should, however, be aware that the Ontario Human Rights Commission or Tribunal may consider decisions to restrict medical services offered, to accept individuals as patients or to end physician-patient relationships that are based on physicians’ moral or religious beliefs to be contrary to the Code.”
The above cited policy document was criticized in the Submission of the Ontario Human Rights Commission to the College of Physicians and Surgeons of Ontario regarding the draft policies relating to establishing and ending physician-patient relationships:
“While the expression of their religious beliefs is essential for religious officials in the performance of their duties, secular service providers cannot claim that the performance of their job functions is an expression of their deeply held religious beliefs. The Supreme Court of Canada recognized in the Trinity Western decision that providers of public services are expected to essentially “check their personal views at the door” when providing a their services. For example, in Hall v. Powers, a Catholic school board was required to allow a male student to attend the prom with his boyfriend because, although the board was entitled to hold beliefs against homosexuality, it was not permitted to act on these beliefs in a discriminatory manner.”
According to the World Health Organization (WHO), access to contraception is required to ensure the protection of human rights. The current policy of the CPSO allows physicians goes against the WHO recommendations. For a quick summary of recommendations please see the summary recommendations on page 9 and 10 of the document Ensuring human rights in the provision of contraceptive information and services (http://apps.who.int/iris/bitstream/10665/102539/1/9789241506748_eng.pdf?ua=1).
Why the CPSO policy NEEDS to be changed:
The CPSO’s current policy document is open to interpretation and vague on the college’s policy regarding a physician’s religious beliefs influencing a physician’s delivery of care. Physicians are providing a secular public service and therefore should not be implementing faith based practices.
The CPSO’s policies should focus on patient care and the policy as written protects the physician and is not in the best interest of the patient.
Why this is a gender issue:
As pregnancy is a health issue that only affects people with a uterus, and as not all genders have a uterus, access to contraception and information about contraception is a gender issue. Not providing essential care to a specific group is discrimination. For various reasons an individual may wish to prevent pregnancy and access to contraception should be protected and not limited by a physician’s religious beliefs.
A barrier to care:
A physician refusing patients or patient care based on religious beliefs is a barrier to care.
Allowing for religious beliefs to influence a physician’s practice is especially dangerous to vulnerable and minority populations: gender minorities (cis-women, transgender*, non-gender binary, etc), sexual minorities (gay, lesbian, bisexual, etc), religious minorities and people of colour.
For many reasons Ontario residents do not always have the luxury to pick a physician and as a result have to rely on walk-in clinics or have a limited choice in physicians. This limitation is not exclusive to family practices and can extend to other specializations. Here are a few reasons Ontario residents may not have a regular family doctor or not have access to the care they need:
- Rural area with very few physicians
- Discrimination based on gender, sexuality, religion, race, etc.
- Limited physicians in a specialization
- Recently re-located and have not found a family physician
- On a waiting list to get a family physician
- Due to work schedules may have to rely on after hour clinics
- Vacationing in Ontario
When prescribing care, a physician should take into consideration the wishes of the patient, even if the patient’s wishes conflict with the physicians religious beliefs. If we allow a physician’s religious beliefs to influence a physician’s delivery of care it further limits the access to care for some populations.
Physician’s do not dictate public morality:
The religious morality of a physician should not be allowed to dictate a patient’s treatment or influence the information provided to a patient especially if the information could be misinforming the patient or a potential patient. A physician’s religious morality does not dictate public morality and therefore should not influence medical ethics and the administration of public care.
Science based medicine:
If a physician has legitimate medical concerns regarding a course of treatment the physician should voice those concerns with the patient. However, if the physician’s concerns are faith-based and not scientific, the physician is interfering with the patient receiving quality medical care. Medical treatment should be based on science and take into consideration the needs and wishes of the patient, not the physician’s personal religious beliefs.
Religion does not have a place in the medical community. The medical community should rely on medical science and not be based around systems of belief or faith. The CPSO’s policy should not allow for the refusal of patients based on a physician’s religious beliefs. The policies also should not allow faith based care if it goes against a patient’s wishes or is discriminatory.
A conflict of interest:
If a physician holds a religious belief that could interfere with the physician’s ability to perform the regular duties of a practice or specialization, the physician should not practice or specialize in the area that would cause a conflict.
For example: For religious reasons a physician will not prescribe oral contraception. The physician should therefore only practice in specialties where prescribing oral contraception would not be a regular duty (example: otolaryngology). If a family physician holds personal religious beliefs that people should not use oral contraception but is willing prescribing oral contraception to patients, there is no conflict of interest and can provide care as a family physician because their religious beliefs do not interfere with the physician’s regular duties.
The CPSO’s policy should prevent any conflicts of interest based on religious beliefs at an early stage, not in the medical facility.
Public opinion can harm minority populations:
The decision to allow physicians to exercise religious freedoms that discriminate or infringe on the rights of others should not be left up to public opinion if the public opinion is discriminatory towards minorities and vulnerable populations. It is the responsibility of the CPSO to ensure that their policies protect the rights of minorities and vulnerable populations. The current CPSO policy does not protect minorities and vulnerable populations.
The freedom of religion is not protected if it infringes on the rights of others:
According to the Constitution Act of 1982 (http://laws-lois.justice.gc.ca/eng/const/page-15.html)
Therefore, if a Canadian’s religious freedom infringes on a citizen’s right then their religious freedom is not protected.
I agree that physicians do not dictate the public morality. My question is what does? The charter of rights and freedoms is not nearly comprehensive enough to allow for the many moral decisions faced by doctors every day. Which moral system do you suggest? Utilitarian ethics? If we are requiring doctors to act in accordance with some moral standard, it must be clearly stated and agreed upon. In the absence of such a system, the best we can do is to allow doctors to practice in accordance with their own moral standards, whether arrived at personally or through religious belief. What is the moral foundation you propose to support the system you are proposing?
You are quoting the Ontario Human “Rights” Code which is not the law of the land and may in fact promote opinions contrary to the Charter. In fact the Canadian Charter of Rights and Freedoms defines the rights of the Canadian people. These rights cannot be infringed by any government or legislation (including human rights legislation).
The second most important freedom for the Charter is Freedom of Conscience and Religion. What good are those freedoms if a person cannot practice them? You may not agree with another’s religious perspective however we do not live in an absolute secular society providing absolute secular services. That is misinterpretation of fact or else how can we say people are allowed a religious perspective which by its very nature is an integral part of human cognitive nature protected by Charter yet you condone discrimination against a protected Charter recognized right of an individual to his genetically formed cognitive religious/moral brains while at the same time argue that if one has a belief they are transgendered, defined as a mental illness, then that person cannot be referred to appropriate medical treated, for which there are several options by a medical professional or a medical professional cannot addressed a person with having such a mental disconnection with a person’s physical and metal self for doing so according to you and OHRC but not the Charter is a form of discrimination. People with such illogical thinking should not be telling others how to behave.
Last time I checked to create HUMAN life it is required the EQUAL amounts of chromosomes, 23 single chromosomes from the egg of the mother and 23 single chromosomes from the sperm of the father not merely the egg of the female. When the two unite, the chromosomes combine, giving the new cell the proper number of 46 chromosomes. Thus both a man and a women create life as a joint effort, thus both become pregnant however nature or God (or greater being) only necessitates through biology one of the two sexes, the female with the ability to gestate that new HUMAN life with a purposeful build organ for only this function, the womb until it is most viable outside the womb. Therefore both have equal right to that life and thus equal responsibility as so many single mothers have argued in court when it comes time to support that child. This biological and scientific fact may not be recognized by the politicised OHRC however there ignorance does not deny the facts. Birth rights are based on laws of a religions dimension which predate our civilization and from which we actually look to formulated our laws therefore it is legitimate for those with conciliatory views to exercise them since in fact they have always been there and were exercised as part of our defining culture. To deny them today is discriminatory.
Further the WHO is trying to promote the murder of the unborn as a medical necessity around the world and had even gone so far as to say the Vatican teaching on abortion may be a form of ‘torture’??? What possible legitimacy can such a body have after such flawed logic?
Doctors do not dictate public morality they do however from a port of it and thus they are entitled to their share, entitled to practice them, entitled freedom to express them, entitled to shape their lives around them and entitled to promote the sanctity of life and only those procedures that save lives not terminate them. Have you read the Hippocratic Oath?
Further, almost every major hospital and school in Canada was founded by faith based religions institutions (predominantly Catholic or Protestant) whether you like to acknowledge it or not therefore religious conscious was utilized as the building blocks of these institutions. They were an integral part of the health care based serveries offered in Canada. It is only in recent times that people like you are choosing to discriminate against these facts and deny their continual use. I suggest you read St. Thomas Aquinas “Acclaimed” to understand that this so called distinction between science and religious thought is in fact mere opposites sides of the same hand bound to coexist and necessary for the others existence. How can man’s laws be legitimate if they violate natural law if they violate the sanctity of life? Therefore a moral bias is inferred and where that come from is man’s human brain thus a moral code predicated on religious belief does have a place in medical practice.
By the way secularism is just another belief system opposed to all religious beliefs and/or practices systems where by the state remain merely independent of them. This is simply just another man made construct. A secular social order may or may not be antagonistic towards religious thought or beliefs and our Charter is clear that religious free thought is an integral part of our society thus people can chose to promote or demote it but it should never be denied. Thus a doctor should never be denied employment or practice simply because his opinions, religious or otherwise contract yours. A just and tolerant society recognizes the other that is why these faith based medical institutions which existed before any other have grown to accommodate the other. Now it seems their charity is being repaid by people such as yourself with intolerance and hatred for another.
Further as evidenced by those that promote the secularist doctrine, it is used as a means to attempt to silence their opponents and obfuscate debate on issues of moral significance. Why should man be prevented from exercising his conscious beliefs whether shaped by religion or otherwise when they concern the treatment of others with an outcome which affects all members of society? A moral good may deny another from taking a certain act however not all acts should be considered neutral in consequence. The Charter does recognize “Canada is founded upon principles that recognize the supremacy of God and the rule of law” Thus in order to legitimize our laws and actions we must consider His will as legitimately expressed thought religious texts most of which predate our civilization.
Great … someone who believes life begins at conception and that rapists have the same rights as their victims.
Life beginning at conception is a fact for those of use that acknowledge and accept the science of facts and a belief only for those that evangelize the denial of that fact through the deceptive use of “pro-chose” since the unborn are given a 50% chance of no choice in a “pro-choice” argument.
Second all nationals of Canada must have equal rights and protections under the law and assumed innocent until proven guilty or else we have no just society. If a person is found guilty then they must be punished in the most appropriate manner which leads to redemption and correction of wrong behaviour however it does not necessitate that the unintended human life be murdered for the wrongs of the father.
As a matter of fact, life does begin at conception. And by definition, human rapists do have the same human rights as their human victims. But the comment which you were commenting on does not defend rapists. It condemns the prenatal violence tolerated by many Ontario residents, apparently you too.
This argument is in point of fact, self-refuting as it cannot reconcile two mutually refuting clauses.
This respondent asserts that, “A physician refusing patients or patient care based on religious beliefs is a barrier to care.”
Later, the respondent states, “If a physician holds a religious belief that could interfere with the physician’s ability to perform the regular duties of a practice or specialization, the physician should not practice or specialize in the area that would cause a conflict.”
Where the pool of potential physicians is artificially limited by a policy forcing those physicians who have certain religious beliefs to practice a specific, non-generalized form of medicine creates a much more pervasive and systematic barrier to be able to access care.
Since this respondent has pointed specifically to the issue wherein a woman approached a walk-in clinic with the intent of obtaining a prescription for oral contraceptives, the respondent goes on to make a tremendous leap in logic; namely, that the doctor’s primary motivation was for religious reasons, and not out of exercising his best medical judgement.
For instance, it is well-established in the medical literature, but not necessarily well-known that hormonal contraceptives increase the risk of venous thromboembolic events, (VTE’s) [http://archinte.jamanetwork.com/article.aspx?articleid=217495&quizId=1795&atab=8], which can have serious consequences on a patient’s health.
Though the absolute risk is low, medical prudence would seem to dictate that any doctor, whether for religious reasons or no, may hesitate to prescribe oral hormonal contraceptives in the context of a walk-in clinic, if only because there is absolutely no guarantee of securing follow-up visits with the patient.
What is forgotten in the respondent’s discussion seems to be that the doctor in question may have chosen to err on the side of medical prudence. Indeed, if a complication had resulted from prescribing the desired drug when it may have been unsafe to do so, would the doctor in question not have faced possible discipline by the College? Is the College really willing to force physicians to hazard their careers by forcing them to prescribe drugs when it may be dangerous, or irresponsible to do so?
That the risk is low cannot be allowed to prevail in such matters. A physician must be accorded the absolute right to exercise their medical judgement in such matters. That this judgement may, or may not be informed by religious considerations is utterly irrelevant, when it can be plainly established that though it is perhaps over-cautious, the social concerns or certain political groups, or even the desires of the patient themselves cannot be allowed to override the prudent and sober medical judgement of licensed physicians.
Finally, with regard to religious considerations specifically, there is the issue that changing the policy as it exists to a policy where physicians must comply will inevitably create an environment of systematic anti-Catholic discrimination.
In Humanae Vitae, Pope Paul VI clearly, and unambiguously states that contraceptives are condemned by the Roman Catholic Church, “Equally to be condemned, as the magisterium of the Church has affirmed on many occasions, is direct sterilization, whether of the man or of the woman, whether permanent or temporary.” (http://www.vatican.va/holy_father/paul_vi/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae_en.html)
Where doubt may exist in the phrase of Pope Paul VI, the Catechism of the Catholic Church is absolutely clear, “In contrast, “every action which, whether in anticipation of the conjugal act, or in its accomplishment, or in the development of its natural consequences, proposes, whether as an end or as a means, to render procreation impossible” is intrinsically evil” (http://www.vatican.va/archive/ENG0015/__P86.HTM)
As Canada is not a Catholic society, but rather a society which contains Catholics, Canada would undoubtedly assert that an individual has the right to use contraception, or not, as they so choose, and the Church is not free in Canada to prohibit even its own members from accessing contraception, but by their own willing submission to the directives of the Church.
However, this is not sufficient for an observant Catholic physician. Though many do choose to ignore the directives of the Church, some do not, and with regard to prescribing contraception, which is the issue at hand, to co-operate in the facilitation of an act which the Catechism of the Catholic Church defines as intrinsically evil is also to do evil. Specifically, it is the sin of scandal, whereby a person knowingly entices another to behave in an unethical fashion.
Thus, the ethical action for a Catholic is to refuse to participate, regardless of the particular identity of the patient. At no time should this be understood to mean that it is acceptable for a Catholic physician to demonstrate any racism, sexism or other prejudice towards a patient, and indeed, to refuse to participate in the provision of contraception is not a refusal to provide other unrelated services.
Compelling physicians therefore to prescribe contraceptives will create a barrier to entry for those Catholics who choose to faithfully, and lawfully observe the teaching of the Church, and cannot be other than a form of unnecessary and unjust discrimination.
If the College should elect to modify its policy so as to compel Catholic physicians to provide contraceptives, and possibly participate in abortions, will the College similarly lift its prohibition on female circumcision? Will the College permit, or compel physicians to assist in euthanasia?
Changing the policy as written will create a dangerous precedent, and I urge the College to uphold the human right of a physician to act in accordance with their conscience.
Physicians need to provide medically necessary services that they are qualified to provide. If they have strong personal beliefs that would prevent them from providing certain services they need to communicate this clearly to patients as early as possible in the professional relationship and there is an obligation to refer the patient to another physician who can provide the care, if he independently determines that it is medically necessary.
Physicians are people too and have a right to their beliefs. It is however totally unacceptable for any person to prevent access to specialized care for any reason other than medical necessity.
On becoming a physician, and a physician in Canada, a secular free country, my obligation is to treat everyone irrespective of creed race etc. I am observant jewish, yet at no time would I hesitate even for 1 second from treating someone. It is my obligation.
What appals me is that this question has even arisen, and that the votes are in the yes majority. Not one of my colleagues, has ever held back from treating someone because of their religion. If the yes votes win, and a physician can back out of treating someone based on their religion, we have just destroyed the fabric which makes up Canada. All humans are EQUAL.
As an Ontario resident I would like to thank you for your comment and your approach to your practice. Thank you.
Surely you’re capable of seeing that it’s all in the term “treatment”. If your conscience told you that something others see as treatment is actually quite harmful, you wouldn’t do it, would you?
Thank you so much for your clear thinking on this emotional issue. Biases are a part of every human being. All of the experiences that we have had will influence us and what we perceive to be “right for our conscience”. Since everyone has had different experiences, we will all have a different conscience and biases.
My issue is the people who keep saying that a physician has to stay true to his conscience to have integrity. I believe the opposite it true. A physician with integrity is a physician that recognises his own biases and is willing to maintain his professionalism in spite of them. Treating all humans as equal is a part of that integrity. Another part of that professional integrity is as you say, recognising that the physician’s religous or personal biases cannot compromise the treatment choices that are presented to patients.
Your argument conflates “treating everyone” with “providing whatever services a patient demands, even if one feels the practice does harm”
The question that has arisen is about making an ethically-informed professional judgement about providing or declining to provide certain specific interventions, not about refusing to treat whole groups of people based on religion. One can decline to provide certain types of services, and still treat all people equally with the human respect and dignity that is owed to them.
This is Canada, thankfully, and we have freedom of religion and conscience. Physicians already have the right to limit their practice, and the ability to “back out of treating someone” is a moot question, because if the physician is following your professional body’s expectations, s/he would have communicated “clearly and promptly” that they do not perform certain interventions at the outset.
We all agree that All humans are EQUAL, though I fail to see the relevance.
“All humans are EQUAL”–whether inside or outside the womb? Then why does OHIP fund abortions, and why do many pharmacists and surgeons refuse to cause them?
Equal in what? Men and women are not equal in anatomy. Fetuses and octogenarians are not equal in age.
God keep our land glorious and FREE.
Doctors are not civil servants, and we look to them to give us their best advice and opinions. If we say doctors cannot have opinions, that patients are allowed to dictate their wants to a physician, then what good is a doctor? Whether or not to do anything is a moral decision, and to point the finger at those with religious backgrounds is prejudice. Doctors refuse to do procedures all the time. They might tell a thin woman that she can’t have liposuction, they seek to do what is in the patient’s best interest from their perspective. We should value their morality and not punish them for it.
First of all, I would like to address the need for PAS/E. I practice chronic pain medicine on a referral base only and I have yet to see a patient who cannot be helped in some way – and chronic pain is lived day in and day out over many years. Canada needs nation-wide quality palliative care services and if such were to be available I think that the demand for PAS/E would greatly diminish – possibly melt away – the fear of dying would be greatly reduced.
Secondly, I would like address the coercive aspect. There is the potential of physicians being coerced to provide, or refer to, PAS/E services whether they support this or not. Supporting PAS/E could be a condition of medical licensure [in a worst case scenario], the provision of hospital privileges; it could also become a legal matter for the courts, subtle and not so subtle pressures on academic promotion, and hospital medical leadership promotion. This is a freedom of conscience issue. I have no wish to see a totalitarian approach to the practice of medicine in Canada – whether it is from the ’right’ or ‘left’ – where life is cheap as we have seen in both the past and present.
Thirdly, one has to ask the question whether PAS/E is good for the ‘fabric’ of society. I would suggest that anything that devalues the value of human life devalues the value of society as a whole – as Trudeau once said ‘we live in a free and democratic society’ and this needs to be maintained.
I think it is important to distinguish between being unwilling to provide general care to individuals based on their race, religion, sex, orientation, etc. and not providing specific aspects of care (i.e. euthanasia, abortion, birth control) while still being willing to generally care for the patient.
The former is bigoted, based on a categoric hatred and rejection of that subgroup with out any individual knowledge, and should not be permitted.
The later is motivated by the belief that those specific actions are harmful to the patient and therefore not in the patient’s best interest, even if there is a disagreement on that with the patient.
Very different motivations, and they need to be handled differently.
I think the CPSO policy does a good job of making that clear. It bans the general discrimination against a person based on their characteristics. It also fairly requires the physician in the latter case to be clear and up front about what their morals are, and how they may affect the patient, allowing the patient to decide if they are willing to participate in the relationship.
I hope the current policy is not changed.
But what if the belief that it is harmful has no basis in observable reality? I mean, let’s say that the physician believes that by doing something will harm the patient’s soul. No one can prove, in any way, that harm will or will not be done, but the physician insists that it will.
A physician who is unwilling to provide birth control or refer for abortions, is a “rejection of that subgroup with out any individual knowledge, and should not be permitted.”
Thank you for this clarification. I think a lot of people are losing sight of this distinction. Why are people so eager to have doctors who will harm them just because they asked for it??
I also hope it isn’t changed
since when it is a given that MDs are the designated to euthanize patients or “assist” in suicide. I dont feel our profession should assume we are the “chosen” ones to take lives. Anyone can assist in death in many ways. our patients will be very confused if we are at bedside to decide if we are there to cure, comfort or kill them. our profession will become more schizophreic than it is now.
thank you for your great insight. when we talk about these policies of physicians assisting in taking a life, we must picture the bedside, as you state. Picture a ward full of people screaming, keep that doctor away from me !!
constantly, the College comes up with new and “innovative” policies measures to police doctors better on old issues like this. I can see wanting to make a new policy on a new program like telemedicine, but not this.
Is it ever enough? Will there a point in time when the college says that yes at this point we are doing enough to police doctors.
We have a justice system in Ontario. If a patient feels violated about their human rights, they can and should sue the physician in the court of law, and not try the physician at the College which is free of charge for the patient and and lacks transparency and consistency for the physician. Physicians are citizens of society too and should be given the same protection of law as patients.
My advice to any young person wanting to become a physician: DO NOT! As all it takes is one patient complaint to end the career you invested your whole life in.
If the government is trying to legalize the killing of patients – Then the government MUST provide their own non-medical executioners.
We Physicans must NEVER be forced to kill
Our job is to save lives and to provide kind palliative care in the terminal phase of life
Hipprocates was right
We need to reinstate the original Hippocratic Oath for ALL doctors
Do patients want to be looked after by doctors WITH or WITHOUT moral integrity ?
Denying our FREEDOM OF CONSCIENCE creates doctors WITHOUT moral integrity
Most physicians/medical students take some form of Hippocratic Oath, to “do not harm, provide best care and not provide poison to patients with intention to kill the patient and older version also had reference to not aiding in aborting fetuses on request”, aside from religious beliefs there are also some universal moral and humanitarian values, like not killing another human being, and main issues really are abortion which is legal and accessible for both medical reasons as well as “women’s choice” and maybe it is a good thing that it’s not readily available on every corner, as gives women time to reflect and maybe change her mind, as abortions are not harmless and have potential repercussions physical and psychological for the woman.
A new issue now is legalizing PAS and Euthanasia and what would be expected from physicians and nurses once this becomes an option, I do not see myself giving patients “lethal injections” and should not be expected or forced to do so, and by the way that’s not because of any religious beliefs but because I believe that taking human life is wrong. The answer to suffering at the end of life is more access to palliative care and there is already option for Palliative terminal sedation as last resort for unrelieved pain and suffering….
Physicians should remain able to refuse to perform certain tasks based on their own beliefs. If you force a physician to do something which they see akin to murder then that could negatively impact them for the remained of their lives. Someone should never be put in that kind of situation.
If a patient does not agree with or like a certain physicians viewpoint then they are capable of consulting another.
The human rights codes of Ontario and Canada apply to all residents of Canada AND are legal matters. If patients have issues with a physicians regarding their rights violations, they can take it up with courts or the human rights tribunal. The College is not a legal body and should have no business in this matter.
It is discrimination against the professional rights of the physicians for this matter to be addressed at the College, which by all legal standards, lacks transparency, objectivity and most of all consistency. The same exact complaint can end in a public reprimand or revocation against one physician and nothing against another.
The College lacks objective due process for the accused, the physicians in this case, and due legal process is a human right in Canada. Aren’t physicians humans?
If I had known how I would have no rights to a sound legal process to defend my life’s work and reputation, I would never have become a physician. And my advice to my kids and all young people is the same: DO NOT RISK YOUR LIFE’S WORK AND AMBITION IN A PROFESSION WHERE EVERYDAY YOU GO TO WORK IS LIKE ROLLING DICE WITH YOUR FUTURE AND REPUTATION. Do not become a physician.
I firmly believe that a policy that forces doctors to “check their ethics at the door” would not only endanger all patients, but would also spell the end of our free and democratic society, by excluding from the professional life many excellent doctors who refuse to violate the moral and religious teachings of the Christian, Jewish and Islamic religions among others
You are confusing “ethics” with “religious views.” They are not the same. An ethical doctor will check their religious biases at the door, and base their practice on the best possible health outcomes for the patient. Modern health practices should be based on the scientifically researched and validated practices that are demonstrated via repeat trials to provide the best possible mental and physical health outcome for the patient. Whether or not the writing of a bunch of goatherds from two thousand years ago agrees with those best practices is irrelevant to modern health care. Any doctor who gives higher weight to their own personal religious views than to the best information from modern medical research, is not behaving in a professional or ethical manner.
Actually you are confused since “ethics” are shaped by “moral” thus “religious views.”
Now you are confusing moral with religious views, and once again they are not the same. History shows that religious views can be either moral or immoral, and as such should not be used as the definition of ethical behaviour.
If you worked in the medical profession, you would know that many of the difficult decisions being faced by patients and physicians are in fact ethical dilemmas, not questions open to clinical trials. This code addresses those questions specifically.
There are many people that object to euthanasia based on ethical and moral, not religious, grounds. Is our opinion also invalid?
How is forcing someone to act against their conscious not an infringement on their human rights? Our ability to choose is what gives us our humanity. A physician has the right not to perform a treatment they think is harmful in the same way a patient has the right to refuse a treatment that is beneficial. We are equals. The patient does not own the physician any more that the patient owns the physician.
There is more at stake than the rights of doctors and medical personnel or even the rights of the patient. If is about the ethical and cultural foundations which defines our society. Thus the CPSO must not narrowly define the real debate as one of just religious and morals versus politically driven Provincial Human Codes which may in fact violate the Charter. Rather this debate is about the future dimension of what we call “civilized” in our present “civilization” and how we treat all members of our society especially the most venerable. Any man made law or code which violates the maintenance and promotion of life, quality of life and standard of living is a violation of natural law, a degradation of the person and discriminates against his right to life as defined in the Charter s.7. Any law or procedure which violates or terminates life is absolute in nature, that damage cannot be undone and denies that person the right to those principles so important that we enshrine them in law. Further a society is made up of persons regardless of how we define their professional competencies, physical and metal capacities and their capacity is legitimately shaped by their religious, moral and conscience thoughts forming the fundamental building blocks of our society. To suggest that they may be trade like currency or auctioned off is a violation of our very foundations and legal rights collapsing the principles of legitimacy of that society and thus invalidating its use unless we chose to deconstruct society and repurpose its existence as a means to terminate life not promote it. No person regardless of position is society can compel another to violate life that is why we have eliminated the use of the death penalty, yet incredibly CPSO is debating whether a doctor should be allowed to expresses this professional conduct in promoting life which may or may not be shaped by a personal religious dimension but rather a professional or human perspective? Should it not be the default position of the CPSO that its members are empowered to save lives at all efforts regardless of costs and every medical professional is charged to defend that position until the end even when there are some who’s quality of health are not harmed or in jeopardy nonetheless desire procedures to terminate life? Not only are a doctors actions in objection to termination justified on moral, religions, conscientious and human grounds but to the natural recognition that those whom voiceless are always given the legal benefit of choosing life. Any rational person when given the choice between quality of life and death will rationally chose life, if not it will not do the injured patient any benefit for a medical professional to deny rational thought by appeasing the irrational considerations of the patient though referral to another whom motivated by profit will violate and do harm to the injured patent and by those vary actions bring shame, disgrace and harm the very nature of the medical profession, promotion of life.
If Canada is truly a free nation as it claims to be, then freedom of conscience is not open for debate. Denying physicians this freedom directly contradicts what this country claims to stand for.
I believe that if a patient doesn’t agree with a doctor’s professional judgement about the best course of treatment they can always get a second opinion or pursue other treatment options. Other professions are given the opportunity to make these calls and so should physicians.
I strongly believe that physicians need to retain the right to follow their conscience in terms of critical health-care issues such as reproductive technologies and right-to-life perspectives. The ability to follow, unfettered, their conscience is necessary for physicians to retain integrity in the practice of their profession. Judgement calls are part of the everyday practice of medicine and, as such, are also part of a physicians right to personal choice. Access to reproductive technologies at all levels are not inhibited by a physicians decision not to grant them in a particular instance. Our public system guarantees access and thus the decision for any one physician to make decisions based on his or her conscience protects the rights of all. Equal access to personal choice is a value we must uphold for all concerned — including our physicians.
It will be a dangerous world if we force doctors to do what they think is wrong.
I am against any policy that would force doctors to do what they think is wrong, especially when there are options for the patient to seek care elsewhere in a reasonable time or with slight inconvenience.
You cannot legislate good, up to date medical practice because it is an art which balances technology, scientific knowledge, observation and knowledge of the patient, social sciences and compassion in the context of a doctor who has integrity, and who won’t do what he or she thinks is wrong for the individual or family.
No, a doctor should not have the option to refuse care on any ground.
Let’s begin with the Oath to the profession – the Hippocratic Oath. Does the Oath allow for exceptions? Do no harm, therefore, period!
Human rights codes prohibit unlawful discrimination based on prescribed grounds of the Code. If a doctor refuses care on any ground of the Code, they must be subjected to consequences equal to any meted out to other violators.
The complication might be competing rights as in rights based on the ground of creed, for example, that may compete with a claim of discrimination on ground of sexual orientation.
The analysis in such a case, must use multiple lenses and employ procedures for resolution prescribed by Human rights policy.
The CPSO must play its part by informing future prospects about Code requirements so that anybody who chooses to join the profession will do so with full knowledge of Human Rights law, policy and procedures.
Please note the Ontario Human “Rights” Code which is not the law of the land may in fact promote opinions contrary to the Charter. In fact the Canadian Charter of Rights and Freedoms defines the rights of the Canadian people. These rights cannot be infringed by any government or legislation (including human rights legislation).
Since you are supporting the Hippocratic Oath then it follows that you support right of refusal by doctors to take the life of he unborn. I agree, this natural right to do no harm must be protected at all costs even if it violates a man made changing law or code. This Oath was not formed by Christian religious philosophy but in fact shaped by it.
To whom it may concern,
I just wanted to inform you of my support for clear and unequivocal language in your Policy that guarantees and protects the freedom of conscience of physicians and other health care workers, including the right to not participate in procedures that would violate the health worker’s conscience.
This is particularly important as the euthanasia issue comes again to the fore, but is also important for those who have moral objections to abortion and other procedures. We must not exclude bright and promising individuals from the medical profession based on their moral values or religious beliefs.
When I interviewed for medicine in 1992, I was asked if there was anything I felt I might have trouble doing as a medical doctor. I said I would never be able to perform an abortion. I was not asked to explain why but the answer is that I would be violating my conscience, in that I believe that life begins in the uterus and not at the time of birth and that I don’t actually believe women should have the freedom to abort a child simply because we choose to. While I did wonder after that interview if I had ruined my chances of becoming a physician, I was willing to give up a career in medicine, in order to be true to my convictions. Never did I dream that in the future I might be called on to take a life, in the form of physician assisted death and could lose my license if I refused. I strongly believe we should have a choice not to do things that are against our moral convictions. Although I love my profession, and am dedicated to my patients and their needs, I will stop practising voluntarily rather than be forced to do something I feel is morally wrong. To date, most people I work with would tell you that I’m committed to always trying to do the right thing and that that quality builds people’s trust in me and is an asset. If I can’t follow my conscience, I will find something else to do with my life, despite the regrets that I would be left with.
Your paragraph has convinced me that you have made the wrong career choice. If you believe that your own personal code of ethics is more important than the best possible medical outcome for your patients, then perhaps you should have become something that does not require you to make decisions that impact the health and well being of other people.
Your moral convictions are yours alone and they should never be foisted upon others, especially to the possible detriment of that other person’s physical or mental health.
If you do change careers, be careful what you choose. There are very few careers out there where they let you choose your own ethical agenda over the best interests of the people you serve. Police, teachers, lawyers, and the list goes on. All are required to put their personal opinion aside and serve all people to the best of their ability. When was the last time you saw a police officer picking and choosing which laws he wanted to enforce based on his own personal or religious biases? Just because you do not personally agree with abortion does not make it illegal in this country, and does not mean that you have the right to negatively impact the physical and mental health of women in this country.
Dear Member of Public, you seem very confused. Since when can one equate the taking of life as a medially positive thing to do for the life of the person taken, especially when that life was not given a choice? This is not a religious issue but a question of what type of people we chose to be. One which value life at all cost and recognize that not all choices are equal and good or one which bitingly succumbs to the will of nature unfettered by issues of right or wrong, good or bad, just or unjust? How do you think society is formed if not by addressing such philological questions such as these? You suggest that we be void vessels, the will of the dictator and his instrument of what ever he choses as right or wrong. I guess you are a supporter of the most despotic of societies such as Nazi Germany under Hitler which essentially followed his dictates regardless of moral objection. Those German police and solders should have been able to use the defence of law to justify their actions during that regrettable time. However the Nuremburg trials did not accept these arguments since no one has the right to exercise aggression, war, genocide and mass murder against another regardless of local law or “Human” code.
Dear Member of the Public,
You say to Physician #30, “Your moral convictions are yours alone and they should never be foisted upon others, especially to the possible detriment of that other person’s physical or mental health.” Do you not see that is exactly what you yourself are doing by suggesting that physicians who conscientiously object to abortion should provide abortions anyway? That is your moral view, and you want to “foist” it on all physicians. Why is your moral view superior to the view of those who object to abortion?
You also say: “Just because you do not personally agree with abortion does not make it illegal in this country, and does not mean that you have the right to negatively impact the physical and mental health of women in this country.” No one is saying abortion is illegal in Canada. The issue is not whether abortion is legal, but whether it is ethical. Not everything that is legal is ethical; some people would say adultery is unethical, but it is still legal. So the fact abortion is legal does not help us to resolve the issue of whether or not it is ethical.
And when it comes to the “physical and mental health of women” there is much research to suggest that abortion actually increases the risk of physical and psychological harm to women. If you choose not to believe the research, you are free to do so. But, again, why do you have the right to foist that view on a physician who may genuinely believe, after analyzing the research, that abortion does increase the risk of harm to women (and even more so in the later stages of pregnancy)? A physician may genuinely believe that an abortion, although legal, is not only not in the best interests of the prenatal child, but also not in the best interests of the woman. Would you force a physician to offer a procedure to a woman that the physician believed in good faith would actually cause more harm than good?
It is important to remember that when the Supreme Court struck down Canada’s abortion law in 1988, it did so only because of procedural flaws inherent in the particular abortion law that was in effect at the time–the Supreme Court did not recognize a Charter right to abortion as abortion proponents often claim. And importantly, the Supreme Court was unanimous in saying that the state has an interest in the protection of the fetus.
So with no more criminal restrictions on abortion in the wake of that 1988 decision, abortion by default fell to the medical profession to deal with. And certainly, if an abortion is going to be performed, we don’t want anyone other than medical professionals performing it, for the sake of the woman’s health and safety. But that is very different from saying that physicians have a duty to provide abortion, or by extension, a duty to make abortion referrals (since referral for a procedure involves complicity in that procedure.)
So given that the Supreme Court has never recognized a Charter right to abortion, and that there is no consensus amongst Canadians on the morality of abortion, and that there is some evidence that abortion can actually harm women, and that most abortions are not done for health-related reasons but social reasons, and that freedom of conscience and religion are protected by the Canadian Charter, and that while the Supreme Court has recognized that the state has an interest in the protection of human life, it has never recognized a state interest in the destruction of human life—given all these things, it’s unclear to me how CPSO would be able to justify any policy that would punish physicians who abide by their deeply held conscientious convictions not to take any part—either directly or through referral—in the deliberate destruction of a human life.
I think this specific example clearly demonstrates how the quality of our health care system will deteriorate if we do not allow doctors to follow their conscience. If we do not allow doctors to follow their conscience, and assuming they have one, would we not lose them as health care providers. In order to truly “care” for a patient, does one not need to have a conscience.
It is easy to use a scenario and angle its perspective to accommodate our opinion. We need to be careful. At the end of the day, if we lose good doctors, will that not hurt us? If I were considering the health care profession, but understood that there was a possibility where I might be forced to go against my beliefs, or go to jail (or some kind of significant penalty), I would not consider the profession. Many might accept this, but would it not be better to have the best available talent providing the best possible health care at least 99% of the time. Or, would we accept less talented doctors providing the best care they can 100% of the time.
I am happy there are physicians like you who are highly ethical and moral even to the point of personal loss. Thank you. We need doctors like you and no doctor should be forced to act against his/her conscience.
Thank you for the opportunity to participate:
Any policy on controversial issues especially those related to beginning/end of life need to uphold physicians’ freedom of conscience. The emphasis on current and past policies seems to be slanted towards patient’s rights over and above the physician’s rights.
Communication is important. Compassion and voiced non-judgementalism are critical. Physicians must always act in a caring manner towards their patients. They must hold high the best interests of their patients at all times.
Physicians all operate within their own moral framework whatever that may be. This cannot be isolated or excluded. Physicians who cannot practice in the context of their moral beliefs cannot be true to themselves and therefore will not practice good medicine. Physicians need to always communicate wisely even when they see that a patient could be making a grave error in desiring a procedure. This has to be done in a caring and non-judgmental way. This is critical to the maintenance of an ongoing honest and healthy therapeutic relationship.
Physicians should not be mandated to refer a patient for procedures or treatment that they cannot support from a moral or religious point of view. This is contrary to basic human rights- those of the physician. This is especially true when it comes to issues related to beginning and end of life. This does not take away the right of the patient to go elsewhere or seek out the procedure on their own. One must consider the prevalence of access to information in Canada through the social media which has greatly empowered and expanded patient knowledge and has decreased reliance on the “referring capability” of the primary health care giver.
There has to be a balance between the above competing principles.
There must be respect and support for both the human rights of the patient and the physician.
The College should not be swayed by political or social activism to the detriment of what constitutes ethical and sound medical practice.
Many physicians go to school to save lives, not take them. A physician should not be forced to take a human life.
I went to school to help alleviate suffering. In the case of abortion, I do not believe I am “taking a life.” In the case of assisted suicide, I would believe that supporting an autonomous suffering individual’s choice is a morally just act. Physicians who went to school to “save lives” will be terribly disappointed, often, we can do little more than palliate, though I view this as an incredible privilege.
Exactly. How evil and macabre that in the same hospital are both physicians saving preemies and abortionists killing them!–and that the physicians and abortionists can be the same people!
Please protect, respect and not discriminate against the physician’s right to conscience freedom. We must and do respect patient’s human rights. Are physicians not humans as well? Otherwise we regulate physicians to the role no different than just robots. I personally, and I believe my patients would as well, prefer to have a physician with the freedom of his/her own conscience even if their beliefs are different from my own, over an oppressed, limited, service provider.
The Ontario Human Rights Code: REASONABLE
The patient has the right to leave one practice for another- no concern
The physician should have the right to transfer patient care for multiple reasons with adequate explanation, and referral. E.g.
a. moving to another region
b. not available- away, ill etc
c. poor physician/patient relationship. Refer the patient to her FP, with intent to transfer care and records.
d. Does not carry out requested procedure. Explanation with Refer to associate who does.
e. Multiple complex reasons eg pregnancy termination, religion etc-Explain and referral
The patient has rights to move on for any reason.
Like the patient, the physician must have the right to transfer patient care after explanation, and appropriate referral.
I agree! It is an inherent right that Physicians have the FREEDOM OF CONSCIENCE in their practice. To force them to go against their conscience is WRONG. We speak so much today about being tolerant towards others beliefs but when it comes to respecting the beliefs of those that are not mainstream there is an outcry of “injustice”. No, if the patient wants an abortion or birth control go to another doctor that will, don’t force these doctors to go against their conscience!
“Appropriate referral” is an impossibility for many or most cases of an offended conscience. For example, if it is wrong for me to kill my neighbour, it is just as wrong (as did the Biblical King David) to get somebody else to kill my neighbour.
I am of the opinion that if a doctor chooses not to perform a procedure requested by a patient, the doctor should have the right to refuse and refer the patient to a doctor willing to perform the procedure.
All physicians need to remain free to refuse to provide or refer for services that they believe to be gravely unethical and immoral. A policy that forces doctors to “check their ethics at the door” would not only endanger all patients, but would also spell the end of our free and democratic society, by excluding from the professional life many excellent doctors who refuse to violate the moral and religious teachings of the Christian, Jewish and Islamic religions among others.
Thank you for this opportunity to share my view.
I feel conscience is the ultimate safeguard of human dignity.
We must allow professionals and others to follow their conscience, whether we agree or not. This is the essence of being human and of a democratic society.
Physicians are not contractors who will do what they are requested to do for a price. Physicians are individuals who have entered into a relationship of trust with their patient on the basis of which they are obliged to do what they deem to be in the best interest of the patient according to sound evidence-based medical practice.
To violate this approach to medical care by rules which deny the physician the right to offer the best medical care for her patient destroys the nature of the physician/patient relationship, runs counter to the long history of medicine and flies in the face of reason, human rights and common sense. A physician cannot be morally neutral and retain her integrity.
I agree that all physicians need to remain free to refuse to provide or refer for services that they believe to be gravely unethical and immoral. It is their constitutional right for freedom of expression and of moral choices in both their life and their job. To take this right away is leaning towards dictatorship which many of our ancestors died to protect. Please do not go down this road and please allow all people whether they are doctors, nurses or whatever their profession is to have the right to refuse to provide services that go against their fundamental believes.
Dear Fellow Humans, I would like to add my voice to those who are decrying policy that would threaten the democratic principles we as Canadians have always held. It is absolutely necessary for Physicians and surgeons to have the right to refuse to perform, or refer for the purpose of performing acts which violate their individual consciences, such as abortion or euthanasia. By trying to control doctors in this way, we will eliminate many competent, compassionate doctors from practicing their profession. Since the first statements doctors take in their their profession is to ‘first do no harm’, doctors who choose to uphold that promise by killing human beings at any stage, are following what has always been and still is not just a matter of conscience, but also a matter of professional responsibility. Let scientific fact and not political pressure rule.
There is a clear middle-ground here.
If a physician doesn’t want to perform existing socially agreed upon tasks such as abortions or providing birth control because of personal religious reasons, they should find an area within medicine that doesn’t require doing these things.
In the case of new obligations like euthanasia, a new specialty may need to be designated with the express understanding that would-be-physicians going into this area of study will be called upon to perform this potentially objectionable task.
In both of these examples, an aggrieved doctor can remain a physician without dismissing their protected moral and religious obligations. This means a physicians beliefs aren’t preventing them from practicing medicine, though a physician may be prevented from practicing in exactly the form they like.
This is the situation in every other profession. No one gets to dictate the exact nature of their work or the working conditions within their industry.
Have we forgotten history completely? What were the Nuremberg Medical Trials? These were trials to judge Nazi physicians who committed medical crimes/experimentation on prisoners. What was the defense of these Nazi doctors? They said, well, we were just following orders, that they themselves did not agree in conscience with what was going on, but they were simply doing their duty, doing what the law and their orders told them to do. Did the judges at the Nuremberg Medical Trials accept this as a defense? No. The judges concluded that conscience is above laws and orders. Is there any analogy to the present situation? You bet there is.
What is the universal physician declaration that arose as a result of the Nuremberg Medical Trials? The Geneva Declaration of Physicians which says: “I will maintain the utmost respect for human life, from the time of its conception, even under threat. I will not use my medical knowledge contrary to the laws of humanity.” The primacy of conscience and adherence to the laws of humanity override unjust laws.
And then there is that inconvenient thing called the Hippocratic Oath of Physicians. What does that Oath say – the exact Oath that I and all my classmates recited on graduation? It says “I will give no deadly medicine to anyone if asked, nor suggest any such counsel; furthermore, I will not give to a woman an instrument to produce abortion. With purity and holiness I will pass my life and practice my art.”
Is it possible that Canada will join ranks with the totalitarian regimes that included the Nazi’s and the Communists in forcing health care professionals to do unspeakable things against their conscience? Is this really the path you want to take?
If you want to study history and see how important conscience is in the practice of medicine, read—-
It documents how some troublesome doctors in Germany opposed the Nazi medical crimes against humanity, and how they wanted a list of these physician “traitors” who displayed their “Christian ideals.” That article also discusses how one cannot conceive of a healthy society without a healthy medicine. If you destroy the morals of medicine, what is the natural outcome of society?
PS- What did Nobel Laureate Mother Teresa have to say? “If we accept that a mother can kill even her own child, how can we tell other people not to kill each other? Any nation that accepts abortion is not teaching its people to love, but to use any violence to get what they want.” Something to think about next time you hear about a school lockdown or workplace shooting.
Certainly, doctor, your argument for that instance is strong, but what about the opposite case?
What if the conscience or religious belief of the doctor dictates (as an example) that homosexuals are an abomination and should not be tolerated. And what if that doctor was suddenly faced in the ER one day with a patient who is a homosexual, with a type of cancer that could be contained if treated quickly, but if left to languish, would kill them inside 3 years?
What if the doctor’s religious beliefs held that abortion is a sin, but they had a patient with a medical condition who just found out she was pregnant, and it was determined that carrying the baby to term would almost certainly kill her?
What is the doctor’s duty of care in that instance? To his or her conscience/religion? Or to the health and safety of the patient?
Today men who have sex with men remain the group most heavily affected by new HIV infections.(Center for Disease Control, cdc.gov/nchhstp/newsroom/HIVIncidencePressRelease.html). Should not a doctor warn his patients in good continence about these health risks if he is known to engage in such risky behaviour? If not for his patient then at least for his community? Is this not the most ethical and morally correct thing to do? Don’t doctors communicate the necessity for vaccines for this very purpose?
The act of murder is a sin in any religious faith, thus an important conscience imperative of our social construct regardless if one desires to murder a middle aged person, the elderly or the unborn. Thus the act of “aborting” or dismembering the child in the womb with the intent to kill it is wrong in any sense of the word and if you believe a person regardless of professional designation should not be able to speak against this if she so chooses then the problem is with your notion of “conscientious rights.” It seems to me this is not the country for you.
My last post did not list the specific references; here are 2 of them:
- Ivy AC. Nazi war crimes of a medical nature. JAMA 1949;139:131-5.
- Lifton RJ. The Nazi Doctors: Medical Killing and the Psychology of Genocide. 1986
I want medical professionals to be able to follow their consciences and to be able to refuse involvement in what they consider to be morally Wrong procedures, and this includes not being forced by the state to refer patients to other medical professionals who will do these procedures . They can inform patients up front that they will not be involved in any way in specified procedures or practices and prospective patients can choose to go to another proctor if they don’t like it.
Hopefully this forum is meant to confirm that our physicians & health officials in Ontario are gathering to confirm our pronince’s strong stand for caring & treating the sick & infirm & handicapped & not following in Quebec’s slippery slope of euthenasia. Killing is never the solution.
To say that doctors must check their consciences at the door will do a disservice to doctors and the patients they serve. Do we not want doctors who live by their beliefs and values? Forcing doctors to participate in things which they believe to be unethical or lose their licenses will weed out exactly the sort of doctors the public wants and deserves.
In the past, doctors have checked their consciences at the door to participate in whatever practices society deemed ethical. This lead to some of the darkest and most gruesome parts of medicines history. Don’t push Canadian doctors into that same situation. It is arrogant and ignorant to assume that our society is able to deem what is ethical and right in a completely accurate fashion, while anyone who disagrees is wrong and must be forced to change. Past societies were sure they were right and forced individuals to bend to the collectives opinion, and in hindsight we now see that society was wrong.
Patients who want to receive services such as birth control are more than welcome to receive it from doctors who are comfortable prescribing it. Asking a doctor to prescribe it against her beliefs is like asking a Muslim restaurant owner to serve alcohol against his beliefs. People are free to go to another restaurant if they feel that alcohol is necessary for their dining experience, and the owner should not have to choose between giving patrons something which would violate his beliefs and being able to practice his profession. Doctors should receive that same protection.
I know people will say that birth control is medically necessary and so it is different in that respect. Some doctors do not believe it to be a medical necessity, as it is not returning an ill patient to health but is distorting a natural and properly functioning process in the body through chemicals. While many people disagree with this viewpoint, it is not for them to say that doctors are not allowed to have that viewpoint. Doctors, and all Canadians, should be allowed to have their own beliefs and follow them without fear of punishment or discrimination. Is that not what our tolerant society aims for?
No person should be forced to perform services that are against his/her conscience. If the Dr is in doubt, he/she should get counsel from his/her Pastor or a qualified person from the College.
Are you kidding? All persons serving the public should be forced to forced to perform services that are against their conscience, because any one person’s conscience is a moving target that should not usurp the basic human rights of a member of the public. A christian teacher must teach evolution, a racially biased police officer must protect people of other races, a non-native conservation officer must protect the treaty rights of first nations people, an athiest politician must protect the right of a religious person to safely practice their religion (as long as it does not interfere with the human rights of others), and every doctor must give the best possible medical advice regardless of their personal religious or ethical beliefs.
A doctor’s personal beliefs are a code that he can live by, but not a code he can force others to live by. If he cannot separate that personal code from his professional life, then he is not serving the public in an honest and faithful manner.
By the way, getting counsel from his pastor is the last thing he should do. I would be absolutely livid if I thought that a religious personage with no medical training or license was being given a voice as to the viable medical solutions that should be presented to me for my health issues.
The “best possible medical advice” one can get from a doctor is one that the doctor is allowed to make freely within his conscience. Why would we want to place our lives in the hands of someone who does not have the moral integrity to act on his conscience, someone who can park his personal convictions at the door and perform a “job” against his own beliefs? And yet you think this is the kind of doctors that will “serve the public in an honest and faithful behaviour”. What exactly is this honesty when the doctor tells you something he is supposed to say to keep his profession, but he does not personally believe in it. Do you call this professionalism? You ask physicians not to force others to live by his code, and yet you expect physicians to live by a code to which he disagrees.
The “best possible medical advice” is the one that a doctor can freely make within his conscience. Why would we want to place our lives in the hands of a doctor who is willing to act against his own principles or convictions? And yet you think this is the kind of doctor that will serve the public in an “honest and faithful” manner. What exactly is this “honesty”, when a doctor has no choice but to tell his patients something he doesn’t agree with, because it is his “job” to do so, or because of fear of losing his job? Do you call this professionalism? A doctor should not force others to live by his code, and yet you think you have the right to force all doctors to live by yours.
If we deny our physicians the right to freedom of conscience, we are violating them in the very worst possible way. It is impossible to perform any profession that requires complex decision-making without referring to one’s morals as a guide. To ask a physician to violate their consciences and provide, or refer for, a procedure that they feel is morally wrong (and therefor bad for the patient) is essentially forcing them into malpractice and potentially violating their psyches as well.
Also, as one physician mentioned below, forcing him to practice euthanasia on vulnerable patents would force him to step away from nursing home care completely. If we drive physicians out of certain fields because of morally charged issues, we risk harming patients and reducing access to care.
For all of these reasons I strongly oppose any increased restrictions on freedom of conscience. In fact, I think freedom of conscience needs more protection.
I heard that the CPOS is currently asking for public opinion concerning a physician’s right to deny a patient sterilization, birth control, or abortion. I’d like to state that a physician should not have the right to say no to a patient simply on the basis that it goes against their personal beliefs – a physician’s primary concern should be the health of the patient and not whether or not the patient’s concern abides by their beliefs.
I was surprised to learn that physicians currently have the ability to say no to a woman/patient who is seeking birth control. Given the amount of money spent on doctors it is not efficient for them to be selective. Not only that, but women should not feel guilty/out of place should a physician refuse to give her access to the service she would like. It is not the place of the physician to judge a patient’s wishes; they are there to serve and provide medical advice and care, not provide religiously/culturally based opinions.
I hope this feedback will be sent to the right place as I’d really like for it to be heard and be considered. If I sent it to the wrong email address, please let me know; otherwise, please confirm receipt of this feedback.
Thank you for your time,
So wasteful !!
There are so many brilliant Canadian students who already choose not to pursue medical school because of the pressures applied by those interviewing for them to deny scientific reality re life in the womb and agree to perform abortions ……. don’t make it worse than it already is. Soon we won’t have any doctors who respect human life.
Those who know it is wrong to poison, starve and tear off limbs of babies within the womb are already paying taxes to perform these tortures legally because we have no choice .
However our faith and trust in the medical profession is lost.
First of all Pregnancy is NOT a disease. Abortion doesn’t travel alone. Abortion is always accompanied by Euthanasia—simply because it upsets the balance of Nature. For those women who praise Abortion I suspect that they are not listening to their conscience and so could be facing a more recognized illness Psychologically. Extreme cases of this are Stalin and Hitler.
A woman is a woman and not a man and deep down she realizes she is carrying a child. This can be ignored but it will not go away. No one can kill an innocent child and walk away untouched. Kill becomes the answer to many solutions and that includes the lives of the elderly.
There are many other side effects of Abortion: problems in carrying a future pregnancy to full term; any reminders that life is precious and must be protected can be threatening to those who have aborted and we see this at our universities today where the Pro Life groups are denied Freedom of Speech. One of the most upsetting incidents is University students in New Brunswick Protesting the closure of the abortion clinic. They have their whole life ahead of them yet they are shouting for Death and I guess that’s the whole story of Abortion.
Nothing good has resulted from Abortion because it is totally Contrary to Human Nature. We are given Life to Support Life– Not Death. When I hear anyone in favour of Abortion the thought always comes to mind—You’re very fortunate your parents didn’t think like that.
This issue isn’t even really about life and death, its about patients getting to do what they want, which isn’t what doctors are there for. If you don’t like your doctor, GO SEE ANOTHER ONE. We do it for every profession. Denial of treatment isn’t a new invention, it goes on everyday and will continue. Right now apparently public opinion is trying to tell doctors how to do their jobs when it comes to medicine, which is laughable. Please, people we need doctors with consciences who have the right to practice medicine to the best of their ability, not to conform to our standards of morality (or lack thereof).
I agree, especially with the last part of your statement. Doctors should have well formed consciences (on what is objectively good and right and true) that are not swayed by public opinion, since objectivity can’t be changed.
What we are witnessing here is our secular society going so far left that it becoming Marxist and Communist, not to mention hypocritical. Doctors MUST continue to have the freedom to do what they think is right for the patient, and must only operate based on their freedom of conscience. This will have the best outcome for patients. Doctors are not mindless mechanics replacing mufflers. They are human beings with a conscience, and we can’t deny that. To deny a doctor the freedom of conscience to practice medicine as he/she thinks best, is to turn them into robots and grease monkeys. Let them be free!!!
the question wasn’t even about abortions it was about religion. In most cases a GP isn’t going to do surgery of any kind. No one is forcing a doctor to do the abortion the patient can be referred. If it was the only doctor left in the country or some life threatening emergency then the Doctor must try and save her life even if it might terminate a pregnancy.
The most fundamental human right is the right to life. Not defending it but defending others makes no sense. Doctors are, by definition of their position, defenders of life. Their ultimate goal should be the preservation of life and the upholding of its dignity. Denial of the freedom of conscience of physicians is unacceptable because it overturns the calling of a physician – to take care of a patient.
Here’s my blogpost on this consultation and issue.
Note to people who are dismayed by the YES vote on the Quick Poll: LifeSite (anti-choice website) is promoting the poll and antis, as usual, are following instructions.
It is ridiculous to consider allowing conscience rights for Doctors. Do firefighters get to see your financial statements before they save your house? Do pharmacists get to ask for your marriage license before prescribing Viagra? NO!
It is difficult to find a doctor, some people have limited access. Great doctors do not shame or impose their religious beliefs on others. Stop this attack on reproductive rights. If I want these services, the doctor should be making a medical decision not a religious one. If I want a religious decision I know where the local churches are.
Churches worship; life is religion.
If a physician refuses a service because their conscience dictates action or non-action they should be required to refer the patient to another physician within a reasonable distance who is willing to perform the service.
If they are the only physician within a geographic area, the situation changes and the level of responsibilities change.
There are mechanisms for physicians to change the standard of care, a standard that cannot be altered on the whim of an individual.
I believe firmly that a Physician should have the right to refuse acts which go against the conscience of the physician.
I’ve voted a firm NO.
Doctors are well aware of what is involved with their job. If they are unable to perform certain duties because of religious belief, then they should opt out and choose another career. Next they’ll use this as an excuse to refuse to treat homosexual patients, because their religion says homosexuality is wrong, or refuse to treat patients of a different religion or no religion. This is proposing discrimination based on religious belief. They can follow their religions at home and in their personal lives, in the workplace they have to be secular and neutral, especially given they are drawing salaries from the government. It’s the only way that everyone gets fair treatment. Allowing religious belief to dictate practices in the workplace is a violation of the human rights of patients and cannot be condoned.
Look up partial birth abortions and tell me you would be able to take a baby 3/4 of the way out of the mothers womb moving and with all their limbs and body intact and stab them in the back of the neck with a knife to kill them just so that it won’t be considered a life. If you could do that you have not conscience and I would not want to have a doctor who would do that. It is sick and a horrible way to die. Or they cut a baby up while it is still in the womb and pull the limbs off of it. Shame on you for thinking a doctor should be forced to do this. It is heinous crime in my eyes. If I knew that that is what they did to my baby I would never ever have an abortion they don’t even explain to women what the procedure entails or I am sure many would not have an abortion.
A doctor has the right to follow his own personal beliefs. Patients have the right to get a second opinion. Why are we taking away these basic rights?
I really hope this is a joke. Doctors refusing treatment is a disgusting proposal. If you allow cultural corruption to enter the medical profession then you will regret it.
As a gay woman, I worry that emergency treatment could be delayed in my care if a doctor has religious beliefs that differ from mine, Obviously! If a doctor is unable to treat all who need treatment do to the doctor’s religious beliefs, than I would expect the doctor to find another profession. If religious beliefs are allowed to be used to deny treatment, could the doctor not also then refuse treatment because they are a young earther, or hate women, or believe we shouldn’t eat shellfish so don’t treat allergic reactions?
I don’t want a doctor worrying about my personal beliefs so I should not have to worry about theirs, just give treatment based on science, not beliefs!~
Why force doctors to do abortions? I don’t understand the logic. Why not make them do dentistry as well? You have specialists in all areas, if a doctor doesn’t want to do abortions, why on earth force them. It makes no sense at all. Shame on you for trying. Stick with abortion clinics. This way people who wish to avoid them can, and those that wish to participate can too.
No one is forcing doctors to perform abortions. People do not walk into a GP’s office and get an abortion. If a doctor does not want to perform abortions, they are free to choose a career path that does not include surgical procedures.
What is at question is a doctor’s “right” to refuse treatment for stuff that they do not like due to religious or personal biases. For example if their religion says birth control is bad, they will not prescribe it and can tell the woman to go somewhere else for it.
The problem with this is the mental health impact that this could have on an at risk youth, or an unplanned pregnancy for an unprepared teen. When religious or moral biases are pushed on others, the poor and the uneducated are always the ones that are impacted the most. Doctors need to be professional and keep the best health interests of their patients first, not their own persoanl biases.
No one is forcing doctors in Ontario to perform abortions–NOT YET.
In May 2004 a news magazine reported that “a medical student in his last year at the University of Manitoba Medical School will be denied his degree, because of his unwillingness to partake in any abortion-related activities. The Christian student, who wishes to remain unnamed, received a failing grade in the obstetrics and gynecology portion of his program, for refusing to perform or refer for any abortive procedure. Three separate appeals to the medical school all failed to correct the matter… A spokesman for the student’s family… said the student was failed despite the fact that he had high grades in every area of study and strong words of affirmation from clinical supervisors.”
According to another news source, currently “a Swedish midwife is suing in local court after being denied employment at three separate maternity centers because she is unwilling to assist with abortions. Traditionally, the job of a midwife is to bring life into the world by assisting mothers in labor deliver their babies. But in Sweden, which has the highest abortion rate of any Nordic nation, and where abortions are provided by the government free upon request until 18 weeks of pregnancy, midwives are often called upon to assist with abortions, too.”
Also, not all abortions are surgical. Are you aware that many–perhaps most–”contraceptives” are abortifacient? They prevent implantation and thus kill new human beings.
I have read the current policy of the “Physicians and the Ontario Human Rights Code”.
I am deeply alarmed by the proposed changes to the code which would mandate that physicians must provide ‘treatments’, even if they would ‘conflict’ with the physician’s religious/moral beliefs.
Obviously, we are speaking about forcing doctors to kill. (Abortion and euthanasia [mercy-killing] are precisely the ‘treatments’ that would present these religious/moral objections).
It is interesting that the Hippocratic oath mandated that a physician, “must do no harm” (abortion was specifically condemned as well) and now it’s being proposed that a physican must do harm (and specifically, must do abortions).
Surely, this proposal is targeting Christians and more specifically, Catholics (since Catholics have always and everywhere taught that abortion is intrinsically evil). To propose that Catholic-doctors must perform abortions is tantamount to saying that Catholics may not become doctors.
I strongly urge the College of Physicians to NOT discriminate against Christians/Catholics and to continue to allow physicians to refuse to provide ‘treatments’ which conflict with their religious/moral beliefs.
I believe that a doctor should be allowed to act according to his or her conscience. We are living in a world where the value of human life, especially in the womb, is no longer sacred and if we go down the long and slippery road of euthanasia along with Quebec doctors, our doctors will be expected to end human life and go against the law of God “Thou shall not Kill.” We need strong, and morally sound doctors who will stand up for what they believe. It is against their human rights to force them to do things that are against their religious beliefs such as performing abortions and assisted suicide.
Absolutely a conscience clause for doctors is an essential ethical right. As a patient I have chosen a doctor whom I know has ethical standards and where I am safe from the growing pressure for active euthanasia in Canada.
As a nurse I expected to have honored a conscience clause as well, in particular if pressured to assist or refer to abortion procedures.
I think physicians and all medical staff, including nurses, should have a right to act according to their consciences/morals.
I think it is completely unfair and unjust to force Doctors to have to abandon what they believe in and be forced to give abortions and other pro-choice options. We live in what is suppose to be a free country, if this is true we should not be forcing people to do something they do not support! There is abortion clinics for people that want to have an abortion, they can go there. Doctors should not be forced to do this.
If a physician is going to put his or her personal beliefs above the care of the patient then he or she need not practice medicine. Or maybe they can practice in a Christian Science setting. At the very least when they advertise in tge phone book or on TV there should be a little truth in advertising. Something like, “the physician in this advertisement will refuse to provide any medical care that goes against his/her religious beliefs. That way, customers have a choice to find a physician that will be suitable for their own needs and not worry about the beliefs of a treating physician.
If I were to pick a doctor only to find out after having changed my insurance that my needs come secondary to their beliefs I would be pretty upset.
Ladies, how would you feel if you found a gynecologist and then realized that he was Muslim and could only examine you using a mirror? Because if you allow treatment based on Christian beliefs then you have to do the same for physicians of all faiths. Period.
No doctor should ever refuse treatment based on that. My Christian doctor refered me for a second trimester termination despite religious beliefs to the contry. An excellent doctor .
I believe that anyone wishing to be in family practice or on gym should be prepared to deliver or support the full spectrum of women’s reproductive healthcare. If you can’t do that, be a dermatologist.
Current Fps should let women know when booking appointments, the limitations of their services. It is deplorable that some will a waste a patient’s time, then bill the gov’t for the visit.
I believe that anyone wishing to be in family practice or obgyn should be prepared to deliver or support the full spectrum of women’s reproductive healthcare. If you can’t do that, be a dermatologist.
I think it is a violation of a doctors human rights and his right to freedom of religion to force him to do anything that is not ethical in his eyes. A doctor should not be forced to give birth control and especially abortions if it is against his beliefs to do so. There are plenty of doctors who will do these procedures that don’t have the same ethics. I think it is a travesty to think that a doctor should be forced to take a human life just because some believe that a fetus is not considered to be a human until it is out of the mothers womb. If it weren’t a life it wouldn’t be able to kick and move and have emotions. Please don’t force doctors to do something that is morally wrong in their eyes.
It’s simple. If you can’t handle the normal operations of your job, get a job somewhere else.
Religion has no mandate within medicine.
Under no circumstances should a physician be allowed to withhold treatment based on his/her religious beliefs.
If religion and not healing (or science) is more important to them, they should go into the clergy.
Denial of treatment based on iron age superficial beliefs unfounded in reality is just another step back in time. Take it far enough, and you have Iran or Saudi-style fundamentalism. (no retirement homes, no cross gender patient/doctor medical treatment etc)
If you chose to become a physician you have chosen to fulfill the oblications of being one.
Remember the oath. Denying certain treatments based on religious beliefs is a perfect example of breaking it.
A physician is of the most resourceful indivals in society with an enormous amount of resources compared to the weakest in society.
The health of the public should not suffer in exchange for sparing the unfounded bad conscience of the elite.
Health treatment is a human right.
Being a doctor is NOT.
A physician should NEVER be allowed to make medical decision or choose patients based on physician’s religious faith or dogmatic beliefs. There is no direct evidence of an existing god or other such superficial omnipotent beings, so it would be madness to allow a physician to make decisions on whom they choose to treat on ad hoc or mass beliefs.
It would tantamount to gender discrimination in disguise. If any such fanatical physician exists, remember they also were given birth through a woman’s uterus. They called her “Mother”. There isnt anything morr absurd, illogical and unethical on this planet. What would be next – refusing to treat anyone not believing in “god”, or not becoming a convert or not believing in “creationism”?
These “physicians” did go to medical school, learned evolutionary biology and passed the examinations on human reproductive system that proved sperm-egg combination from copulation process, and not a magic show from an imaginary divinity.
I can’t believe you are even asking such a question in the realm of science and medicine. Since when do beliefs hold any weight in the context of legitimate scientific practice? Next, you’ll be asking whether teachers/professors should have the option to decline to work with particular students based on their religious beliefs, or vice versa. Seriously, is this a practical joke?
The patient has the right to say no thanks because it is the patients body. The physician who practices medicine has no right to refuse to provide a patient with a treatment because be does not own the body of the patient, that’s why the patients religiotard belief matters, not the doctors.
First DO NO HARM ! No room for religous views!!!
Being a doctor is an extremely praiseworthy vocation. People who help the sick should be commended.
That said. If this is your job, you do it. I don’t want to find out a doctor who’s a Jehovah Witness won’t perform a blood transfusion. Or a scientologist refuse to prescribe psychiatric medicine.
But of course, these aren’t the procedures that people are thinking about. It’s another attempt to limit women’s access to abortion provision.
Oooh, this has caught the attention of the folks at the Richard Dawkins foundation, because whoever came up with this SHOCKINGLY poorly conceived public feedback made it so convoluted and impossible to find the relevant information, it has made The College of Physicians and Surgeons of Ontario look positively MEDIEVAL.
Why is it stated absolutely NO WHERE what about the current policy has been proposed to revise?
Why does that appallingly UNSCIENTIFIC poll feature allow international feedback that will not reflect the wants and desires of Ontarians? How will the results of that poll weigh on any revision of policy? Does this ridiculous interface take into consideration that religious extremists from all over the world could take a few moments of their time and try to throw the care provided to Ontarians back into the Dark Ages? Because it’s certainly allowing atheists a loud voice, hmm?
I am an atheist, so I would hope they keep voting, but that’s rather irrelevant. I am very, very disappointed that The College of Physicians and Surgeons of Ontario would engage in something so…void of true scientific process and allow all of this data to become so completely and utterly tainted. As a Canadian and Ontario citizen, I say SHAME. We deserved far better, because I would hazard to guess our tax dollars paid for this nonsense.
The pertinent facts about a patients medical condition are completely secular. As such, treatments and practices should reflect the secular nature of the scientific facts dictating the most appropriate course of action for a patient. Modern medicinal practices are founded upon well evidentiated treatments, based upon solid and reliable knowledge and fine-tuned over many years to offer the most effective treatments possible to a patient. Physicians are more than entitled to exercise their beliefs and commitments to their faith, but a physician must prioritise their commitment to the practicing of the most effective treatment available. Furthermore, withholding such knowledge from the patient is a complete breach of the necessary transparency of physician-patient contact. For simple illustration purposes, suppose treatment A has a 80% success rate but is deferred on account of physicians beliefs. Treatment B on the other hand has a 40% success rate, but is preferred by the physician. In referring all of that physicians patients to treatment B, he is statistically deferring them to a treatment which will cause half as many successes, and in terminal cases will cause 200% more fatalities. Fatalities which were and are easily avoided. So, clearly the physician must refer the patient to another on the sole grounds of the patients health. However, since there may be a large number of cases where this might be needed, it is simply not a feasible option considering that there are a limited number of physicians available at any time.
As well as this, the beliefs of the physician should not in any way be consequent to the differing treatment of one patient over another patient who is being treated by another physician with differing beliefs. Aside from the beliefs being completely irrelevant to the proper practicing of medical science, this sort of inconsistency in treatment is detrimental for patient, physician, the health organisation and medicinal practice globally.
Finally, the results of the poll on this matter show absolutely no useful knowledge as they are inherently biased in favour of people who hold beliefs on account of their greater number. If one should hold a belief, then they will more likely vote in favour of prioritizing beliefs than against it. This is the very nature of faith, one who goes against their faith is in some way punished or frowned upon under their faith. Due to the fact that the majority of the world is of some faith, it is a fair statement to make that the majority of poll-answers are from people who have some description of faith. Therefore, the majority of poll answers will exhibit a bias towards promoting the importance of faith in a medicinal context. However, we need to focus on what is really important here: the patients health. What is not important is pleasing the beliefs of the majority, since in many cases they are likely to invoke negative consequences for patient health. Medicine is underpinned by scientific knowledge. Scientific knowledge is completely secular. To go down the route of inconsistent, less-effective treatments due to physician beliefs, is to adopt the very same problems as with homoeopathic medicine. It is not a credible, evidentiated or reliable course of action.
The majority of the world does now know any of the relevant scientific knowledge involved in these treatments, and I do not claim to either. However this means that it is up to those educated on the matters to decide on the matters, and the opinion of others is wholly irrelevant and biased through ignorance.
It seems there is a lot of discussion on this page referring to ‘ethics’ and ‘morality’, but is important to note that ethics is not the same thing as rule-under-faith. To argue that doctors should not be forced to go against their sense of morality/ethics is to implicitly imply that they are one in the same thing – which they are not. In fact, it’s my opinion that the majority of cases which the debate refers to are cases where morality/ethics is shunned in the name of faith, since morality necessarily involves upholding the best interests of the patients health.
Morality and ethics both refer to doing (speaking, thinking) what’s right and good. They derive from the will of God, and I’ve always thought them to be the same thing.
As religion comes in an endless variety of creeds and levels of extremism it is inevitable that these will contradict secular values as protected under our Human Rights Code. It is imperative that society protect these fundamental human rights above all else. Religious freedom cannot mean freedom to be otherwise unlawful and discriminatory.
Human rights are not open to referendum and polls.
Only the religious could be so immoral as to deny care. Strange given the story of the Good Samaritan which Christians and Muslims revere. Who is voting so outrageously?
What Doctor worth the honour and privilege of the degree even asks a patient the question before giving care?
The Lord Jesus told the story of the good Samaritan to answer the question, “Who is my neighbour?” Even a lowly human fetus is my neighbour for whom I should care.
“First, do no harm.”
Allowing a physician to refuse treatment to a patient for any reason other than the patient’s medical needs is a violation of the most fundemental principle of medicine.
Physicians: if you cannot provide objective medical care as you were trained and hired to do because of your particular religious beliefs then you are not fit to work in the field, and I invite you to withdraw as soon as possible. Applying your personal religious restrictions on the public is not a tenable position.
Leave your religious nonsense at the door. It has no place in medicine.
I can’t believe this is actually being considered. If your “morality” conflicts with certain medical practises and you strongly feel that you can’t undertake/prescribe/refer said practises then you shouldn’t be a doctor. Period. If you decide to care for people for a living then your absolute top priority should be providing the care your patients require within the confines of the law. It should never be about a doctor’s belief just about his/her extensive training.
If I refused to do part of my job for any reason other than it being unsafe I would pretty well be guaranteed to be out of a job. We don’t get to pick and choose which parts of our jobs we feel morally inclined to perform. We do however have the freedom to choose a profession that is more likely to conform to our moral code.
What’s next? Should our police be given the freedom to choose who they protect or which laws they uphold based on morality? This issue is simply ridiculous. I fear for our future.
I couldn’t agree more.
The one distinction I would make is that the issues doctors have might very well be legitimate moral issues – in which case they should be discussed in the public sphere, where our legislative system can be taken advantage of properly.
I keep seeing comments like “I think it’s against a doctor’s human rights to force them to go against their moral code”. Listen, the human rights code protects people from being discriminated against based on certain, very specific criteria. The important thing to note he is the term “discriminated against”. In no way is expecting a person to do their job discrimination. Sorry.
Also please stop using this forum as a means to express your opinion on abortion. This issue has far greater overarching consequences than that one specific issue.
Ofcourse a Medical professionell cant deny someone treatment, does that not go against thé hipocratic oath?
My daughter went to her family physician to get an abortion and he set it up but told her not to come back plus the office called me with the appointment knowing she no longer lived at home!!! Im sure that was unethical if not illegal!
Freedom of Conscience is an unalienable right. If people are willing to deny physicians that fundamental right then they will also have to be willing to lose numerous doctors who will simply have no choice but to cease practicing medicine.
First a potential MP candidates was denied their freedom of conscience and now the College of Physicians is planning to do the same thing.
Why are so many people comfortable with this current in society?
A physician should have the right to refuse specific services based on their religion. If they are going to choose to do this they need to be upfront about it. There would need to be a stipulation stating exactly what procedures or services they had the right to refuse, an exactly how they had to divulge this information to their clients. Emergancy rooms would have to be exempt.
Which course in medical school teaches blood letting? Which course emphasizes the effectiveness of prayer? Exorcism?
Which religion and its practices have been shown to be most effective for treatment? Are Native American chants more or less effective than the lord’s prayer?
Superstitious nonsense doesn’t belong in any medical practice.
The moment a physician inserts his (or her) religion into his practice it ceases to be medicine what he is practicing.
Insertion of religion by the physician into any medical procedure should result in immediate loss of his license to practice.
Your comments are both offensive and discrimatory against so many people and cultures. Have you any idea of the breadth and depth of Catholic philosophical belief and writings of the past 2000 years??? Hear of St Thomas Aquinas, St Augustine and Dante for example? Are you aware of how many hospitals were founded by religious orders in this country alone employing medical science to heal people?
Does the Hippocratic Oath not mean anything anymore? Last time I read it, it said “An oath taken by physicians to protect ALL life”
If a Doctor refuses to treat a patient because of their religious beliefs, they are in violation of the Oath
Like all human beings with rights, doctors should be free to negotiate the work they will perform with their clients or employers. The proposed change to the rules will exclude people of faith from practicing medicine, marginalizing people of faith and preventing us from receiving medical care from members of our own minority communities. We will be forced to receive prenatal care from people who recommend and encourage abortion. This is highly offensive and marginaling.
No doctor should EVER be allowed to refuse a patient treatment, based on religious belief or personal morals. That smacks of Americanism.
Perhaps there are no simple answers. Yes, a physician has a right to their own religious beliefs and should act in accordance with their conscience, but what happens if that fight infringes on the right of a patient to receive equal treatment, or if refusal to treat a patient results either in endangerment of life or the death of that patient? In those cases, I think that the physician has a Duty of Care to either provide the treatment required, or ensure that the patient can get the treatment required from someone else in a timely manner.
The best argument I’ve heard on this topic is, roughly, paraphrased as follows:
“If a physician chooses to deny a particular medical service (such as a blood transfusion, or an abortion) out of ‘conscience’, they are in effect using their position as medical expert to force their moral stance on their patients.”
Considering that a doctor works in service of public health, I find this very persuasive. I would similarly expect a crown-appointed (and paid) lawyer to represent clients they find despicable in service to the principles that are at the core of our democratic civilization.
In other words, public servants ought to serve according to the laws of the land. If a medical service is morally questionable, I would advocate moving debate on that particular issue into the public sphere where it can be resolved in a way that takes advantage of the rule of law.
And when has it happened that a doctor has refused a transfusion? However asking a doctor to murder the unborn is not a right in Canada and never should be. Period. Should be then have the “right” to murder the post born such as yourself without your consent as mandated by state law as was afforded the pre-born?
Perhaps you would be happier in Rwanda.
I’m writing to inform you of my concern with the current Physicians and the Ontario Human Rights Code policy.
“Included in the first section of the policy is specific direction pertaining to physicians’ moral and religious beliefs in the provision of medical care.”
This directly contradicts respecting the moral and religious beliefs of the patient, which should be the paramount consideration when providing health care.
For example, if my physician is a Jehovah’s Witness, and I am a Christian, would I still not be offered a blood transfusion if my medical state warranted it?
Although this is an extreme example, common sense dictates that any and all health care options should be both presented & available to the patient, who then uses their own morals and/or religious beliefs to make informed health care decisions.
To substitute patient autonomy with a physician’s personal moral or religious presupposition is at least unethical & at worst harmful to the health of the patient.
The only opinions that a physician should be expressing are professional ones, based on medical knowledge. To let personal opinions in diminishes the quality of care & is wholly unprofessional.
The Ontario Human Rights Code states several times that this is the case, for example:
“The right to freedom of religion is not unlimited; it is subject to such limitations as are necessary to protect public safety, order, health, morals, or the fundamental rights or freedoms of others”
While I appreciate the ‘College Expectations’ try to clarify for their physicians, but they are quite troubling, and seem to directly contravene the Ontario Human Rights Code.
I sincerely hope that your policy will be improved by making it clear that an Ontarian’s right to comprehensive, respectful medial care is not negotiable.
Thank you for your time,
Greetings from British Columbia,
It seems to me to be unconscionable that a lone physician in a small remote community, for example, can, on the basis of his/her religious beliefs, refuse to provide a prescription, referral or procedure to a patient. If I were a patient in such a community wanting a safe procedure such as a vasectomy for birth control, I would expect that the lone physician would carry out the procedure.
If the morality of the physician would prevent me obtaining the procedure, I expect it would that the refusal was because of the physician’s religious tenets. If it is his or her self-interest (commission of a sin and the consequence of eternal damnation, for example) that gets in the way of my treatment, that is wrong. I do not accept that morality is based on religion. Morality came long before religion! Religion is based on the morality of the secular community at large.
On a medical school’s Professionalism page it is pointed out that renouncing self-interest in the treatment of patients along with other attributes of the Hippocratic Oath echo the modern views of professionalism.
The Hippocratic Oath was an oath taken by physicians to protect all life, to hold in highest regard one’s teachers, to recognize one’s limitations, and to renounce self-interest in the treatment of patients [Emphasis added]. Certain values inherent in the Hippocratic Oath are echoed in modern views of professionalism. Such attributes continue to define modern expectations of physicians and medical students alike, Other views found in the Hippocratic Oath, such as those on abortion and surgical practice are not consistent with contemporary beliefs in modern Western secular societies. Given the complexity of medicine in the 21st century, an ancient oath cannot possibly encompass current values. Therefore, the significance of the Hippocratic Oath does not reside in its specific guidelines, but rather, in its symbolism of an ideal: the selfless dedication to the preservation of human life.
I am responding to your OHIP poll concerning whether or not Dr. should be able to withhold treatment on the basis of religious or moral belief.
I could not reasonably respond to the poll because it is inherently flawed.
You are not distinguishing between a doctor who chooses not to offer a certain service to ANY patient, versus the doctor who DOES offer the service but refuses to give it to some people.
For example, you are failing to distinguish between someone who says “I am not an abortion provider” and someone who says “I am an abortion provider, but I will not operate on people who are members of religion X,” Those are monumentally different questions.
Secondly, you have failed to distinguish between subspecialties of medicine. For example, there’s no reason a doctor can be a Jehovah’s Witness, but there is a reason why a doctor who is a Jehovah’s Witness can’t be an ER doctor.
Similarly, there is a huge difference between a gynecologist who is not an obstetrician and who refuses to do abortions, and an OB/GYN with an obstetrics practice who refuses to give one of his own patients an abortion to save her life.
That brings me to the third flaw in your survey. You are not distinguishing between routine medical care and life-saving medical care.
What would make more sense would be to specify which behaviors are required for each specialty and which behaviors are optional. For example, the rules for an ER doctor in a pediatrician are not the same.
What is of greater concern to me, is the issue of turning patients away because they are elderly. Elderly patients do take more of a doctor’s resources. But if most doctors start refusing to take older patients, we are going to have a health care crisis on our hands.
A distinction also need to be made about WHY the patient is refuse treatment. Is it because the doctor doesn’t like that particular person because the patient is Jewish or black or atheist or whatever else? Or, is there a medical reason to turn that patient away – for example, if a pediatrician refuses to have patience in his practice who have not been immunized because of parents personal choices (as opposed to those who cannot be vaccinated, medically) one could very reasonably make the argument that that pediatrician is protecting the other children in his practice.
So, in summary, I think you need to be much clearer about which parameters you are discussing, whether it’s based on the person, the procedure, or the specialty, or on other legitimate reasons. Until you do that, I think your poll is largely invalid.
Thanks for your comments. Your pointing out that there is a distinction between a physician’s refusing to provide a certain service to ANY patient, versus a physician refusing to provide a service to some patients based on their religion, lifestyle, gender, etc. is very important. I would say that the first case does not constitute discrimination because the refusal to provide the service is not based on the patient. Clearly, the second case would constitute discrimination.
Also, whether or not the treatment concerns a life-threatening condition or not is important. Refusing to prescribe oral contraception should not be in the same category as refusing to provide an emergent blood transfusion. In the first case, the patient can seek a prescription from another care provider and, apart from some inconvenience, would not be harmed. In the second case, the patient does not have alternatives due to time and the physician’s refusal to provide a blood transfusion will harm the patient. That said, I have never come across a physician who would refuse to provide life-saving treatment in an urgent situation, so to get too wrapped up in such hypothetical situations can be a bit misleading.
To The College of Physicians and Surgeons of Ontario,
I would like to provide my feedback to you on your poll regarding whether a doctor should or should not be able to refuse treatment to someone based on their religious or moral beliefs.
In my honest opinion, I believe that you have placed two concepts that may be polarising into the same category. Religious beliefs and moral beliefs are two different things, although I can see how they centre around the ideology that they are values that may unconsciously influence a person’s conscious actions. I have voted no on the poll, and now I would like to explain why, because I think a ‘yes’ or ‘no’ answer is nowhere near sufficient to make any rational or logical decision on this matter.
I believe that, by choosing the occupation of doctor or health physician, you sacrifice your own prejudices and you externally release your judgement – no matter how this may conflict with what you think internally. This is because a person sacrifices themselves to you entirely – whether it be their physical or mental concerns, they come and divulge their perceived weakness to you because they want to be cured of it. I would personally be extremely offended and feel unsafe and insecure if a doctor, of all people, were to refuse a service to me based on their initial perception of me – because what then stops them from giving me sub-perfected treatment when they decide that I am not a person that they like?
I am fully aware that doctors are, of course, people too, and that anyone will have some judgement of a person on first contact. I, however, believe that a doctor has to forego this judgement and ignore it, at least externally, to fulfil their role as principle carer, educator and health ambassador. I expect them to strive to do their best to care for me and help me help myself.
However, I also acknowledge that there are entire spectra of belief systems out in the world, and that these may form the entire being of a person. If this happens to embody a doctor, then I accept this too, and I accept that they cannot care for a person that they might not like/feel they cannot treat simply because they will unconsciously fail to do so.
In such a situation, I believe that this should be relayed to either a higher order, or a colleague, so that someone that would be willing to treat said person will take them on board instead, without them being informed of the prejudices that the initial doctor may have had – an explanation of ‘this would be better treated by ‘colleague’ because I strongly feel that I will not be able to provide satisfactory treatment in this particular case’.
This should only be acceptable practice in rare and exceptional circumstances, because a doctor/physician has an occupational reputation to uphold so that the public may view them as what they should be – non-judgemental, accepting, and open. If they cannot do this, then regardless of their religious beliefs or their morals or pride, they are not in the right occupation, because being accepting is part of the job description. Frankly, if a physician expects that they can reject an entire gender, sexual orientation, religion, or any group – no matter what their place or size – unless it is some behaviour that prevents the physician from doing their job (e.g. smoking for a respiratory illness or drinking for a hepatic or pancreatic condition), then they are not mature or insightful enough to be treating people. Being accepting is a skill that I believe should be acquired during training in University and during training as an intern and resident.
(Note – I currently exclude debilitating behaviours, although I expect that I will learn more about this matter in future, and I may change my views.)
I say all of this as a student who is currently enrolled in a doctor of medicine degree to prove that, while I have extremely high standards of health physicians, I expect to join them one day, and that I will place such rigorous and strict expectations on myself as well, because I know of the responsibilities and requirements that come with the job description.
In an idealistic world, everyone should be getting the same level of treatment. This is not an idealistic world, but I think that doctors of all people, should be trying to make it a reality.
I respect your movement to try and revolutionise and modernise your human rights code, and I have high hopes that the rest of the world will continue to follow suit. Thank you for providing a public outlet to express our views.
Kind Regards, and good luck!
This sentence in the code is especially troublesome. “This means that a physician who refuses to provide a service or refuses to accept an individual as a patient on the basis of a prohibited ground such as sex or sexual orientation may be acting contrary to the Code, even if the refusal is based on the physician’s moral or religious belief.”
This goes against everything that the code and Canada stand for. The very “may” introduces a vagueness that entirely denies the the full protection of human rights for the patient. Physician’s moral and religious beliefs have no place whatsoever in the medical profession. These must be left at home, or in church, mosque or temple. Morals in medicine are instead decided by boards of departments of health and colleges of physicians, and are thus then made into the laws that govern the procedures of which physicians access and act upon here in Ontario. These must be the only guidelines. Allowing any other entry point for ‘personal’ morals to affect medical decisions immediately destroys the concept of equal and fair access to health care for all citizens. Physicians must remember that they are employees of the province, and thus must operate as such. If the wish to bring personal morals into play in their work, they should find work in a culture that embraces such philosophies, and not in a culture which embraces and enforces human rights for all.
The primacy of human rights and equal access to health care must be made clear. The vagueness through which the text meanders between rights of personal beliefs (ie freedom of religion) versus the rights to interfere with the others must be made clearer, and much stronger emphasis must be shown to delineate between belief and conduct. Is counselling belief or conduct? If a physician merely expresses his or her belief is this conduct? This area is woefully unclear. The text must show that a physician must do nothing – inclusive of speech, personal opinion, expression of disapproval, referencing literature, omission of information, referencing further council, and myriad other actions that may not be construed as medical conduct – that is affected or informed by their personal or religious beliefs.
As for the survey, there are numerous false and misleading dichotomies presented throughout
For this question “In some circumstances, the physician must help the patient or individual make arrangements to see another physician with who they can discuss their situation if the treatment conflicts with the physician’s moral or religious beliefs.” the question should read: Should a physician must be allowed to refuse a treatment conflicts with the physician’s moral or religious beliefs? In this case I strongly disagree.
This same issue of course nullifies this next question: “The physician must advise patients, or individuals who wish to become patients, that they can see another physician with whom they can discuss their situation if the treatment conflicts with the physician’s moral or religious beliefs.” – I do not believe any physician should be allowed to deny any Ontarian any procedure that said physician is capable of performing based on said physician’s personal beliefs. They are paid by taxpayers, not churches or other interest groups, and have must only bring the philosophies of contemporary medicine to choices made about their services.
“The physician must communicate clearly and promptly to their patient about any treatments or procedures they choose not to provide because of the physician’s moral or religious beliefs.”
Each physician must provide medically appropriate services that they are trained to perform to all Ontarians. Otherwise we have a system that will allow avenues for favouritism, prejudice, sexism, eugenics, class disparity and a myriad of other evils to flourish.
On question 14: No. If they are not willing to perform services for which they are trained and licenced for in Ontario, then they should be forced out of the college. Social medicine has no room for those that would try to shape policy and culture by selectively denying treatment to individuals on personal, case by case, basis.
Objection of conscience is a constitutional right. No policy of any kind can go against it, at least not legally. Physicians with no conscience are the equivalent of zombies. Same can be said for politicians or any other human being. Freedom of conscience must include the absence of an obligation to refer to what the professional is opposed to. Referral is complicity. Forced referral is forced complicity.
Objection of conscience is a constitutional right, being a doctor is not. Any doctor whose conscience will not allow them to provide the best possible mental and physical health care for their patient is free to follow their conscience and choose another profession. They should not be free to negatively impact the physical or mental health of their patients by refusing to provide care, or providing only a subset of the best possible care.
Thank you. That is exactly the point. They have a right to disbelieve in abortion. They do not have a “right” to be doctors.
If I were to decide I got to pick and choose which parts of my job description I would refuse to do, for religious reasons, I’d be fired instantly.
They are perfectly free to take up other careers if they can’t fully work at this one.
No Christians need apply?
Surely, this proposal is targetting Christians and more specifically, Catholics (since Catholics have always and everywhere taught that abortion is intrinsically evil). To propose that Catholic-doctors must perform abortions is tantamount to saying that Catholics may not become doctors.
The proposal to FORCE anyone who is a doctor and wants to practice in Ontario, to ONLY promote abortion is NOT a product of democracy and CHOICE.
This proposal is just one sided, and HIDES all the information. Kind of like communism – only permit certain information – never all the information.
This is the action of people in fear. Fear that when the population is given ALL the information, some of the population will decide with their human conscience and intelligence. Cowardly.
I go to a doctor for medical care, not for a judgement based on his or her religious beliefs. If a physician is allowed to refuse a patient treatment because of his or her religious beliefs where is the line drawn? Will an evangelical christian deny treatment to a gay person because their “lifestyle” is against their religion? Will a muslim doctor refuse to treat a woman who is not accompanied by a man? What about providing birth control pills to an unmarried woman? Sex outside of marriage is considered a sin in many religions.
How about we leave religion in the church and out of hospitals and doctors’ offices? If you can’t do that then don’t call yourself a doctor.
If there is only one doctor in town, then your statements could have some weight. If the person has other choices in terms of physicians, your statements are instead statist and bellicose.
Why should your moral rights trumps another’s? If you live by no moral code or a different set of codes must everyone else? Which Muslim doctor has acted as you state? If it were, there are already laws in place to address this. It’s called the Charter. Birth control is a drug not a right just like driving is a privilege not a right. Are you aware of the health and environmental health affects of birth control? If one doctor has moral issues with issue then in our information centric world there is near no barrier to find such product or places to acquire it.
I’ll leave my religion in the church and out of hospitals and doctors’ offices once you leave the state out of them. And we haven’t even yet discussed whether you should leave YOUR religion out of them. (You can’t. Nobody can.)
And, yes, you are religious. Everybody responds to God in some way; ignoring Him is also a response.
I have a few thoughts that, to some degree, have already been voiced by others on this forum, but that I would like to echo in my own words and expand upon.
First of all, in reality, if a physician refuses to perform, prescribe, or refer for a treatment/procedure for a non-life-threatening condition, this usually will not prevent a patient from accessing the treatment/procedure he or she is seeking in the end. Certainly, it may cause the patient some inconvenience if he or she has to see another care provider, but there are very few cases if any where a patient would not be able to access the care he or she wants. On the other hand, if physicians are forced to go against their consciences, then their right to freedom of conscience and/or religious belief is most certainly violated. Therefore, the truth is that in most situations where there is a discrepancy between what a patient wants and what a physician is willing to provide, it is the patient’s convenience versus a physician’s right to freedom of conscience and religious belief that is at stake.
Secondly, with respect to violations of physicians’ consciences and religious beliefs, some of the specific situations that have been mentioned and alluded to on this forum are not minor or trivial. A classic example would be abortion. Those who refuse to provide abortions or refer for them generally believe in their heart of hearts that abortion is the killing of an unborn child. Thus, in their eyes, to provide an abortion or to refer for one is tantamount to participating in the killing of a human being. While many may disagree with such a viewpoint, it cannot honestly be said that there is a clear consensus–morally or scientifically–on when life exactly begins. Many physicians believe life begins at conception, so to force such physicians to be involved in an abortion at any stage would, in their eyes, be to force them to participate in killing an innocent human being. So I suggest that, regardless of our views on abortion or any of the other controversial treatments/procedures brought up so far, we try to see that we are discussing potentially huge violations of some physicians’ consciences.
Thirdly, as some have pointed out, requiring physicians to go against their consciences puts the well-being of the public at risk. Even if we don’t agree with our physicians’ views on everything, we hope that ultimately they seek to do us good and avoid harming us. In other words, that my physician will practice with integrity is foundational to my trust in him or her. A medical system where the integrity of physicians is not upheld is one that does not serve the public interest in the long-run. It would be a very dangerous precedent to expect or force physicians to routinely go against their moral convictions.
To conclude, I believe that the current CPSO policy with respect to the Ontario Human Rights Code sufficiently protects both patients’ and physicians’ rights. It also allows physicians to practice with integrity, which is fundamental to the medical professions’ commitment to seeking the welfare of patients. Any change to the CPSO guidelines that would force physicians to go against their consciences would be completely unnecessary to ensure patients have access to care they want and need, would result in gross violations of physicians’ rights to freedom of conscience and religious belief, and undermine the integrity of the medical profession, thereby putting the public at risk in the long-run.
Thank for this lucid articulation of the ethical and health issues at stake in this discussion. Unfortunately, much of the debate about abortion tends to be simplistic; continuing that way is irresponsible and leads to misuse of critical public resources.
It seems to me that the Hypocratic Oath is not under challenge here. What is under challenge is the wide spread public view that pro choice by extension requires free access to abortion. That position leads to the view that abortion is just another family planning ‘technique’ and that physicians should just hold their nose and do it! It is not.
Abortion brings with it significant ethical, as well as mental and physical health issues that have long lasting implications. Seeing abortion as just another ‘contraceptive option’ leads to irresponsible behaviour, ethical dead ends and bad public policy.
A Doctor or any other public servant has a right to their beliefs and morals. They have absolutely no right to inflict them on others. If a Doctor has a religious need to deny or refuse treatment, then they have no right to serve in a public hospital. Let them have their private practice and put a sign on the door announcing which services they refuse to offer or persons they refuse to serve. Then the public can vote with their wallet.
Why should a Doctor’s rights be any less upheld than yours?
Because when a patient visits a doctor, it is not because the doctor’s health is in jeapardy. When a doctor’s health is in question that doctor can impose their own religious morals on their own program of care.
Opening the door for physicians to refuse to treat patients will only lead to problems for minorities. An Egyptian doctor in Winnipeg already refused to treat a lesbian couple because they offended her religious beliefs. In Winnipeg, there are other options but what about rural communities where there are no other options?
If someone cannot do a job because of their religious beliefs, they need to find another job.
who can physicians complain to when they feel that the CPSO or patients are violating their human rights?
When it comes to human rights, why does this CPSO often sound as if physicians are something other than human? It’s not like patients are human and physicians are some other species.
CPSO has to remember that despite the doctor-patient relationship, a physician is still a human being, and still should enjoy the same rights offered by the Canadian and Ontario Human Rights Codes as his/her patients.
A physician may choose not to perform a certain procedure or prescribe a certain medication for many reasons. Some of the reasons can be the physician’s comfort level or experience with the procedure or medication. For example some family physicians do colposcopy and some don’t. some prescribe certain narcotics and some don’t.
To force a physician or anyone else to do something against their will and conscience, is a form of forced labour. Forced labour is against the most basic human rights in this country.
The issue of expecting a physician to do certain life-saving procedures has some merit if the physician is the only one in town, or the only one available. If there are other physicians available doing those procedures, the issue has no merit, and is just leftist statism and bellicose tyranny.
If you’re picking and choosing who gets to be your patient based on your religion, you can go be a doctor in another country.
We are in a country that upholds life, not takes it. All medical professionals should have the right to uphold that fundamental Canadian belief!
Hearing/reading about this debate I cannot help but wonder when did the Hypocratic Oath become optional and/or selective? When did it become OK for a doctor to see his right to free religious thinking as supraceding his obligations as a doctor?
Frankly, if you are a physician and see this as a right, a new job might be in order.
Shameful and embarrassing for physicians as professional class.
The Hypocratic Oath is not under challenge here. What is under challenge is the wide spread public view that pro choice by extension requires free access to abortion. That position leads to the view that abortion is just another family planning ‘technique’. It is not. Abortion brings with it significant ethical as well as mental and physical health that are long lasting.
In my view, seeing abortion in simplistic terms is irresponsible and leads to misuse of critical public resources.
Our country is founded on faith and morales. To deny a doctor a right to use them to help make right choices is to deny the foundations of our great country
This Cannot be done on line 50% of canadians do not use internet constantly or at all. even those who do do not know of this much. Public forum would be much more appropriate and serve democracy with a eight month full discussion and then mandatory public vote.
If a Doctor wanted to keep hold on superstitious religious bunk, they should not have become students of medical sciences. They should have joined a mosque, or a church, or a temple.
The duty and responsibility of a Doctor is to assist ANY human patient, to improve, or save their lives with the most up to date, and advance means available to them.
They should not be sticking their heads in the dirt and allowing people to possibly DIE or receive sub-par care due to the physicians own personal beliefs resulting in gross incompetency.
Have you herd of Leonardo da Vinci or Galileo? Both catholic, you know believed to a certain degree in all that “superstitious religious bunk” yet were great scientists.
And Copernicus was a scientist, physician and priest…
Physician clinical decision making should be evidence based,not based on personal opinion.
I believe it is imperative that physicians be allowed to have the freedom of conscience… for honestly, a physician that has no choice in the care he deems medically sound for his patient is a frightening concept. As a patient, how am I to deem what is the best course of action when I have had no medical training or background? I understand that following any treatment is my choice, but it is also the physician’s choice whether or not he will provide that treatment. As for abortions, birth control, etc, if I really wanted it, and a doctor refused to provide it, there are a multitude of other physicians whom I may self-refer to see. Please allow the physician’s the right to practice by following their conscience, for a future without freedom of conscience is very frightening and as an individual with numerous health issues… I wouldn’t feel very secure if that happened.
Physicians as well as nurses are health care providers and all in emergencies must provide all the care which time and circumstance and ability permit them to give any patient .However, when people opt for elective procedures which the health care providers find contrary to their personal beliefs or conscience they should not be called upon to provide such services.
We are supposed to live in a democracy which permits us freedom of religious beliefs and those who are faithful to their beliefs live their lives 24/7 acknowledging and living according to those tenements . These rights should be protected for all humanity .
Christians from the first century have proven that they are prepared to die for their faith. It is a travesty that in a free country ‘so called’ a physician should have to choose between obedience to Christ or murder an unborn child.
When I was conceived, my mother was serving in the RCAF. If abortion had been as readily available then as it is now, she would have taken that course. As it turned out, she was not able to have any more children. It was me who gave her the joy of grandchildren and great-grandchildren. It was me who helped her through her elder transition years, and it was me who closed her eyes on her death-bed.
You say it is legal to kill an unborn baby until it has totally left the womb, i.e. partial birth abortion. This is nothing short of barbaric. Does the hippocratic oath mean nothing to you people?
We hear feminists talking about women’s rights to their own body. They have the right to consider moral values and potential consequences BEFORE they indulge their carnal desires. Even in the remote circumstance of rape, why should a baby suffer because of the sins of the parents?
It is NOT LEGAL to have an abortion. The absence of a law does not make something legal.
Doctors should have a ready list of all the bad effects of contraception and abortion to women in all different ways and give out that information to patients so they can be educated as to why the doctor does not want to do it. Let us not trample over what is good reasoning when it concerns our health for women and everyone as well.
I’ve read through a lot of these comments and I’m surprised to find no mention at all of the inherent power imbalance between physicians and their patients.
Physicians are powerful and patients tend to be vulnerable. This is particularly the case for patients who need treatments that some religions considered controversial.
Allowing doctors to refuse access to certain treatments on religious grounds gives a powerful person more power over an already vulnerable person. It’s shocking to me that this is even being considered.
It’s evident to me that this relationship is already imbalanced. Everything possible should be done to ensure that the patient’s wishes be respected and that they are provided with the care they are seeking.
“Physicians are powerful and patients tend to be vulnerable. ” That is such a loaded statement without any backing.
I am not sure what power physicians have where it is patients who always can sue or file a complaint against a doctor for no fee at all. Physicians actually have very little compared to patients. Patients can immediately switch physicians without notice. Physicians cannot even fire the more obnoxious and abusive patients, and have to give them at least 30 days notice with lots of other paperwork and still risk a college complaint.
I am very lucky to have a doctor which shares my religious beliefs. Although I understand his medical training has provided him with all the knowledge of science, he continues to put his/our religious beliefs into the conversation.
I believe it would be a big mistake and impossible to enforce should the CPSO ask the doctors to perform duties that may be against their moral convictions.
Doctors are committed to uphold life and Absolutely should be allowed to refuse to provide abortion which takes away the life of a fetus. We should not be funding this practice in our hospitals either as it is definitely not a health service.
Excuse me, but the question, “Do I get to pick and choose which parts of my job description I can just not bother with” is NOT something that should be put to a VOTE, for gods’ sake.
No other job will let you do that.
If they find themselves incapable of fulfilling all elements of their job — let them get another job. This goes for pharmacists, nurses, doctors — everybody.
I’d be fired in an INSTANT if I decided I didn’t feel like doing parts of my job for “religious reasons.” FIRED.
yes. firstly physicians are not employees. they are independent contractors. and in the contract with the ministry, there is no stipulation that every physician must do everything. In fact, most physicians are specialized or focused in certain areas. you can’t expect a dermatologist to write blood pressure medicine, or a cardiologist to write for acne cream, even though they can. Most physicians do things they are trained in, and feel comfortable and competent with. So if a physician is not comfortable performing abortions, or prescribing birth control for any reason, then you can go to one that does. If there is a shortage of doctors, then complain to your politician.
If the physician is the only one in town or available, then you may have a point, but if not, you are just a bully who wants to force someone into something they are not comfortable doing. The reason even does not matter and force labour is a violation of their human rights.
You don’t have more human rights than a doctor, because you are not more human.
Does your job make you take another person’s life? If not, you cannot compare.
That is not true!
Imagine that rules are changing in your workplace and now you are required to kill another human being as part of your new job description, would you still comply?
A doctor should not be allowed to refuse services to somebody just because that service is against the doctor’s personal religious or moral beliefs.
What if that doctor is the only doctor in a remote area and he is a religious conservative who thinks that birth control is wrong because you should’t have sex before marriage, but young women in the region want to get the pill? Then you would essentially be denying those women the right to manage their own sexuality and fertility, their own bodies, in the way that wish. Even if the person lives in a big city with many doctors, the woman wanting birth control would have to spend the who would be willing to do this for her which cannot be assumed to be an easy thing to do.
Or what if it’s a transgender person who wishes to get hormone therapy in preparation for a sex change operation? Again, if this is the only doctor in the area, that denies the transgendered person the treatment the need, and again, in a big city, time and effort would have to be expended to find another doctor.
The patient’s right to receive treatment trumps the doctor’s religious beliefs.
I understand the role of medicine is to save lives, and improve health. Now if a doctor says, “I’m sorry, you and your unborn child are healthy, I cannot assist you in taking the life of your child” he is subject to discipline by the organization responsible for ensuring he saves lives and improves health of children in the womb”
Very sad situation.
You should also include gender/gender identity on the list of reasons a doctor can’t refuse treatment
Absolutely physicians should have the right to have their moral or ethical beliefs protected! This is Canada, isn’t it?
Besides, when I was about to have my first child, I wanted some requests met during childbirth, nothing out of the ordinary, I just wanted as natural as possible and 2 doctors abruptly told me that just as I had the right to certain requests, they had the right to refuse to attend me! SO, if Doctors have the right to refuse a delivery of a baby, because it may be more work for them, then they should absolutely have the right to refuse to end a child, senior, handicapped, or seriously ill person’s life!!!
Some doctors have already forgotten the Hippocratic oath they had taken at the time of the graduation from medical school, that they will only try to improve the quality of life and prolong life, and not to cause harm to anyone or to shorten it.
Some people who have seen this kind of doctors, those in name, but do the opposite of what is expected of them, think that they can force all doctors to do that, that is to to say, help in the killing business.
One does not have to go to a medical school to learn how to kill a person, anybody can do it. Medical schools exist to teach the students how to prolong life.
If doctor is not allowed to act conscientiously, he is nothing more than a vending machine. You press this button, you get that drink or that pill or this medicine.
Doctors who act according to their conscience seem to be listening to the patients, comforting them, and spending more time with them. This practice itself has a healing effect.
So allow the doctors the freedom of conscience for the good of the people in general.
Physicians should always act according to the best of their conscience. They provide the service to the patient,their conscience is paramount to their act.
Physicians should always act according to the best of their conscience. As health service provider to the patient,their conscience is paramount to their act. To be obligated to do otherwise is an impediment to their professional and personal freedom of choice.
Please protect doctors’ freedom of religion by allowing them to pass patients to another doctor when they are not comfortable with providing certain treatments or medications. Keep canada free!
Does it really matter to me if I need to see a different doctor now and then? Not at all! Some of us are offended too easily by our differences.
The wording of the question is leading and inflammatory.Do you believe physicians should have the right to refer patients to a colleague for treatment if they have religious or moral conflicts with respect to performing certain procedures related to such treatment?
Vous faites une consultation concernant le droit à l’objection de conscience, voici ma pensée à ce sujet :
La conscience est ce qu’il y a de plus intime à l’être humain. Elle est ce par quoi il est un être humain. Évidemment, l’incapacité à user de sa conscience à cause d’un handicap ou d’un accident, ou d’un problème génétique n’enlève en rien à l’être humain sa dignité humaine. Le droit à l’objection de conscience est l’ultime droit qui confirme la liberté des individus. Nul être humain n’a le droit de s’arroger le droit de nier à un autre être humain son droit à l’objection de conscience. Seul les états totalitaires se sont permis cela et ils l’ont fait afin de détruire les êtres humains en les avilissants comme des esclaves, en les incarcérants pour les empêcher d’exprimer leur conscience et leur opposition au totalitarisme en place, ou bien en les tuants pour les faire taire. Nous ces exemples durant la dictature de Hitler par exemple.
Le seul fait qu’une société qui se dit démocratique se pose la question de la possibilité de nier à certaines personnes leur droit à l’objection de conscience démontrent que cette démocratie est en danger, et qu’elle est probablement déjà prisonnière d’un système qui se met en place rapidement pour devenir dictatorial.
JAMAIS le droit à l’objection de conscience ne doit être nié à personne mais toutes les personnes.
The doctor has taken an oath to do no harm. If providing a procedure that they feel would do harm, they should have the option not to perform any procedure. There are always others that will do it. If they believe that a fetus would be harmed, they have a right to decline. Who will stand up for that unborn life. What makes the difference inside or outside the womb?
Under what circumstances does the physician’s personal beliefs supersede the patient’s well-being? Primum non nocere, correct?
What kind of a backwards world would accept this decision, let alone consider it a debatable topic? Is this what progress really looks like?
I am totally shocked by even the suggestion that the state should ever think to force anyone to act against his or her conscience. First of all, because this is quite impossible. For the only way to act against your own conscience is to destroy the sense of who you are (yourself). So, all people, doctors or otherwise, must follow their consciences, it is an obvious fact. Some consciences are well-developed and enriched with reflection and thought, others, not so perhaps. Doctors might have to resign if they are true to themselves, society and the Hippocratic Oath to always preserve life, if confronted with anti-life problems. If you had kept the Hippocratic Oath, this problem would be redundant.. Doctors, like it or not, are already acting within their consciences and always will. Legislation will never change that .Ultimately,if you have your way, only doctors who haven’t developed their consciences will be providing services in Ontario. So, I ask you to think about the consequences before you act. Then, act within your conscience.
To the College of Physicians and Surgeons of Ontario,
As a Canadian born citizen, I feel that it is very important that the freedom of conscience of doctors be afforded greater protection than presently provided by the Code. It must be very clearly stated in the Code that a physician should not have to choose between his profession and his faith. At present, the Code provides no such clarity or protection. A physician should be able to refuse to provide a service that is a grave interference with his/her core religious or moral belief.
I understand that the right to freedom of religion is not unlimited. However, it is difficult to argue that public safety, order, health, morals or the fundamental rights or freedoms of others are threatened if a doctor for reasons of conscience refuses to practice euthanasia or abortion, There are other doctors available who will provide these “services” without suffering conflicts of conscience. Many doctors would find repugnant the destruction of a viable foetus simply because it is female. However, there are physicians who suffer from no such compunctions. At present, the Code states that there is no defence for refusing to provide a service on the basis of one of the prohibited grounds, but goes on to say that the law in this area is unclear. Religious conscience can be one of those prohibited grounds, depending on how you interpret the Code. Basically, the Code says that it is unable to advise physicians in this area and that this problem area is being left to the Commission, Tribunal or Courts.
The Code reads that the balancing of rights must be done in context. It states that the Courts will consider how directly the act in question interferes with a core religious belief. There can be no doubt that both providing either euthanasia or abortion would be considered a grave matter to doctors who do not just pay lip service to their faiths, but live by the tenets that they believe come directly from God. For these doctors, to provide such services would directly interfere with a core religious belief.
I agree entirely that the physician should communicate clearly and promptly about any treatments or procedure that he chooses not to provide because of his or her moral or religious beliefs. it interesting that if a physician chooses to limit his practice for the reason that providing such services would directly interfere with a core religious belief, according to the Code, he or she must still provide information about all clinical options that may be available relating to the patients needs. In brief, he must provide information on how to obtain an abortion. This directive flies in the face of logic since providing such direct information would make the physician partly responsible for the death in question, should the patient decide to proceed in such a manner. I feel that the Code should require the physician in question to provide a list of available support services, both clinical and social, appropriate to their situation, as well as advise patients or individuals who wish to become patients that they can see another physician with whom they can discuss their situation and in some circumstances, help the patient or individual make arrangements to do so.
As you can see, I have read your Code very carefully and have given your present challenge much thought. I sincerely hope that you will give some thought to what I have said. I no longer live in Ontario, but I did for many, many years. Recently, for reasons of health, I have had much to do with the medical profession. I have profound respect for the work of physicians and surgeons and much gratitude. It is my belief that freedom of conscience should be guaranteed in your Code. A Canadian citizen should never have to choose between his or her profession and God.
Of course a humane society allows physicians to avoid acting in ways they consider immoral. What is the alternative? To force human beings to act against their conscience? Outrageous. How did it ever come to this?
The organic and functional divide results in many prejudiced biased inhumane systemic treatement. It is time that steps be taken to stop labelling, assumptions and judgement. It seems that when medical practioners do not have answers they are quick to blame the victim, label the patient, and that it becomes impossible to get medical service. Even when one has the physical, mental, emotional, intellectual and financial resources to make their way through a biased, judgemental and very degrading system, it becomes devasting. One can only image what that looks like when one is homeless, speaks english as 2nd language, does not have family support etc. The system works well when the medical practioner has an answer (diagnosis is possible, treatment path known) but for those with complex and/or undiagnosed situations, the system is inhumane and alienating. Glad to provide lots of sustantiation of my position, based on much harm that has been done to my daughter.
Denying medical care based on the doctor’s bigotry and biases is obscene.
Imagine a firefighter refusing to save people from a burning building because he’s white and those trapped are black or First Nations.
Imagine an ambulance attendant refusing to treat a victim because the person is transgendered, leaving the person to die on the street. That has actually happened several times in the US, people left to die on the street because bigots refused to do their jobs.
“First do no harm” also includes NOT mentally and emotionally abusing patients by refusing to treat them based on personal bigotry. I thought it was called the Hippocratic Oath, not the Hypocrite’s Oath.
If those “doctors” don’t want to do their jobs on “moral grounds”, they should turn in their licenses and stop practicing.
#144 – You clearly have no understanding of the question at hand, please take time to read the current policy, the question of the debate, reflect on what is being examined and then if you have something of substance to contribute post a reply.
In searching the comments on this matter, I was surprised that only one, #42, referenced the experience of physicians in Nazi held regions during WWII, and the trials of doctors afterwards. What those trials declared was that doctors must follow a higher code, conscience, than that laid down by the government in power or by present popular conviction.
Respect for the sanctity of human life is a deeply held moral belief that forms the cornerstone of the Hippocratic Oath. A doctor committed to the protection and preservation of human life cannot in conscience participate in, or assist a patient in obtaining, a procedure that causes death, whether that death is the patient’s own (as in doctor-assisted suicide) or someone else’s (as in abortion). Your policies must continue to uphold a doctor’s freedom of conscience in this regard; to do otherwise would constitute a grave injustice and would have the result of driving conscientious physicians out of the province. Ontario cannot afford to lose these principled medical professionals. Please do not seek in any way to restrict the right of doctors to make decisions in keeping with their moral beliefs.
I believe it entirely wrong to mandate physicians to overturn their oath, when it is a matter of conscience or religious belief.
I had a incident at my office a few years ago where a staff member was insulted that a patient preferred that he not be examined by my female assistant. I was able to accommodate the patient because I wasn’t that busy. My assistsnt said SHE was insulted and that HER human rights had been attacked. She threatened to take ME to human rights commission as I had not backed her up.
We cannot accommodate everyone. There is no panacea. I got no help or advice.
Lots of grief and worry about lawsuit from both sides, I am lucky I got out of this situation unscathed.
I beg the College to give us some slack on this issue. We are all trying to be reasonable.
Only by acting according to my conscience am I able to be authentically who I am – a caring, compassionate and responsible physician who has worked tirelessly over the last 30+ years to ensure my patients received optimal health care. If I need to respond to the whims and wishes of my patients out of fear of repercussions due to policies put in place to respond to public opinion I am not being authentic and nor am I caring for my patients in a compassionate informed and responsible fashion.
Public opinion is neither informed nor compassionate. Nor does the general public have a clear and unbiased understanding of the complex ethical issues that I face in the ER, in OB and in the office. I have spent many years studying ethics and different systems of ethics in order to develop my own ethical thinking ability and I am not prepared to have it subsumed by the mimetic nature of a crowd of people (aka the public). For public opinion does not represent many individual opinions free of bias but rather scapegoats the one who is different – the physician who dares to say – killing humans is in contrasdistinction to all of who I am as a doctor.
Lastly the character of a civilization or a country or a group of people is best illustrated by its actions towards the most vulnerable in the population. It is a sorry and sad comment if it is demanded that we act against the most vulnerable of humans to satisfy an interpretation of the Human Rights Code that does not recognize or uphold the right for a physician to act according to his or her conscience.
Why are we bothering to teach ethics in medical school when we are going to demand that on graduation the medical student stop thinking and merely responds to the various demands of their patients. We would probably be all making a better investment in healthcare if we train robots instead of humans as physicians if and when it is decided that doctors should not use their conscience as their guide and are compelled to practice in ways that are against their religious beliefs.
Amen! . . thank you for “unpacking” the complex “components” of a physician’s conscience and its real relationship to your clients . . as distinct from “the public”.
I do not think any health care provider, including Physcians, should be obliged to perform any service contrary to the beliefs and moral ethics
What you are really getting at, with this survey, is asking us if it’s OK for physicians to be made to say that abortions and euthanasia are viable options. Neither of the above “procedures” are a treatment; they are death. It is not the physician’s job to prescribe death, especially if it goes against his/her religious beliefs. We would not make a Muslim eat pork just because there was a public pole where the results said “we” thought they should. Religious freedom, the last time I checked, is still something to which Ontarians, and all people (regardless of their job), are entitled.
I strongly feel that Doctors should have choice for their actions.
I believe that a physician should have the right to follow his or her conscience. Patients can receive any legitimate procedure they choose as there are an abundance of clinics in cities to accommodate them. A phone call to a clinic or a look up of a clinic on the internet and people can find the help they want.
“Conscience”: formed to the TRUTH of the DIGNITY of the PERSON, a person being a fact from conception until natural death. Therefore, assuming that “procedures” would include the destruction of a babe within the womb, then, OF COURSE, the physician has the RIGHT and OBLIGATION IN CONSCIENCE to refuse this intrinsically evil “service”!
Marxist atheism, by definition, has spread everywhere the error of the denial and of the obstinate rejection of God.
It’s application, first witnessed in Soviet Russia, includes the irradication of the inalienable rights of a person’s freedom and dignity. The idolatry of the State-as-”god” holds all citizens as the State’s PROPERTY. ( . . no person; no soul; no infinite worth; dispensable and disposable as the State sees fit e.g. as in atheistic communism under Lenin, Stalin, Pol Pot, Mao Tse Tung, Castro etc.)
The opulent West, it seems, has taken the “torch” of Soviet atheism -spread through wars and blood since Oct. 1918-
replacing steel and fire-power with stealth and scalpels. “Our nations float in an ocean of innocent blood.”
The West materialist West has chucked the Christian Moral Law, proceeding to unravel, in law, the foundation of the (true) family, replacing it with “FREE LUV” and all its rotten fruit. The innocent victims of irresponsible copulation are aborted as the “final solution” in failed contraception.
So, while Moral Law-based freedoms still exist in the West- but what a joke that’s becoming!!- OF COURSE physicians have a right to act according to a morally true conscience!
The subject of abortion should be separated out from the main question. I believe that abortion should be a matter between the woman, her partner and the doctor with no political interference. As for the rest of the question it is too ambiguous to give a definitive answer. I hope it was not meant to be such.
Doctors MUST react according to their conscience. Under no circumstance must a doctor perform, for example, an abortion which is against everything they believe. Though our government advoctes for abortion on demand(so we may be re-elected) doctors must respect their oath to respect life in all its stages, including the nine months in the womb of the mother. Thank You
Under no circumstances must a physician be required to perform an abortion or participate in an assisted suicide against their conscience.
I believe one of the most important items to clarify is what is meant by medical care. If we define it as diagnosis and treatment of disease, injury, or illness, it clarifies the issue.
Anyone facing these should receive immediate care if necessary and further referral at minimum. Other procedures that fall outside of this definition should be up to the individual physicians purview whether to provide, refer or not.
My concern is with the broad public perception that abortion is simply a another family planning option. It is not. In fact, it is a very serious ethical as well as a mental and physical health issue with long lasting consequences.
Also, I have problems accepting that public resources are allocated to a totally elective medical procedure like abortion, while other critical health needs continue to be inadequately serviced.
I support free choice on the matter of abortion and I also accept that there instances where pregnancy can be a health to a woman’s health where abortion is a legitimate response and where public funding is appropriate.
I disagree, however, that the freedom to chose an abortion means the public should by extension be required to pay for it or that physicians should in all circumstances be required to perform abortions.
Are not a lot our freedoms just that? I am free to have children but do I not have the responsibility to protect them, to raise them, and to pay for their care?
We talk of human rights but what about the human rights of physicians who are opposed to abortion or euthanasia. Any attempt by our government to force them to provide such services would be in direct violation of their human rights – freedom of religious beliefs.
I think doctor should have a right to refuse or involve In anything that is against their consciences.
To whom it may concern:
If we have freedom of religion under the Charter of Rights and Freedoms, then doctors should have the right/freedom to practice their religion in the workplace. There will be those who do not exercise the same beliefs as their doctor, and these people are free to see another doctor if they do not agree with his/her moral standing on some treatments and procedures.
Generally speaking, abortion interferes with the normal, healthy bodily functions, causing an increase in the rate of illnesses like breast cancer. There is no illness before the abortion, so no abortion should be required of any physician to be carried out. Medicine should not interfere. This is unethical.
to the CPSO:
I am physician who believes that I must be free to follow my conscience. I am not a puppet to the state/nation/culture. how can I possibly consent to do what you what I believe is harmful to me, let alone to you? do not take away our freedom to act in good conscience!
I believe doctors should be able to act according to their conscience. The most likely reasons would be:
Not wanting to kill a child in the womb via medication, i.e. that kills after fertilization, or abortion Not wanting to euthanize somebody
These are perversions of the physician’s role to save life, they should never be done, and a doctor certainly shouldn’t be forced to do them.
The growing practice of forcing people to act against their moral compasses is reprehensible.
History has shown various classifications of people who have at one time or other been subject to cruel discrimination sanctioned and encouraged by the law and regulations applying at the time.
Human nature does not change.
We must do our utmost to protect those brave individuals who strive to swim against the tide of current conventions and who are motivated by ethical considerations.
Dear Sir or Madam,
It is profoundly important that a doctor be allowed to refrain from doing anything that is against his conscience or how can he live and work under such a terrible slavery to the state. The world is moving on a downward spiral in terms of the rights afforded people, especially those with Christian beliefs. I seems that just about anything is to be tolerated today EXCEPT Christian belief. This erosion of conscience rights would mark a slippery slope for doctors who must give their patients the best care that they can within their vocation as primary caregivers. To force them to do a procedure against their will makes us just like China, which is not a good thing! There doctors must perform abortions and sterilizations against the PATIENTS’ wills!! And I am sure many of the doctors as well. What tyranny. Please allow the doctors there basic human rights of conscience.
Just as a mechanic can say no to a particular repair job on your car, maybe because it is beyond his competence, or he is too busy, he doesnt have the tools, or reliable help, fear of not getting paid, or its potentially a can of worms he doesnt want to get involved with.
I also think a doctor should be able to refuse a service based on any number of reasons including his concience or religious beliefs.
I’m a human rights lawyer practicing in Ontario.
Due to severe health challenges over the course of my life, including a battle with cancer, I’ve interacted with a number of physicians across the province. I’ve been very impressed with their professionalism, knowledge and with the quality of care that I’ve received.
I am surprised that the College appears to be considering requiring physicians to act in manners that may violate their conscience or beliefs. Should the College take such action, it is my understanding that it would be in violation of a number of Canadian statutes. Further, it would set an unbelievable precedent – requiring physicians to violate their understanding of quality of care. To me, this is unfathomable. We value physicians for their experience and professional judgement. To strip them of the ability to act accordingly would undermine the medical profession. It may also cause physicians to leave the province.
Thanks so much for this comment
Dear Sir or Madame
With reference to the following:
“The Ontario Human Rights Code articulates that every Ontario resident has a right to receive equal treatment with respect to goods, services and facilities without discrimination based on a number of grounds, including race, age, colour, sex, sexual orientation, and disability. This imposes a duty on all those who provide services in Ontario-which includes physicians providing medical services-to provide these services free from discrimination.”
Nowhere in the quoted text does it mention religious freedom. For example, a patient requesting a referral from her GP for an abortion and the doctor strongly opposes such an action based on his/her religious beliefs. In order for the doctor to legally comply with the Ontario Human Rights Code would the doctor be required to provide said patient with a referral to an abortion service? If this is the case, based on future legislation, would it not be a direct a violation of the doctor’s human rights with respect to religious beliefs.
How truly sad that our unborn children have no rights. I can see a time in the not distant future when even doctors, sworn to uphold the Hippocratic oath, will not be able to protect our unborn children.
We need to step away from purely emotional arguments and take a look at the logic here.
Upon what universally accepted principle should individuals be forced to give up their own convictions and made to act upon the contrary moral beliefs of an employer, union, professional association or state?
The decision that something ought to be done reflects a moral or ethical belief, exactly the same kind of belief as a decision that it ought not to be done. One cannot exclude belief from moral or ethical decision making because all who exercise moral or ethical judgment are acting upon a belief of some sort. Belief may be religious (man is the image of God) or non-religious (man is a rational being). To claim that only non-religious belief is valid in moral or ethical decision making reflects anti-religious prejudice, not sound reasoning.
As soon as a council or government removes protection of conscience laws, they permit coercion and human rights abuses to occur. We cannot afford to allow this. It is essential that the state preserve freedom of conscience for health care professionals, for those they care for, and for the good of society as a whole.
The religious and moral beliefs of current secular humanism, on which the Ontario Human Rights Code is based, are incorrect. Christianity is correct.
Physicians should, first of all, do no harm. Killing people because of their small size or early development, for example, is hardly a “treatment or procedure” that accords with a human rights code.
The way that the college has framed the poll is extremely biased. It is insidious. Why not ask straightforward questions such as,
“Should a physician be forced to kill an unborn child at the mother’s request?”
IN your College you state:
“The performance of, or referral for, FGC/M (FEMALE MUTILATION) procedures by a physician will be regarded by the College as professional misconduct…”
How now with this clear example already in your books, cannot the CPSO grant the right to a physician of not wanting to refer for practices such as abortion and euthanasia (the latter a real threat given the latest developments in Quebec). Conscience rights are a big part of a strong democracy. Do not deny them.
We are politely dancing around the issue, reluctant to speak clearly with common language. If a doctor is not comfortable helping with birth control, abortion, sex selection, euthanasia, then he/she should be allowed to hold to that position without net reference by the Human Rights Commission. To rule such conduct as cause to suspend the medical license is just another step in the direction of George Orwell’s prediction of mind control. Do we really want to cancel these freedoms?
Denial of freedom of conscience for physicians is wrong. They don’t deny it in other professions and shouldn’t here.
Physicians should be free to refuse to perform abortions or euthanasia and also refuse to support other physicians in such operations including referrals. Physicians should also be free to refuse to offer information on artificial birth control other than natural methods such as menstruation cycles and abstention.
Physicians should be given the ability to choose whether or not to pursue a certain course of treatment based on their freedom of conscience. For example, if a physician believes the unborn qualifies as a person and that to abort it would be murder, it would be highly unethical to force that physician to perform an abortion, as to them it would be the same as committing murder. Moreover, ridding their ability to access their freedom of conscience would rid the province of many physicians who believe that it would be unethical and discourage people from joining the profession.
Patient-rights are the responsibility of the provincial health organization. If a procedure is covered by the provincial health organization, the patient is assured that there are doctors whose conscience will allow them to perform it, so the patient’s rights are upheld. If the patient’s family doctor does not want to perform the procedure, they still have the option of finding a doctor who will perform it. To deny doctors the right to decline a procedure because of their conscience is unjust and inappropriate. Besides, it would seem a patient would rather have a procedure performed by a doctor who does it willingly than by one who does so solely because of legal constraints, but is plagued by his conscience. The public needs to think more carefully: patient-rights are not endangered by upholding doctor-rights, but doctor-rights are clearly endangered when patient-rights are the only rights honoured by law.
I voted YES: my preference is to decide for myself and I don’t appreciate at all being driven by a Nanny State or any organization on these issues. I wonder why you are doing this? Shortly, you will tell me when to go to the bathroom. Enough that society is going downhill, do we need to be aided by “no conscience”?
Furthermore my wife tried to vote on her Blackberry and I tried on my computer, without any success. Barring any technical problems, do you think this is how results and life is determined: The Majority Voted NO.
It is my understanding that no current law or associations’ code of practice or conduct can legally abrogate or derogate the Canadian constitution which guarantees freedom of religion and conscience. I don’t believe any physician would deny necessary medical care to anyone in need no matter what their gender, religion, sexual orientation, etc. It is when you drift into the area of what is medically necessary that difficulties arise. For instance, the medical necessity of an abortion is virtually non-existent as well as a sex change operation. Prescribing abortifacient drugs could not be considered medically necessary nor could prescribing birth control medication and devices unless, for instance, it is necessary to regulate a menstrual cycle.
If the standards of practice were to use the term ‘medically necessary’ it may allow a physician more breathing room to exercise his or her right to freedom of religion and conscience.
Thanks for the opportunity to comment. The guidance is useful and I have no issue with the vast majority of its content. In particular, I strongly support the requirements that physicians a) provide equal treatment without discrimination and b) accommodate the disability of patients/prospective patients. I agree that a physician’s religious beliefs have no bearing on these two requirements.
I am concerned that the guidance and the expectations below could be interpreted as also indicating that physicians are required to offer/facilitate all medical services, regardless of their religious beliefs. This is very different from the two requirements above. It would not be “discrimination” for a physician to refuse to offer/facilitate a specific service to any patient on religious grounds.
In my opinion the College should take great care to distinguish discrimination (as in the first paragraph) from situations as described in the second paragraph.
Unless there is a medical emergency it is difficult to see how refusing to refer a patient for a specific service could deny that patient a “right” — or constitute a failure of the physician’s professional responsibility. It would be very helpful for the College to be clear about this issue as well (the language “in some circumstances” as in the final bullet is very vague). Without such clarification, we will see lawsuits (and allegations of professional misconduct) brought by ideologues who wish to deny physicians the right to exercise their own religious freedoms.
As the guidance says, the religious and moral beliefs of (some) physicians are central to these physicians’ lives
Thank you for the opportunity to provide feedback on the very important issue of conscientious objection. As a future physician, I feel strongly that I, the same as other Canadian citizens, should not be legally obligated to perform an act that I deem against my moral code. For example, if I were asked to perform an abortion, I would feel obligated to inform my patient that I could not do so because of my moral objection to abortion. I feel that abortion directly violates sections 9 and 14 of the CMA Code of Ethics (rights and harm to the unborn child), and I would be following sections 12 and 15 by informing my patient of my inability to agree to the request, and under section 19 I would assist the patient in finding another physician if they so desire.
I think that a legal obligation to perform an act with which I am not comfortable would violate my own basic rights and disallow me to use my own judgement when it comes to sensitive procedures.
I have been watching the vote counter with interest. I am not sure how much weight you are putting on its results. Until yesterday the vote was 90% in the yes camp. Then in less than 24 hours the count flipped in the opposite direction with the total votes cast almost tripling. I have noticed that each time I check the vote count from a different computer I get offered the chance to vote again.
I suspect you are just using the IP address or something like that to ensure that no computer votes more than once. But my teenager could write some simple code to shift IP addresses and place hundreds of votes over a few minutes.
What is the process for ensuring that your results represent unique opinions from individual real people and not one person with IT knowledge?
Thank you for pointing out this very serious problem with the CPSO’s online poll that asks, “Do you think a physician should be allowed to refuse to provide a patient with a treatment or procedure because it conflicts with the physician’s religious or moral beliefs?” The fact that, rather easily, a single individual could place multiple votes totally invalidates the results of the poll. Additionally, as anyone familiar with survey and research methods would attest to, such online polls are severely prone to self-selection and coverage biases. Since the results of this poll cannot be considered valid, then I question why the CPSO posted such a poll in the first place. It gives a false impression to the members of the public who view the results, and because proper survey methods were not employed, the CPSO must not in any way use its results to guide how its ‘Physicians and the Ontario Human Rights Code’ policy might need to be revised. If the CPSO genuinely is interested in quantifying how the public or CPSO members would answer the question posed on its online poll, then it should conduct a proper survey that is either provided to the entire target population or captures a representative sample of it.
To Whom It May Concern,
How can you even ask this question:
Do you think a physician should be allowed to refuse to provide a patient with a treatment or procedure because it conflicts with the physician’s religious or moral beliefs?
How is this a question?
If a physician refuses to provide accepted medical treatment for non medical belief/prejudice, they should not be physicians. The mere fact that your association would legitimize the question by asking is deeply troubling.
I wish to congratulate the CPSO for its clear recognition of the principal of cooperation in its prohibition of referral for female genital mutilation. Consistence would, of course require that referral for abortion or euthanasia be similarly prohibited or at least not required
What are people thinking to ask a doctor that does not want to do an abortion or kill, you people call it euthanasia. The Physicians and Surgeons have a right to refuse, because they took an oath to help people live and not die. You know what you want them to do is MURDER, that’s what it is and there is no other name for it. People, don’t be hypocrites, call it what it is because you all know that it is MURDER. You take more care of a dog or cat than human beings. A man gets two years for dog abuse and a killer gets what?????? An abortionist gets what??? Am I missing something here. Have we gotten so cold and heartless that we all think that evil is good and good is evil. Wake up Ontario, before it’s too late……you see, you’re getting old too, and soon it will be your turn, you may not even be sick, but why should they keep you alive…..they don’t need you, because if this goes through you will have no control on who lives and who dies. You see you will cost Ontario money to make you live…think about that. Babies are being killed right and left, because of ME, ME, Me attitude…hey get over yourselves…..Parent’s why do you bring your little girls to get an abortion?? You are killing your grandchild. May God have mercy on you. People, just to let you know that the moment that a child is conceived it is alive, it has a soul. It is a living being, it has a right to live.
Dear Doctors, don’t let them get to you, God is on your side. Help the ones that cannot speak for themselves, the unborn, the elders, the ones that have infirmities. Don’t be afraid to stand your ground, you will be rewarded in heaven. God help us all because the day is coming and it is coming soon, sooner than most people think, then all you evildoers will be judged for everyone that you have hurt.
To whom it may concern,
I strongly support the refusal to allow doctors to perform FGM or refer patients to doctors who will.
The same role of conscience should be allowed for doctors who choose not to perform euthanasia or assisted suicide.
We are guaranteed freedom of conscience.
To Whom It May Concern,
I would like to express my serious concern regarding the College of Physicians and Surgeons of Ontario’s desire to change their policy to remove conscience protection as this would definitely affect in a very dangerous and negative way the freedom of conscience that we all have a right to… this would need to be a well informed conscience of course.
There are natural laws that a well informed conscience cannot go against and this is a very basic human right.
Ladies and Gentelmen:
I welcome the opportunity to speak to this matter.
In a civil proceeding in Saint John, New Brunswick, it was once noted that in law, witnesses are weighed, but not counted. A case was cited where a number of inmates testified to the innocence of a fellow inmate regarding an in-house offence. However, the hard evidence clearly and directly linked the accused to the offence. The witnesses were lying to a man. In this matter, do not fall into that trap, however prestigious the source of the lies may be.
It has been observed that no amount of repetition can transform a lie into the truth – except in politics. A single utterance of truth should be adequate to strike down a volume of falsehood – except that this is rarely seen in politics. Let the buyer beware.
The 1988 Morgentaler decision, while striking down a regulatory mechansim affecting abortion, did not conclude that abortion was beyond the legislative criminal jurisdiction of Canada; indeed, the Court affirmed that such legislation was indeed called for. To say that abortion is a right in Canada is stretching the point. Decriminalization does not equal a right which the government is obligated to promote and force all sundry to approve and or participate in. Otherwise, doctors could be forced to prescribe and public health services supply, tobacco products at public expense.
When abortion was decriminalized, the public was assured that it would not be at public expense – a lie which has clearly been unmasked. We were further assured that medical practitioners would also have “choice“ and which choice is clearly under attack.
Much has been made of the balancing of rights. This is another lie. What balance is there between a mother`s right and the right of the child to live where abortion is practiced in all circumstances and the child inevitably dies? Even children born alive despite abortion are often left to die unattended in clear violation of the law ccc s223. Does your association not respect the law in this matter?
Further, as a professional society with retained lawyers, you must surely know that not all abortion is legal in Canada. You must realize that no amount of logic or semantic gymnastics can overcome the fact that CCC s 238 criminalizes partial birth abortion or its equivalent, except only where necessary to protect the life of the mother. Contravention of this section carries life in prison. Do you respect the law in this regard? I realize that the Crown may not favour the law and may not wish to uphold it, but that does not mean that it is legal. It would only mean the Crown may be willing to ignore the law they are sworn to uphold. But two wrongs do not make a right. Does your profession respect the law? Or would you be prepared to force a doctor to recommend or be involved in a procedure that is actually criminal?
I would remind you that Human Rights or professional requirements to be involved in medical treatment that violates one`s conscience clearly subvert constitutional protection of conscience rights. If you proceed to force doctors to be involved in any way with what they truly believe to be wrong, how are you any better than Adolf Hitler who required physicians to kill the elderly and also his army personnel to slaughter Jews? Being “personally pro life“ and willingness to slaughter the innocent do not mix, either under Hitler or under the pernicious goals of human rights policy when it comes to abortion.
While the following is in some sense a different aspect, it is nevertheless relevant.
In Alberta, and possibly similar in Ontario, abortion funding is legally tied to medical necessity. A former Alberta Health Minister once wrote me stating that the most effective approach to reducing abortion in Alberta was to reduce unplanned pregnancy. In sayng this, it was ADMITTED IN WRITING THAT UNPLANNED PREGNANCY WAS A MAJOR REASON FOR ABORTION IN ALBERTA.
However, unplanned pregnancy is a social matter, not a medical cause. Still, the Province pays for all abortions at a rate of 100%. Doctors are required to deem that the abortion is medically necessary in order to be funded. But the govcernment knows full well that it is in most cases elective only. And the doctors must surely be aware of this.
This leads to the inevitable conclusion that the doctors are lying through their teeth when they certify that elective abortions are medically necessary in order to qualify for funding. We also conclude the government is fully aware of the fraud.
Since there is a move to force doctors to violate their consciences by involvement in abortion, does your society also intend to require that doctors falsify medical records by certifying as medically necessary abortions which they know to be elective only? In other words, is it your intention to require such doctors to commit criminal medicare fraud as a condition of practice?
Charter conscience protection exists to shield people from the kind of policy that I have described above. The workplace is not a Charter free zone. The balancing of rights ceases to exist when the wish of one person becomes an obligation on another. This is not balance; it is extinguishing conscience rights where the doctor becomes a mindless slave to a political ideology. The right to do something does not constitute an obligation on all to be involved.
While the following is beyond medicine, it is still related in principle as medicine is not the sole arena where our fundamental freedoms are under the wrecking ball. When same sex marriage was proclaimed in Canada, government gave assurance that commissionaires would not be forced to perform such ceremonies in violation of conscience. But it was a lie. One by one the provinces have ordered them to be involved or lose their jobs. Schools are being forced to teach it to children against parental education rights. It is a huge assault on basic freeddoms. This is the true face of so-called tolerance. It is nothing but a mask for totalitarian style intolerance. When they speak of support for diversity, they are lying; they believe in rigid conformity to one ideology only under pain of economic or criminal sanction for anyone who disagrees.
I thank you for considering this. Excuse anyt typos.
I am not a doctor but as a Ph.D. Candidate I hope I can contribute some clear and consistent thinking (and pertinent facts from biological science and political history) to this discussion. I suggest that in general there is no need to compromise doctors’ democratic freedom of conscience for the sake of patients’ access to services, which can easily enough be procured by them from another doctor. Doctors calmly explaining their reasons for services they do not provide without being judgmental of patients with different views who may then wish to go elsewhere contributes to the mutual sharing of different human journeys and ideas in our pluralistic Canadian society where we respect each other’s right to our different human journeys and the values we have discovered along the way.
In the especially thorny case of abortion bigger issues are at stake, and I further suggest that there is NO NEED to violate doctors’ democratic rights to freedom of conscience by forcing them (Communist-style) to prescribe or perform procedures which violate their high principles (including the traditional Hippocratic Oath to “do no harm”) and violate their supremely high estimate of the value of the human life they treat (human life which medical science more than any other well knows is not only harmed but ended in an abortion), only to give patients a more convenient access to a highly controversial procedure like abortion which is NOT a legally defined right in Canada but which is merely permitted because there is NO CANADIAN LAW which defines it (either for it or against it). I suggest that certainly no democratic government should even consider violating the democratic rights of doctors by enforcing abortions (which are forced upon both doctors and patients in Communist China) before abortion is even defined in law; and in the meantime, while abortion is permitted only because there is no law defining it, if patients having access to abortions if they really want one is of concern, such patients can surely find doctors with lower estimates of the value of human life at all its stages which medical science has described in such immense detail, who will prescribe or perform the procedure, without violating the democratic rights of other doctors to not be forced into participating in what they may see as a crime against human life.
It is important to remember too that doctors may regard abortion as a crime against humanity not only because of their personal religious and moral convictions but because the medical science they are experts in tells them in immense detail all about the human life they treat at every stage of its life development, including the stages before birth. Scientifically speaking it is absolutely undeniable and undisputable that the unborn human fetus (Latin for “little one”) or baby is an absolutely unique individual biological human life with unique DNA distinct from his or her mother (who does not even share blood with her unborn baby but nutrients and waste molecules pass between them by osmosis). It is absolutely undeniable scientifically that abortion ends or kills these absolutely unique individual biological human lives with unique DNA distinct from their mothers’. On these scientific facts alone anyone who considers human life valuable and worth protecting in general, even with much less detailed knowledge about such human lives at all stages as doctors have access to, might and do come to the conclusion that abortions are as morally wrong as ending or killing human lives at the stages after birth. If doctors come to this conclusion, it is their professional medical knowledge of human life at all its stages as much as their personal religious convictions which have led them to this view. I note that there are even some Atheist Pro-Life organizations which do not hold traditional religious beliefs but instead value science and logic above all else, and they also conclude that if human life is valuable at all, it is valuable at all ages and stages, and cheapening it at any age cheapens it at all ages. Clear, logical thinking demands that as soon as you say SOME human lives are not valuable and not worth protecting FOR ANY REASON (Jewish, not yet born, handicapped, etc. – and note being both unborn AND handicapped makes you a prime target for abortion in Canada), you logically affirm that NO human life is INHERENTLY valuable just for the fact of being human life. Therefore abortion cheapens the human lives of all of us, because it logically means NONE OF our lives are inherently valuable.
Modern Democracy and Human Rights developed precisely in a context which assumed that all human life was valuable and therefore should not be oppressed, but should even be self-determining as long as it interfered with no other human lives and rights, the most basic and fundamental human right being the right to live. Every oppressive regime (from pagan Rome to Nazi Germany to Communist China etc.) has denied that human life is inherently valuable and thus denied protection to some human lives, the government allowing or even instigating the ending of human lives. So, especially in a democratic country, professional doctors should have the right to uphold the traditional view that human life is valuable at all ages and stages, which is logically consistent with the science of life, and which is as much part of their professional medical integrity as of their personal beliefs – are they not doctors, specialists in caring for and healing human lives? Is not ending or killing human lives then the opposite of the doctor’s calling, as encapsulated in the traditional doctor’s Hippocratic Oath to “do no harm”? So why on earth should they be forced to participate in a violation of the doctor’s calling, as the College of Physicians and Surgeons of Ontario is now considering? Should we not expect the medical profession more than others to remind us of the value of the human life their vocation is to treat and take care of?
Physicians for Life ascribe to the traditional doctor’s Hippocratic Oath and they have the collective medical opinion that abortion is never medically necessary – that even in the extremely rare instances where a mother needs a procedure which might result in the tragic loss of her baby there is no need to actually target the baby for death as an abortion does. And they further note that the current practice of non-medically necessary, elective abortions more than anything else targets handicapped babies in the womb, unique individual human lives with unique DNA who may have some medical condition which doctors are also trained to treat and help to live healthy and fulfilling human lives in spite of their condition. Physicians for Life notes it is a gross injustice to aggressively target these young human lives which may be handicapped for a life-ending abortion. I note that it is also pure Eugenics, and the most famous and most consistent practitioner of Eugenics was Adolf Hitler. Certainly this policy sends the message to every handicapped person in Canada that Canadians think it’s better to be dead than to be handicapped, as they are the very first targeted for abortions before they are born. Should we not expect doctors, as experts in human life and how make it live better and healthier whatever its defects, illnesses or injuries, to uphold the value of the human lives they treat? So surely it would be a gross injustice to doctors for the College of Physicians and Surgeons to force them to end human lives instead of helping them, since, as Physicians for Life notes, doctors always have two human patients not one whenever a pregnant woman comes into their office, and the doctor’s traditional obligation to “do no harm” applies to both. I find it strange that this Forum is about whether doctors with high moral standards who truly CELEBRATE the human life they treat at all its stages of development, whatever age the human life is, who for this very reason are likely to be among the best doctors because of their passionate care for the human life they treat, should be forced out of the profession if they refuse to participate in ending human life instead of treating it. This will only have a gravely impoverishing effect on the medical profession in general, if those doctors who most care for human life are not allowed to practice medicine because they refuse to kill it.
Thus, I suggest that for the sake of clear, logical thinking based on the facts of the life sciences, and for the sake of democracy and freedom in the interpretation of those facts by doctors who are medical experts familiar with those facts, consistent with the very long professional medical tradition of Hippocrates to “do no harm” to human life (a description which cannot be scientifically denied of the unborn); and in order to do no communist-style violence to doctors’ democratic rights entirely unnecessarily, since patients can still get access to services from other doctors who do not conscientiously object to them; that doctors must be allowed to refuse to prescribe or perform services which are against their conscience. I suggest this principle of democracy will prevent the medical profession from being greatly impoverished and falling into disrepute for making the mistake of forcing out of the profession those doctors, many likely among the best just for this reason, who most cherish the human life they treat and heal, just because they refuse to kill it.
This thread was not meant to be a platform for you personal view of abortion.
Yes, abortion would certainly be one of the issues involved in this concern for a physician’s religious beliefs.
However–There are cases where an abortion is necessary to save a woman’s life
–Not all your statements are consistent with what Science says
–Obviously, you do not agree with abortion, but others do feel there are valid reasons to have one. They should not be forced to abide by your beliefs nor by a physician’s personal beliefs.
Not everyone has the option of going to another physician as you suggested. If they can, great. However, there are ares where there may be only one physician available.
This issue is not just about abortions. There are a number of other treatments about which a physician may have strong beliefs and wish to refuse to offer–
–contraception medications and/or devices (which, BTW, are used for other issues besides birth control)
–morning after pill
–pap smears, internal exams for unwed women
–putting someone on life support
–not putting someone on life support
–providing services until the patient has said tried some prayers
There are any number of things that any particular physician could oppose.
I agree it must be a dilemma for a physician when personal beliefs collide with available medical options. However, basically forcing patients to abide by their physician’s beliefs is not the answer. Each patient has a right to have access to all the options modern medicine has to offer.
I’m responding to the commenter on June 27, 2014, at 1:39 pm. I am not the original commenter on June 26, 2014, at 12:37 am.
You concluded, “Each patient has a right to have access to all the options modern medicine has to offer.”
A right? Really? Does access also include funding?
Is the pre-born child a patient? Why not? After all, “Science” (your personification) says that the human fetus is just as much a human being as you or me. And I would point out that according to God, who is three persons, we may not kill a human being.
Abortion is medicine? What disease does it cure? Is the electric chair medicine, too? Note that pro-life doctors do not label as abortion the D&C used to end an ectopic pregnancy (which is probably what you’re referring to as “necessary to save a mother’s life”). The goal is not to kill the child but save the mother. Neither the child nor the mother can survive an ectopic pregnancy allowed to continue. There is a disease here.
I am a volunteer at the Pregnancy Resource Centre in our town. I have seen first hand the results of Post Abortion Stress Syndrome. We have now started to provide courses for women who need closure and forgiveness for taking a human life when they were young and vulnerable. Why should our doctors with Christian values be forced to perform abortions when it goes against their beliefs. I for one feel that they should have the right to refuse. I also think that our health system is paying the price for their liberal policies in the number of young women who are suffering from depression. We as tax payers will be footing the bill for their treatment for many years to come.
Conscience and morality are not simply religious values. In order to practice medicine, one must acquire extensive scientific knowledge. Doctors with moral objections to scientific procedures do not approach them solely from a religious perspective–they have medical knowledge that justifies their beliefs as well. For example, Natural Family Planning is very carefully researched and effective if practiced properly. If a doctor recommends these methods instead of artificial hormones that will change my body chemistry, she is not doing so because it is in keeping with her religion, but because she believes it is what is best for me.
If I know the treatment I am being given is truly what the doctor believes is in my best interest, then I can trust this doctor. If I feel that the doctor has made an error, I have the freedom to consult another doctor who can also give me the best possible advice according to the full extent of his or her knowledge. Without allowing doctors to exercise their freedom of conscience, how can they be trusted?
A physician should not be obliged to perform a procedure which is contrary to his oral or ethical beliefs
If the physician can easily ensure that the patient is seen by another physician who is comfortable discussing and providing care options, then that is a reasonable course of action. By ‘ensure’ I do mean make sure it happens immediately. Simply sending a referral to another physician could result in long wait times. That is unacceptable. The physician should personally arrange for a timely appointment with the other physician. This could work in clinics where there are a number of doctors or other doctors close by.
However, in certain areas of the province people are having difficulty finding a physician. Having the option of a couple of physicians is out of the question.
A physician could be the only one to provide care in an area. Everyone in that ares should not be subject to that particular physician’s belief system. That certainly would destroy consistent provincial care.
It could happen that the physician holds a ‘genuine and sincere’ objection to vaccinations. If s/he can then refuse to provide this treatment, it could mean preventable disease outbreaks in that area. Hopefully, all physicians understand the importance of vaccinations. But, there could be a small percentage who don’t.
If the only available physician objects, because of beliefs, to discussing or providing any form of contraception, that really treads on every woman’s right to family planning options. Also, some contraception medications/devices are used for concerns other than preventing pregnancy. Women should not be refused access because of what the doctor believes.
Canadian includes people of many religions and of n religion. The medical care they receive must not be determined by the particular, personal beliefs of individual physicians.
Physicians are certainly entitled to their personal beliefs, as is everyone else. If a physician knows his/her beliefs will limit the options s/he will provide for patients, that physician should seek a practice location where other physicians are readily available who can and will provide the complete spectrum of available options.
The medical options available to me must not be limited by or subjected to my physician’s person religious beliefs.
I feel that healthcare professionals should have the right to refuse procedures that go against their religious beliefs and morals.
-The Colleges mandate is to serve and protect the public interest. Therefore comments indicated how that objective is compromised will carry more weight. Use your own words and thoughts, but here are some examples:
- Taking away the right to conscientious objection compromises the integrity of health care leaders, and the system as a whole – leaving the way open for political and/or industry manipulation
- Indicate how uncomfortable it would be to be seen by a doctor who can’t practice according to conscience. Could you trust such a person?
- Would you feel safe in a health system where policies prevent the free thinking of doctors in ethical matters – especially when policies can be made with agenda’s that put vulnerable people at risk (Elderly, mental handicap etc.)
I think that for a fair balance between the rights of the doctor and the patient that: A doctor must have the right to not prescribe medications or treatment if it is against their beliefs or conscience, as long as there is no harm, inconvenience, obstruction or delay to the patient.
If there is no other doctor easily available or accessible for the treatment, then the best interests of the patient must have preference over that of the doctor. In all cases it is responsibility of the doctor to ensure that the patient is treated according to best practises, even if they wish not to treat them themselves.
I would suggest that your survey question ought really to be: Should physicians be compelled by the Province to provide a patient with a treatment or procedure that the physician deems, in his or her professional judgement, is not in the best interests of the patient?
This is not about professional judgement. This is about the physician’s personal moral preferences over-riding professional judgement. That is why the policy requires that the physician suggest that the patient visit another doctor who does not have the same moral qualms. It should be much stronger.
Ethics and professional judgement are inseparable. For example, when a pro-life doctor has diagnosed an ectopic pregnancy, he recommends a procedure that acting on any normal pregnancy would be termed an abortion.
When ethics do not inform professional judgement, a competent but evil profession can forcibly sterilize women (as has happened in the US), harvest organs (as has been said to happen in China), conduct experiments without the patient’s consent (as happened in Nazi Germany), mutilate a girl’s genitals (as happens in some Muslim countries), or kill children (as happens in Canada and around the world). These are human rights abuses and violence, and they are perpetrated by doctors.
“Personal moral preferences”? Morality is not optional. God has made clear in the Bible what is right and what is wrong. The church has had two thousand years of application of ethics to Western civilization. The state does well to take heed; indeed, it ought to respect, not usurp, the authority of the church.
A physician should be obliged to provide all medically available services regardless of the physician’s religious or other beliefs. If a physician is unwilling to provide a service, such as family planning, the physician should be obliged. If the physician will not provide such a service, they should practice in an area that will not conflict with their beliefs.
When I was in Japan, I worked with a doctor, who was the head doctor at a private birthing centre. He refused performing abortions and would advise another hospital, or would invite the woman to have her baby, and he would work with an adoption agency and they would make sure that the baby was adopted by another family. In Japan abortions in 2007 were 300,000 a year and the number of tourists coming to Japan for abortions from the U.K., the U.S. and France, where abortions were strictly restricted, Japan ended up to be called “an abortion paradise. Yet a doctor has the right even in Japan to refuse performing abortions. I cannot understand that when a woman has the right to have an abortion, and the doctor has NO RIGHT to refuse? Preposterous! I believe that this even goes beyond a right or no right! The question is between “do I want to kill or not want to kill.” Another contradiction is that the pregnant woman says, “I have the right over my own body forgetting that she is holding another alive body.” Does that mean that the unborn has no right to live?” We are so inconsistent in what we say and believe.
I want all my relatives and friends to fight for the doctors who refuse to kill an innocent child.
It worries me that any government organization or college of professionals would restrict the freedom of my doctor to practice according to his conscience. As a professional in another field, I greatly value the integrity of conscience to limit and restrict what a person is willing to do. Not only should these freedoms be preserved for our doctors, but doctors of differing views need to be invited to share their conscientious thoughts freely in order to safeguard our system from losing touch with genuine concerns of morality and ethics.
A physician or any other public servant cannot be compelled to do something against their conscience. The 2008 guidelines are clear that the physician must 1)communicate those procedures that they will not perform 2)provide a full set of options for the patient and 3) advise the patient if there are other physicians that provide the procedures in question and 4) respect the patient by not expressing personal opinions about their lifestyle or choices. These guidelines should be reinforced in a new Human Rights policy. It should be particularly clear that any decision to refuse treatment is not discriminatory under the Human Rights Code.
A physician must provide for the patient;s needs but the actions must not be contrary to his ( her) own conscience.
Clearly the CPSO should and must be a firm supporter of conscience rights for the health of the profession. The very conscience that tells us that life is important, has inherent dignity and worth and should be protected is also the conscience that tells me to always be honest with patients, to bill ethically, to treat the marginalized patient with the same respect I treat a CEO. As physicians our reputation is related to our conduct in history…taking care of the marginalized, individuals without a voice – even when society has disagreed. We continue to treat individuals that are difficult, we treat people that cannot pay, we go the extra mile to ensure patients are cared for when society and even their families have forgotten them. This is why patients trust us, this is why my patients listen to my recommendations – because I do what is right not what is always easy. What else will we lose when we silence and marginalize doctors with a conscience?
You are incorrect. That is not why patients trust you. We don’t want your personal opinion, actually.
Patients trust you because you are unbiased, non-judgemental, even-handed and fair. A scientist. Supposedly anyway. Religion does not factor in to your thinking. Instead, you deal in verifiable truths.
Taking a paternalistic view toward your patients is not at all welcome. As we all know, this coming from a man, this is a conversation about abortion rights and birth control generally.
This is the settled law of the land. The majority spoke and the battle is over.
Doing what is right and not always what is easy is certainly laudable.
But this is not one of the situations. You are not a white knight here to save us all from ourselves. As above written, the majority has spoken. The law is clear. And as an agent of the state, you best focus on doing your job or do something else.
July 2 commenter, you are incorrect. I trust my pro-life physician because I know he does not kill the vulnerable; he would rather go into another occupation or leave Canada than kill another human being. It his religion that informs his conscience.
Apparently you are a scientist, but I don’t mean that in a complimentary way. I mean that your religion is scientism, an unwarranted faith in the ability of mankind to save himself from problems that derive from his own nature.
One of the first “verifiable truths” that this kind of scientist needs to accept is that the human fetus is a human being. Once you talk about “personhood”, you have entered the realm of philosophy and religion.
And a physician is NOT an agent of the state. The origin of Western medicine has much more to do with the church–monasteries and Christian hospitals–than the state.
There is a great error in your comment. A right to abortion is NOT AT ALL “the settled law of the land” in which “the majority spoke and the battle is over.” It is misleading to say that “abortion is legal” in Canada, and more accurate to say “abortion is not illegal in Canada.” There is a huge difference between the two. Abortion is NOT AT ALL legal in Canada in the sense that Canadians have a legally defined right to abortion. It is only “legal” in the lesser sense that abortion is “not illegal” because there is currently no law defining abortion either for it or against it. Any number of bizarre practices can be said to be “legal” only in this way, and there is no sense of “right” attached to them! Indeed, the previous law which restricted access to abortions was struck down, but at the time the courts expected it to be replaced with a new law which would set new limitations, but this never happened. No referendum was ever taken to establish the majority opinion in Canada, but it most certainly is not that abortions should have no restrictions whatsoever, which is the current reality only because there is no law one way or the other. In this legal void situation, people in Canada can and do have abortions right up to 9 month full term babies about to be born (who cannot possibly – even by the ignorant – be considered “just a tissue blob”), or because they don’t want a girl (or sometimes a boy), or even because they have plane tickets for a vacation during the due date and they don’t want to cancel their vacation. Even most Canadians who generally favour abortion as an option are not aware of and would not approve of this extremely unregulated situation because there is no law at all. But the doctors are on the front line of these bizarre and disturbing reasons to end a human life, being asked to be the cause of such senseless deaths – their right to conscientiously object to taking part in such deaths for something that is not at all a legal right but only “not illegal” because there is no law governing it, must not be taken away. This would violate democracy in the worst way.
You seem to misunderstand the nature of the law. All things are legal that are not specifically illegal. Whether they are “bizarre” in your terminology has nothing to do with it.
Because abortion is not illegal, it is legally permitted. Patients are entitled to have access to all legally permitted treatments without having to deal with some practitioner’s personal moral qualms.
The lack of a law forbidding something does not mean that anyone is entitled to it.
Furthermore, the law does not entitle anyone to compel others (including physicians) to act against their conscience.
As a patient of the clinic (different doctor) where the 3 doctors are refusing birth control to women I was appalled. After figuring out that it was indeed still 2014 and not 1914 I was livid. To refuse women birth control, in my opinion, is anti-women and it puts women who visit this clinic at risk, it is a dangerous backslide on women’s rights. While I know my argument would be better served leaving women vs men out of the picture, could you imagine a similar incident where a moral or religious judgment put men’s heath at risk? Never! To deny women birth control, morning after pills and abortions puts them directly at risk of unwanted pregnancy (and the personal, economic, and sociological impacts that go along with it), and in some cases risk of endometrial cancer (PCOs).
Birth Control has been around for how long and is how widely used? Even if you don’t personally love how it alters hormones, what if it’s the only thing that’s keeping a woman with PCOs from endometrial cancer risk? It should be a doctor’s job to inform, and provide their opinion (in a reasonable way) while the ultimate decision should rest with the patient in a situation like this.
To dismiss your obligation to help those in need is selfish. To push aside your responsibility to help these women onto other colleagues is selfish.
When I was a woman in my 20s, aside from the odd super flu birth control refills were the only reason I entered a clinic. And just doing that I have a list of walk in doctor stories of unpleasant experiences. To make it MORE difficult for women to walk in that door and access what they want is cruel. I was a shy, privileged Canadian and it was hard when there were no barriers; what about the shy new immigrant?
First, birth control should be available without a prescription. Other countries do it.
Second, if prescriptions are really required I urge you when considering this Policy to re-write it with firmer barriers to incidents like the one above.
I find it very odd that this person describes the refusal of artificial birth control as putting women “at risk of unwanted pregnancy” as if this was an actual health risk. First of all, pregnancy is not a disease: women’s bodies are designed for it, and being unable to get pregnant is what is a disease! Moreover SEVERAL STUDIES HAVE SHOWN THAT ARTIFICIAL BIRTH CONTROL IS LINKED TO CANCER, WOMEN’S SHELTERS SOMETIMES POST MEDICAL INFORMATION ABOUT THIS FACT, AND THEREFORE ARTIFICIAL BIRTH CONTROL IS CERTAINLY A HEALTH RISK WHICH A DOCTOR MIGHT WELL HAVE NOTHING TO DO WITH FOR PROFESSIONAL MEDICAL NOT RELIGIOUS REASONS. Natural methods of birth control, such as the Billings Method, were developed by doctors based on their intimate medical knowledge of the female body – it is well known that a woman can only conceive about 2 days out of her monthly cycle, and their are regular symptoms in the body which can help identify when this is happening. Those who are trained to recognize these natural symptoms of fertility can then use that information either to avoid or to facilitate a pregnancy, hence this is “natural” family planning – not quite as effective as artificial birth control for avoiding a pregnancy, but close to it if one is well trained, and without any chance of cancer – so these are certainly methods which doctors could prefer and prescribe even without any religious reasons added to them. So there is no need to restrict a doctor’s religious freedom regarding something he is well within his or her competence as a doctor to prescribe in order to avoid the established link of “the pill” with later infertility and cancer.
You want to use Roman Roulette, be my guest. But don’t presume to stand in the way of those who want to use more scientific (and effective) methods.
Artificial contraception is not “more scientific”. As July 6 commenter wrote, it is a little more effective, but in both artificial and natural contraception, prevention of pregnancy is not guaranteed. However, July 6 commenter’s initial observation warrants repeating: pregnancy is not a disease. The female body was designed to become pregnant through sex, and so it is inability of a female to become pregnant that is a disease.
July 7 commenter seems to have ignored July 6 commenter’s explanation of the health dangers of artificial contraception. Who’s really playing Russian roulette? Extramarital sex is not just unethical; it’s also irresponsible and unhealthy.
As a well educated, 27 year old woman I walked into a publicly funded walk in clinic and; after having a regular pap smear from doc, I then requested my usual birth control prescription; this is when the doc informed me that “I do not prescribe this to unmarried women any longer” and handed me Biblical scripture that compared un married women to “fornicators” who shall “not inherit the kingdom of God”. I was shocked.!! He said the only alternative is a) abstinence or b) waiting till marriage. I was really amazed that in a publicly funded clinic I would be lectured so. He also informed me that all doctors in “my clinic are required to follow my path…if people don’t like it, they can find a new job”. I also had NO other doctor available and was amazed that he could do this!! it was crazyyyyy and offensive beyond belief.
I am all about supporting religious beliefs and cultural leanings etc. but I do NOT stand for lectures about religion nor any judgement being passed. I am TIRED of women’s reproductive rights being squashed by the moral high ground of the religious right!
I have had this happen a SECOND time in a different city….different doctor, but for the SAME reasons and it is UNACCEPTABLE. There is a separation of state and church for a reason…why…in medicine, is that the exception??
You wrote that the doctor’s decision and words were “crazyyyyy and offensive beyond belief”. Do you think perhaps that he might have found your lifestyle “crazy and offensive”–and unhealthy? After all, the good God’s rules were meant for our own well-being.
And–what should be obvious–they have higher authority than the Ontario Human Rights Code.
The lecture and biblical scripture are a little over the top, but on the other hand there is no such thing as a right to “not be offended”.
What would you propose instead? That you should be allowed to impose your ideology on every doctor in Canada?
Physicians should continue to provide Human Rights Code-mandated services without discrimination for any reason, including religious or moral beliefs of the physician.
I do not think provision of a public service should, or even can be restricted based on religious beliefs.
Do we allow plumbers to advertise with signs that say “We don’t do service calls to Muslim homes”? Of course not. but that is the legal progression that follows allowing physicians to refuse to provide services based on religious doctrine.
The Ont. College of Physicians and Surgeons Human Rights Code is again being reviewed. It appears that some pro-abortion feminists are trying to change the doctor’s Code to force all doctors to put aside their moral and religious beliefs. In others words force them provide abortions, contraceptives, abortion drugs and possibly euthanasia if the liberals ever get elected federally.
Human Rights Codes (HRC) are popping up in all of our institutions like a spreading disease and many are questioning the sudden need for them.
These ‘common good’ Codes limit mankind’s range of intellectual, spiritual and moral growth by setting perimeters to choice. They were created to establish rules of thought and to silence and intimidate those who disagree with their choices by making ‘equality’ the criteria.
There is no such thing as a collective brain or thought. We can divide a meal among many but we cannot divide it in a collective stomach. Nobody can use their lungs to breath for another or use their brain to think for another. All functions of the body and mind are private. People learn from one another but learning is only the exchange of material. The collective or common good of race, class or state was the claim and justification of every tyranny ever established.
Doctors already have their own Code called the Hippocratic Oath and it far outweighs any HRC.
Human Rights Codes are branches of the provincial government which they can add to at any time. Suppose for a moment that the provincial government decided to add pedophilia or zoophilism to their HRC.
Outright discrimination is bad but banning discriminating taste is also bad and that’s what these manifestoes do. They take away our right to disagree with life choices that we know are wrong. As we have seen with Human Rights Tribunals, disagreement means expensive losses for the individual in their kangaroo courts. All in the name of the common good.
Doctor-patient confidentiality is also a moral grey area, but there is absolutely no question that a patient who has, say, contracted an STD cheating on their spouse, needs to be able to approach a physician for treatment without fearing social repercussions.
This is the same thing. Especially in cases where the treatment is time-sensitive, such as with emergency contraceptives, denial of service can have serious medical, psychological and social repercussions for the patient.
If a physician’s scruples prevent patients from receiving effective care, that is more wrong than removing a freedom of choice within their chosen field.
Physicians are not technicians. They are medical professionals, and as such, need and have a right to use their professional judgment and respect their own consciences.
Many of the issues surrounding a number of physicians’ denial in prescribing certain ‘treatments’ that you read in the papers have nothing to do with health.. i.e. abortion, contraception. In reality, these are lifestyle choices and are associated with health risks. According to the World Health Organization, oral contraceptives are a Class 1 carcinogen right up there with asbestos. This is what women deserve hearing.
On the CPSO’s webpage for the ongoing consultation regarding its ‘Physicians and the Ontario Human Rights Code’ policy, there is an online poll question that asks:
“Do you think a physician should be allowed to refuse to provide a patient with a treatment or procedure because it conflicts with the physician’s religious or moral beliefs?”
I urge everyone to think very carefully about the implications of one’s answer to this question. While some may be inclined to answer “no,” I would suggest that a CPSO policy that forces doctors to provide treatments and procedures that they find morally objectionable would have far reaching and negative consequences for many physicians, regardless of whether they are religious or not, conservative or liberal, pro-life or pro-choice, etc. I also believe that forcing doctors to do things that they believe are wrong undermines the integrity of the medical profession and puts patients at risk of harm.
In forming our opinions about a policy, we usually don’t think about it merely in abstract terms, but we also tend to think about specific real life examples and how they would be affected by different policy options. From many of the comments on this forum and in light of some recent stories in the press (1), I get the impression that there are several specific scenarios that many people on all sides of the debate commonly have in mind when considering whether a physician should be allowed to refuse to provide a treatment or procedure she finds morally objectionable: Namely, these are when a physician refuses to prescribe birth control, when a physician refuses to provide or refer for an abortion, or with the prospect of the legalization of euthanasia in Canada, when a physician refuses to perform or refer for euthanasia. However, it is important to consider how a policy applies in any and all situations to which it pertains—not only those that first come into our minds, those that are controversial, or those about which we have strong opinions—in determining if a proposed policy would be prudent. I propose that some who might initially feel that a physician should not be allowed to refuse to provide treatments because they conflict with the physician’s beliefs might rethink their answers if some other examples are considered.
To illustrate what I mean, let’s first consider the provision of late-term abortions—i.e., an abortion beyond the point at which a fetus is considered viable, which is around 23-24 weeks gestation (2). In Canada, there is no legal restriction on abortion at any point before a baby is born, so late-term abortions are legal, regardless of the reason. Yet, even amongst those who are pro-choice and amongst doctors who perform abortions, many draw a line somewhere around the point at which a fetus is viable, beyond which they feel uncomfortable with elective abortions and believe that, at least in cases where the mother and fetus are healthy, an abortion would be wrong. Indeed, as was stated in a public letter to the National Post, pregnancies beyond 24 weeks are, in practice, only terminated when there are “serious indications that the life of the mother is at risk or that the fetus has very serious malformations,” and that “the assertion that late-term abortions can be performed ‘for any reason, or no reason at all’ is just not true” because abortion providers in Canada generally believe that late-term abortions are otherwise not justifiable (3). In other words, despite abortions being legal at any point during pregnancy in Canada, many—if not all—abortion providers believe that, when the mother and fetus are healthy, late-term abortions are morally objectionable and will not perform them merely because a patient requests one. So, while some physicians find abortion objectionable beyond conception or some early stage in pregnancy, many others find it objectionable beyond viability, especially when the mother’s health is not at risk or there are no fetal malformations. Therefore, the truth is that most physicians make some sort of moral assessment of abortion and that the main difference between those who would consider themselves “pro-life” and “pro-choice” often is the stage at which elective abortion is viewed as a morally legitimate course of action. If the CPSO determines that moral beliefs are not a suitable basis for a physician to refuse to provide a treatment or procedure, abortion providers would be obligated to provide abortions at all stages of pregnancy on patient demand, regardless of the reason. Is this really a situation most physicians and the CPSO want?
As another example, consider newborn circumcision. Many physicians and even the Canadian Pediatric Society (4) have held the view that elective newborn circumcision is a medically unnecessary procedure that needlessly exposes infants to pain and surgical risks. Therefore, for such physicians, circumcision is an unethical practice that they decline to perform or help patients facilitate. However, many parents still desire circumcision for their children for a variety of reasons—including religious practices, family tradition, perceived health benefits and personal preference—so other physicians are happy to perform or facilitate newborn circumcision for their patients. Thus, there is no true consensus in the medical community with regards to whether it is ethical to perform elective circumcisions on newborns, so there is great variability amongst physicians in terms of their willingness to perform or facilitate the procedure. If the CPSO changes its policies such that moral beliefs are not suitable grounds for a physician to determine whether or not to offer a treatment or procedure, then physicians who are of the view that elective newborn circumcision is unethical would be forced to act contrary to their consciences and provide or facilitate circumcisions whenever parents request them for their babies.
As a third example, consider requests for physicians to participate in home births. Interest in having home births is not uncommon amongst pregnant women in Canada, and physicians who provide obstetrical care are sometimes asked to attend home deliveries. Because of the potential risks of giving birth outside of a hospital setting, many physicians would refuse to participate in home births and discourage their patients from having them. Nonetheless, there are others who believe that in these cases, the autonomy of a patient is important enough and the perceived psychological, social and/or spiritual benefits of a patient being able to give birth in her own home are sufficient enough to outweigh the potential medical risks of a home birth; thus, they are willing to help their patients have home births. Thus, physicians (and healthcare providers in general) have divergent views on whether it is ethical to become involved in home births in light of the potential harms that could come to patients who do not deliver in a hospital setting. In a similar way as in the other two examples I’ve outlined, if the CPSO eliminates conscientious objection as a suitable basis for refusal to provide a treatment or procedure, then it would not be possible for those who provide obstetrical care to refuse to participate in home births should a patient request it.
If we are honest, most physicians have moral or ethical qualms about some treatments and procedures and will draw a line beyond which they are not willing to go. For some physicians, it may be prescribing birth control, being involved in abortion at any stage, or participating in euthanasia. For others, it may be providing a late term abortion to a healthy woman with a healthy fetus at 39 weeks gestation, circumcising a newborn when there is no medical indication, or participating in a home birth. The vast majority of physicians I know—regardless of their religious beliefs, worldview, or political persuasion—seek to do their best to serve their patients by providing ethical medical care that provides benefit while avoiding unnecessary harm. Yet, these physicians of goodwill do not always agree and come to different conclusions regarding the ethicality of a small number of treatments and procedures. Consequently, sometimes physicians differ in what they are willing to do and not willing to do for their patients. For controversial treatments and procedures, I suggest it is best to allow physicians to refrain from practices that they find unethical rather than forcing them to go against their consciences. This is vital to maintaining the integrity of the profession. Even if we can’t agree 100% of the time on what should be deemed “ethical” and “unethical,” can we all agree that we should expect doctors to refrain from doing things that they truly believe are wrong? A system where the consciences of doctors have no place in shaping how they practice is one that does not serve the interests of patients.
(1) For example, see this article: http://ottawacitizen.com/news/local-news/some-ottawa-doctors-refuse-to-prescribe-birth-control-pills
(2) The definition of “late-term abortion” is somewhat variable. Some consider abortions later than 16 weeks or 20 weeks to be “late-term.” Others consider abortions beyond viability, which usually corresponds with 23 to 24 weeks, to be “late-term.”
I believe that Public Medicine should adhere to the doctrine of separation of church and state. Religion has no place in a scientific discipline. Whatever your beliefs are, there is a public interest in keeping religion out of medicine for all those concerned.
Keeping both religion and science out of medicine is an impossibility. For example, from biology we understand that a human zygote is just as much as human being as you or I. From Christian theology we know that only God has the authority to kill a human being.
Also, separation of church and state is not the same thing as separation of religion and state.
First of all, your website is difficult to navigate. Even though I knew of the consultation from the Globe and Mail article today, it took me some time to find it and then to work my way through it. This is hardly transparent.
On to the policy. It is unacceptable, whether framed in terms of an Ontario Human Rights Code violation or not, for physicians to refuse legally available treatment that is within the area they are practicing. If they do not wish to prescribe birth control, conduct prenatal tests that may lead to abortion, etc., then they should not practice in these areas or should not practice medicine at all.This is/should be no different than Catholic pharmacists being required to fill prescriptions for birth control (or I suppose a Scientologist pharmacist being required to fill a prescription for an anti-depressant) and Muslim taxi drivers being required to pick up passengers who are carrying alcohol. A medical practice, like a pharmacy or a taxicab is not a place of worship, essentially a club setting the rules for its membership.
Over two decades ago, I “went elsewhere” for an abortion as my doctor at the time was not supportive. I was supported by family, well-educated, financially secure and close to alternative resources – advantages many women do not have and should not be required for them to receive the treatment they need.
It is unacceptable, whether framed in terms of an Ontario Human Rights Code violation or not, for physicians to offer abortifacients or do abortions. Killing the child is not an acceptable way of solving a problem pregnancy.
Over two decades ago, as you wrote, you “went elsewhere” for an abortion as your doctor at the time was not supportive of your abortion. Apparently he (or she) was supportive of your child. His support was an advantage many pre-born children do not have. May the day come when every doctor is a pro-life doctor and all children have a recognized right to life.
I do not think there is an easy answer to the question.
With all the religions, sects and personal feelings about things many doctors must face this problem from time to time. One answer wont fit all situations. Obviously in a life-threatening emergency the doctor must put the patient first. It is fine to advise the patient to see another doctor if that doctor doesn’t want to get involved in some form of treatment but that isn’t always practical. What if the person is going on a trip the next day and doesn’t have time to get an appointment with a different doctor? What if the patient lives in a small town or out in the country where there may be very few other doctors taking on patients. Other health problems and personal finances might make it very difficult and/or expensive to go to another town. Etc. And what if a woman had a health condition that made getting pregnant life-threatening? Shouldn’t she be provided with the best medical treatment necessary, be it temporary or permanent? Including the morning after pill? An abortion if that is the best solution? A vasectomy for the husband ?
I presume that if a doctor refused to provide some service because of a religious belief that they would be expected to refer the patient to a doctor who would but wouldn’t that also be against their belief? It would seem to be a bit hypocritical for a doctor to refuse to do an abortion but to refer the patient to one who would. It would be a bit like refusing to help someone rob a bank but directing them to someone who would.
A real problem for both doctors and patients.
The answer seems easy to me. What life-threatening emergencies have involved a doctor unwilling to help for reasons of conscience? Certainly no Christian doctor would refuse. The very reason that medicine exists in its modern Western form is that the Christian church was trying to SAVE lives.
And that, ironically enough, is the reason that Christian doctors now require freedom of conscience. For, contrary to God’s law and to the Ontario Human Rights code, there are many abortions every year in Ontario. Every single abortion is a case of discrimination on the basis of age. Essentially the pre-born child is considered TOO YOUNG to have a right to life.
Abortion is never a valid solution. You spoke of a “life-threatening pregnancy”, but currently every pregnancy in Ontario is potentially life-threatening for the pre-born child. A very, very small percentage are life-threatening for the mother, and for these ectopic pregnancies pro-life doctors are willing to do the same surgery as for an abortion. However, the surgery is not called “abortion” because the intent is not to kill the child but to save the mother in a situation in which neither mother nor child can survive if the pregnancy is allowed to continue.
I am very concerned about the recent refusal by the Ottawa physician, to prescribe artificial birth control to a patient at his Ottawa walk -in clinic. This is especially disturbing considering the fact that this patient had prescriptions for birth control filled at this clinic for the last two years. Canadians fought for the right to have birth control legalized and won this right in 1969, a mere 49 years ago. To take away this right is a huge step backward. If a doctor does not want to prescribe birth control because of moral or religious values then he or she should consider NOT working in Ontario where he or she is paid by the tax payers. A sign posted at the clinic, and a letter explaining why the doctor will not prescribe birth control is NOT good enough. The letter indicated that another doctor would fill the prescription, but no such doctor was at the clinic at the time. This clinic should have a physician available during its operating hours who will provide prescriptions for artificial birth control. I urge the college to review its current policy on physicians and the human rights code, and to apologize to the patients refused prescriptions. After all, Canada is a democratic country with a history of equal rights for women, and this is the 21st century.
Are you aware that many forms of birth control are abortifacient?
Western Civilization, of which Canada is a part, has a history of equal rights–or, at least, the right to life–for pre-born children. That’s Canada’s Christian heritage, too. That the child has a right to the nurture of its mother can be seen from nature itself. To use your words, “to take away this right is a huge step backwards.”
I am appalled at the possibility that I as a physician might be obligated to refer a patient for a procedure which I find morally or religiously anathema. I have great concerns, for example, that active euthanasia may become law in the near future. I would rather give up my license to practice medicine in Ontario than consent to such a treatment for a patient under my care.
Others feel as strongly about abortion, and birth control. If our society wants automatons practising medicine, we will lose the best practitioners to vocations which still uphold virtue.
You can be sure that if this heavy handed approach is adopted by CPSO, it will lead to an appeal to the Supreme Court of Canada. It is an issue of the constitutional rights of the individual who is providing health care. It is not a matter of patient rights – there will be enough practitioners with varied moral views to accommodate those patients with more utilitarian moral perspectives. Taking a tyrannical approach will have many unseen adverse effects on health practitioners, patients and society in general.
And the idea that anyone “leaves their morals at the door” when practising medicine (or any other aspect of health care) is absurd. Those who hold such a position are simply expecting everyone to conform to their particular moral position.
I as a woman am appalled that physicians would be permitted to dictate my personal moral choices regarding reproductive health. Make birth control available without a prescription if the physician’s cannot handle the responsibility of prescribing it. By all means Doctor, do not use birth control if you do not believe in it. However, do NOT expect that you can dictate my right go use it.
No one is trying to take away your right to use birth control. You will not have any difficulty finding a physician to prescribe it to you. That is the current reality. Even the woman who was so offended by the GP that up front reproductive health was not part of his practice simply went down the street to another clinic to get a prescription. Even in her article she states it wasn’t really an inconvenience. Let’s all calm down about the birth control and stop trivializing this discussion.
The big question up for debate is taking away the ability for physicians to follow a personal code of ethics. That is a huge violation of freedom – such as your ability, as a woman, to have choice over your reproductive health.
If the doctor decides to refuse, it should not be up to the patient to find another doctor. Let the refusing doctor bear that burden. It is not morally defensible for me to require you to bear the burden of my moral decisions.
Completely agree with you.
To Whom it may concern,
What is he world coming to in Canada if we can not refuse to do something that goes against our conscience? There are enough people on every side of the discussion who will be more than willing to give a patient what they want medically without creating a police state by forcing people to avoid training to become doctors because they want freedom of choice. Have we gone back o the Holocaust?! As Canadians we embrace diversity. that is fundamental to who we are! Who is the government to tell us that we can only have their views? The government or governing body has to be made up of people of every bias not just heir own! I would not want to be part of a country that thought otherwise. Why are people leaving countries that have taken away their freedom of religion and free thought?
I feel very strongly that I will not provide services that I feel are morally wrong These include abortion and assisted euthenasia .
no exceptions !
Good evening. I live in Ontario and am writing concerning proposed changes to the human rights code.
Physicians and other practitioners should be allowed to practice according to their conscience. A practitioner should not be forced to perform any procedure that goes against their personal or religious beliefs, nor to take any part in the process which is essential or instrumental, such as referral.
Freedom of speech and conscience is necessary to the well being of any society. This should apply to all, including providers as well as consumers.
I agree, please do not take away freedom of conscience, the consequences would be devastating!
Regarding the issues raised in this Globe and Mail article (http://www.theglobeandmail.com/life/health-and-fitness/health/do-doctors-have-right-to-refuse-to-treat/article19383553/): a complicated issue which will require considerable discussion. However, two points need to be central to the discussion.
When individuals become doctors, they commit to putting the patient’s welfare first, so the patient’s well-being must be the first and primary determinant of treatment. If the most effective methods of treatment contravene or contradict a doctor’s values, the patient’s well-being must be the first consideration, not the doctor’s values.
Second, a large part of doctors’ education is funded by the public. Doctors, when they graduate, are in effect working for society at large and must practice according to current social values, even if those values contradict the doctor’s personal values. That is the deal they have entered into when they accept society’s investment in their education. If doctors wish to practice as directed solely by their own values, they may, as long as they either opt out of the current educational model and pay for their schooling entirely out of their own pocket, or if they repay what society has invested in their education. At that point, they may practice guided solely by their own principles. At that point, also, they cannot be part of any publicly-funded medical system. And if this is how they decide to practice, they must state clearly what they are doing.
Currently, in Canada, for example, we as a society are willing to let women practice birth control. If a doctor doesn’t want to prescribe birth control pills – if that is what the patient requests – that doctor can repay the amount the government invested in his or her education, at which point the doctor can practice according to the dictates of his or her values. If this happens, these doctors can receive no public funding, and they must state clearly what they are doing.
Nice try and I believe doctors should not be able to ration health care to those whose values and beliefs are compatible, but even at that, your funding argument is not practically feasible. The professions are licensed to provide competent and ethical services for the public good. Simply paying for one’s use of such a socially defined standards practice, will not evade who is allowed to administer health care to the citizens of Canada. Like it or not, there is precious little in which persons can provide services without some kind of oversight and governance.
(1) You wrote that “if the most effective methods of treatment contravene or contradict a doctor’s values, the patient’s well-being must be the first consideration, not the doctor’s values.” As a Christian, I don’t so much care about what the doctor values as about what God values. According to Him, we should not kill each other. Even today, there are still many who believe that a child can expect nurture from its mother. Amazingly, there are a significant number of others opposed, and they would call the killing of the child a “method of treatment” for its mother. There are also other immoral practices that a certain segment of Canadian society is calling “methods of treatment”.
(2) Do you know Canada’s national anthem? God keep our land glorious and FREE! I am not a slave of a totalitarian government, and neither are the doctors. Neither is any tax-payer, and I think I’d be open to eradicating all compulsory public funding for education of doctors.
“that doctor can repay the amount the government invested in his or her education.
that’s a pretty steep assertion. If the gov made all prospective medical students sign a contract to that effect, then your assertion would ride if the students became doctors and violated the contract, otherwise it’s just you trying to impose your values on others.
Birth control is not health care. It is a lifestyle choice that lies outside the realm of health care. Physicians may choose to provide such services, but under no circumstances should they be obligated to do so.
If birth control is not health care, then don’t require a prescription from a doctor to access it.
As long as you make the doctor the gate-heeper for birth control, then prescribing it becomes part of his or her responsibility as a doctor — and therefore not a matter to be influenced by his or her personal moral qualms.
We are not dealing here with mere “personal moral qualms” but with moral reasoning as an integral part of professional medical practice. As a patient, I want my doctor to be first and foremost a person of integrity. Under no circumstances should my doctor’s integrity be sacrificed for anyone’s convenience.
Birth control is not always a “lifestyle choice”. It is often recommended to treat painfull, heavy, or irregular menstruation.
Par exemple, je viens de divorcer, mon enfant est malade, ma conjoint vient de mourir, je viens d’être arrêter, je fais une attaque de panique ou mon fauteuil électrique tombe en panne et je ne peux pas me rendre à mon travail.
Mon employeur me demande un billet du médecin parce que je vis un stress intense. Mon employeur me laisse aller voir mon médecin.
Mon médecin réponds que le stress est relié aux causes psycho-sociales et elle ne peut pas signer le billet selon son jugement.
Une femme ayant un enfant a droit a un congé parentale. C’est un accommodement raisonnable dicté par la loi.
Nous pouvons vivre un moment de stress intense. Nous avons besoins d’un accommodement raisonnable. Le billet du médecin est émis selon le jugement du médecin.
Je me suis fait répondre de changer de médecin de famille. Il est très dure de trouver un médecin de famille. Donc, je ne suis pas traité équitablement par rapport à un autre citoyen.
Les RH et le médecin se lance la balle.
Est-ce les ressources humaines sont responsables ou mon médecin ?
Quelle sont les consignes données par votre association aux médecins de famille pour les stress intenses ci-mentionnés?
Il serait bien de parler aux ordres professionnels des ressources humaines, aux collèges des médecins, aux gouvernements provinciaux et au gouvernement fédéral pour en venir à politique unique. C’est le patient qui souffre et non le médecin.
Voici les droits et libertés de l’Ontario
• La discrimination, c’est le fait de traiter une personne de façon injuste en raison, entre autres, de :
• sa race
• sa couleur
• sa religion ou ses croyances
• son origine nationale ou ethnique
• sa citoyenneté
• son âge
• son sexe
• son invalidité physique ou mentale
• son orientation sexuelle
• sa situation de famille
La discrimination peut être directe ou indirecte.
En Ontario, le Code des droits de la personne (le Code) protège les personnes ayant des troubles mentaux et des dépendances contre la discrimination et le harcèlement au motif du « handicap ». Cette protection couvre cinq domaines sociaux :
• L’obtention de biens et de services, et l’utilisation d’installations. La catégorie « service » est très vaste et peut inclure des services qui appartiennent
à des entreprises privées ou à des organismes publics, ou sont administrés par de tels entreprises ou organismes, notamment dans les secteurs de l’assurance, de l’éducation, de la restauration, du maintien de l’ordre, des soins de santé et des centres commerciaux.
Qu’est-ce qui a préséance sur le traitement du patient : la charte des droits et libertés de la province ou du Canada ou le code d’éthique du médecin de la province où celui-ci exerce ?
Le processus de plainte diffère d’une province à l’autre.
Au Québec, on fait une plainte, notre nom est dévoilé et on perd notre médecin de famille.
En Ontario, nous faisons une plainte, nous gardons notre médecin de famille et notre nom est gardé secret.
Les systèmes sont très différents et très inégaux pour le traitement des patients.
Doctors have a public role. They are paid by the taxpayers. conscientious objections by health care providers can only be tolerated if there are robust patient protection clauses. It should be mandated that information be provided as to where the desired service can be obtained.
Remember, doctors are not paid for services they don’t perform.
No physician should legally be allowed to deny a woman’s right to access birth control. Nor should they be allowed to force women to seek out other providers and go to great effort to get birth control. This negatively affects women’s reproductive health and physicians have no business allowing their PERSONAL religious beliefs to enter the exam room and subjugate women.
last time I checked freedom of conscience was a right in the law, but not access to birth control from ALL doctors.
If Dr. A doesn’t provide it, go to Dr. B. Doctors are not your slaves!!
One need not be a slave to have responsibilities.
Doctors are given certain authority as gate-keepers to medical services. With that authority goes responsibility to provide such access without regard to personal moral preferences.
If you don’t want to do the job, switch to a field of practice that you prefer. Don’t say “I want the job but I will do only part of it.”
One need not be a freeman to have responsibilities.
Ontarians are given certain expectations as OHIP holders to medical services. Even in this lamentable socialist setup, with those expectations goes a sense of proportion and an informed conscience appropriate for every mortal patient who is not a god. The Ontarian should not expect her doctor to agree, for example, that killing an unwanted baby is a valid medical service.
If you don’t want a pro-life doctor, switch to a “pro-choice” doctor that you prefer. Don’t say, “I want medical services, and I also demand that he (or she) enable my chosen lifestyle, whatever the cost to him and others.”
I disagree with your policy to allow doctors to withhold regular medical care to patients with whom, based on the the doctor’s religious and/or moral beliefs. it disagrees with their needs for legally approved medications such as birth control.
Doctors practicing and getting paid in a public health system, should not be allowed to decide what publicly and widely used medications will not be prescribed for reasons other than health considerations.
The CPSO declares the conflict with the Human Rights Code provides unclear guidelines or regulations. It is unclear if you want it to be unclear and do not wish to stand behind an ethical and professional standard set by the community in its governance.
Self-regulation does not encompass self-determination or interpretation of the public good.
Create two classes of doctors if you wish but the professionals providing medical services to the Canadian public health care regime, cannot be allowed to independently and arbitrarily decide on their own those who will be excluded from modern medicine be it by decision of differing values of religious doctrine, life style practices, ethnicity, social underclass, or other grounds. Doctors control access to pharmaceuticals and medical care. You cannot decide on patient care based on who you like or do not like in its administration.
The debate is actually pretty simple to resolve. There should be certain standards when it comes to life-threatening medical issues, that all doctors must adhere to. In these situations the patient’s right to life should trump a doctor’s right to freedom of conscience.
But for elective issues, like birth control pills, abortion, etc. the patient should go find another doctor. If there is a doctor across the street that prescribes birth control, why would you want to force this one to do it? The only reason it seems would be to impose someone else’s values on the doctor against his/her right to freedom of conscience.
Physicians are not employees of the gov, nor the College of Physicians. Most physicians work as independent contractors just like many other trades.
Would you force a independent lawyer, plumber, accountant, etc do things against their conscience? This is no different. Just because physicians are paid by gov insurance plan (which is forced on them by the way), it doesn’t mean that they are gov employees to do as they are told.
A very Sensible solution to the current debate.
I note that it places the highest value on the human life of the patient when it is threatened. I just add that this same consideration should also be made in every case where the human life of a patient is threatened. And, as several doctors have noted, whenever a pregnant woman comes to their office, they have two patients, two human lives in need of their professional medical care, not one.
It has nothing to do with tho pays the doctors. It has everything to do with the authority that the doctors are given over how medeicine is practiced.
With that authority goes responsibility to deliver the full package of medical services. You can’t take on the authority and toss the responbibility.
I think the answer is relatively straight forward. If the right is a protected right under the Charter or the Ontario Human Rights Code then a physician should be required to provide care to the patient or provide a reasonable alternative that does not create undue hardship for the patient.
Although the concept of competing rights is important the physician/patient relationship should be based on a patient centred care model which allows the appropriate evidence based treatment to take precedence over any personal or moral/religious beliefs
“Concept of competing rights”–that’s hardly straightforward. The newer group rights (equality rights) were invented to subvert the older individual rights and transition to secular humanist totalitarianism. Theoretically all the “rights” are still in “balance”–meaning absolutely nothing–but the College of Physicians and Surgeons already suggests what you openly state: the fake equality rights take precedence over freedom of conscience and religion. Yes, that’s again more straightforward, but it’s also diabolical.
Physicians in their professional role have a duty to provide services and procedures that are legal, medically indicated, within the physician’s scope of practice and competence – AND in accordance with the PATIENT’S religious or moral beliefs (NOT the physician’s!).
Its pretty obvious from the comments being posted that many people have not taken the time to read the current policy as it stands — please read it before making comments that are either completely off point or irrelevant because they have already been addressed by the current policy….
The needs of the patient should come before that of the doctor, they chose that profession and in so doing made a promise to care for their patients. If they have a moral objection to any sort of medical procedure they should have not become the sort of doctor that would need to do it, they should have gone with another specialty.
As well, especially in the north, we don’t have Doctors growing on trees. If my family doctor suddenly could say no to prescribing me birth control, the process of getting referred to a different doctor would be lengthy. Already we’re at the point where we have to take any doctor we can get, but now if this limits which doctors we can go to it will make the whole thing that much worse.
Physicians’ religion may come into play only when the harm to religious conviction is egregious. For example: Participation in assisted suicide, mercy killing, abortion to fulfill a parent’s gender preference, or such.
In all other cases, physicians should follow the principles and policies established under the Charter of Rights and under Ontario’s Human Rights Code.
Doctors refuse to do certain things for a variety of reasons. Their religion is actually not very high on the list. This is why as an ATHEIST myself, I am very much against forcing doctors to do certain things.
For example, some family doctors perform joint injections, and some don’t. Some performs vasectomies, colposcopies, or mole removal, and many choose not to. Some prescribe opioids for pain, and some don’t or seldom do. Some treat schizophrenia and some choose to refer instead to a psychiatrist.
Physicians usually have these preferences, based on their comfort and experience level with a procedure or medication.
Forcing doctors to prescribe something or to do a certain procedure, especially when it’s elective, is going down a very slippery slope. Doctors need to practice medicine that they are comfortable with. That in the end serves the public, because they benefit from the expertise of those physicians who are experienced in that particular area.
Would you rather get a medication from a physician that is experienced and comfortable with it or from someone who is not?
And what kind of therapeutic bond do you think you can build with a physician if you force him/her to do something they are not comfortable with?
Doctors are not robots to be programmed and I personally would rather have a doctor that I can trust and one that can trust me.
Comrades of Great Soviet of Ontario,
I cannot call you gentlemen, since you even considered to ask this question;
…Allowed ???!!!??? That unfortunately means only the one and only thing; our ones great Western society is gone ….most likely forever. If a doctor has to ask for permission from the state not to murder an innocent (Abortion or euthanasia), it is clear that the same doctor is nothing but a slave at best. He also might be a very deviant slave. Since it is your duty in front of GOD, no that is not something you would sprinkle on your latte, to simply declare the moral truth and refuse to advance the evil. So far you are failing miserably as an organization and as individuals. You sold your humanity for a bowl of porridge, and your mother too. You have no spine, you are afraid you might lose your Mercedes. The bunch of cowards, or immoral deviants. It is practically impossible to see another option at this stage. If you are not in the deviant category, what is it you are afraid off? If you stand united the state cannot do anything, they cannot fire you all, could they?
An before you get all upset in a bound “moral” indignation, don’t. Calm down, truth should not upset supposedly intelligent and moral people. And yes I am an old geezer who grew up in the communist country (now living in a fascist one…precious little difference) so I have some real experience on the theme; what the State could do to you.
Hence if you do not like to be called cowards just go out and prove me wrong, not really “me”, prove it to yourself, to your wife and kids…. To those you did not abort, yet.
To Whom It May Concern
Please note that I am very concerned about the possibility of doctors being forced to perform procedures against their own consciences or moral codes for a number of reasons:
1) To force a doctor or any person to go against one’s conscience is unjust. An obvious example of this type of injustice would be any doctor or soldier in Nazi Germany who was forced to carry out orders that for them pitted doing the unthinkable against certain death because of refusing to do the unthinkable. Is it reasonable, ethical, moral, or humane to give doctors the burden of “Sophie’s Choice”? In case you are unfamiliar with the movie, a Jewish mother in Nazi Germany is given the choice as to which child will live, and her choice of one haunts her for the rest of her life. In this case doctors would be choosing between sacrificing their legal ability to practice medicine for the common good and their consciences: one of these would have to die.
2) To go against one’s conscience is stressful. I work with many doctors in my profession as a social worker, and it is obvious that doctors are already under great stress due to the incredible pressure in the health care system. To add such stress would be inhumane. It could also be dangerous to patients, as it is commonly known that marked stress can lead to mistakes in judgement.
3) To be forced to go against one’s conscience takes away the power of personal agency. This happens in abusive relationships, and I have worked with many abused women who have faced the anxiety (and yes terror) of being forced against their wills and consciences to do unthinkable things.
4) To take away the choice of doctors is not pro-choice. It is anti-choice.
5) Doctors have studied for many years to earn the honour of their professions and have faced many ethical debates along the way. Their ongoing daily contact with patients provides much fodder for learning and wrestling with ethics. We need to give these highly-intelligent and compassionate caregivers due credit for their ability to make decisions that balance the best interests of their patients and their own consciences.
6) There are many doctors whose ethical stances could already be in favour of providing abortions and euthanasia, which respects the (potential) “rights” and access of patients. Why force the provision of these services upon those who could be emotionally crippled with guilt if they do give in, deny their own consciences, and provide such services?
With respect, I urge common sense and compassion to rule over the political banter and bullying that rules our present culture. As Canadians we value diversity and the respect of different beliefs, cultures, and spiritualities upon which this country is founded. Please take the high ground on this upcoming vote, modelling integrity to maintain our citzens’ historic freedoms. Anything less represents a form of moral arrogance that our fellow countrymen have bravely fought against in more than two wars. I implore you as a governing body to allow doctors the choice to provide the legal medical services that fall within their own moral and ethical standards.
Given that physicians are self-regulated, I can see how some members of public, particularly those of the leftist persuasion, are going to view the College’s rules as biased unless it will be completely in favor of women obtaining Birth control or abortion from any doctor at any time.
Perhaps then this matter should be decided by an independent body, such as the Human Rights Commission or the Supreme court.
Freedom of conscience is a fundamental freedom. It must not be taken away from doctors due to prevailing ideology. Doctors should not have to violate themselves by providing (or referring for) treatments that they feel are unconscionable.
“It is clear that thought is not free if the profession of certain opinions makes it impossible to earn a living.
—Free thought and official propaganda, 2000/1922
We are not talking about freedom of thought or the right to hold opinions.
We are talking about the duty to exercise fully, professionally and without personal bias the responsibility conferred on doctors by their role as medical decision-makers.
As July 4 commenter has correctly implied, if there is no freedom of conscience, then Christians will gradually be forbidden from entering the medical profession. Then in
Ontario, for Ontarians allowed to be born, there is only sexual license, an unlimited “freedom” (bondage to lust) to have real or virtual sex whenever, wherever, however, with whomever or whatever.
A recent article was posted to the Globe & Mail website :
I wish to express my heart felt opinion that basic medical treatments and prescriptions, such as a birth control pill, should not be refused to patience based on a doctor’s personal belief system.
It is my understanding that doctors are licensed and practice in a publicly funded system. Therefore, they should expect to abide by the law, and belief systems held by the courts and “general public”.
Doctors who refuse to treat patience should be suspended from practice
I read a Globe and Mail article this morning, “Policy allowing doctors to deny treatment on moral or religious grounds under review.”
I agree that physicians who refuse to provide certain treatments on religious or moral grounds should be required to refer patients to doctors willing to provide those services.
My experience with doctors in Ontario is that they act as gatekeepers, providing some services but often providing referrals to other specialists. In Ontario, it is very difficult to shop around for a doctor especially once you are registered with a family physician.
If that physician refuses to provide a treatment that he/she deems is not necessary and refuses to provide a referral, a patient could easily feel stranded, stymied and without options – especially if the patient is uncertain, scared or easily intimidated.
Physicians should have the right to provide certain legal services, but that does not trump the patient’s right of access to medical services.
Thanks for the opportunity to provide feedback. More transparency on the part of the CPSO may be fraught and a little unsettling for some members, but I endorse it fully.
I think you’ve identified a very important point:
‘In Ontario, it is very difficult to shop around for a doctor, especially once you are registered with a family physician’.
This is a consequence of the government’s imposing on patients enrollment with a particular doctor in, for example, family health teams, organizations etc.
In theory, this enables better care as it gives you access to ‘free’ allied health services associated with the team. Doctors get paid an annual ‘capitation’ payment and minimal bonuses every time they see you.
The government then punishes doctors by docking their capitation payment if, for example, you go to a walk-in clinic. So, if your family doctor refuses you a service like birth control and you go elsewhere, your family doctor loses money.
Some family doctors will take exception to this and ‘deroster’ you which may affect your ability to access allied health team members although you can still see your family doctor who will then bill OHIP ‘fee-for-service’.
The system is set up such that doctors will often squabble about why a walk-in-clinic doctor (fee-for-service) billed this or that amount and was it justified according to the billing guidelines. This is because a family doctor gets regular ‘outside use’ reports and they can track where you’ve been seen elsewhere.
The government thus have doctors essentially spying on each other and ratting each other out, discouraging choice and freedom of patients.
So here again we have evidence of a flawed system not only putting doctors at war with each other but translating into potentially less choice for you as a healthcare consumer.
I fully support freedom of conscience for physicians. Integrity of life demands that we not leave our consciences at the door when operating in the public domain.
Freedom of conscience is a basic human right and must be maintained.
Dear committee members,
I am writing to state my strong conviction that doctors should be required to provide patients with birth control prescriptions and devices, regardless of the doctor’s own beliefs regarding birth control.
Most Canadians practise some form of birth control that helps them to control their fertility. We are very lucky we have effective measures compared to our forebears. Each of my grandmothers had ten children, and one of them died as a consequence of her tenth pregnancy, at the age of thirty-four. Women, single or married, should not have to bear the worry of unwanted pregnancies.
Any doctor who wants to practise “natural family planning” is entitled to do so in his or her own relationships. But he/she should not have the right to let this have any influence on their medical practices. We, the taxpayers, pay their fees and have paid for a good part of their education. If they do not want to provide the information and prescriptions needed by their patients, they should find another profession, or another branch of medicine that puts the public out of harm’s way of their personal values.
There is a forceful argument about this issue made in the Globe and Mail today – July 3rd – on page nine. Please read it, and please reconsider your decision to let physicians force their values on everyone else, particularly on such a personal and important issue.
Just make birth control pills OTC (over the counter medication )with booklet on risks and side effect and make it available to all, this way no obstacles would exist for any woman to use it, as from above discussions physicians role in it becomes irrelevant anyway…
How many doctors actually refuse to provide care based on moral or religious grounds? Is this likely to be a problem for the majority of Ontarians? Despite what recent media coverage has led us to believe, the number of doctors in this category is very small. Perhaps some consideration should be offered the the people who would intentionally seek a doctor of this kind, for various reasons. In the case of family planning, a doctor who refuses conventional methods is probably well-versed in the alternatives, and patients who are interested in actually discovering the root causes of their infertility, or patients who desire to use natural child spacing, would actively seek out a doctor who understands these desires. Perhaps some thought should be given to the rights of patients who use alternative methods of birth control. There are so few doctors with a true understanding of how the female body works, and in my experience, the few remaining doctors with this knowledge fall into the group of those who refuse to provide contraception. A patient who objects to artificial contraception should not be subjected to a doctor who continually pushes his or her preference for artificial contraception, to use the same argument that a doctor who objects to contraception on moral grounds should not speak openly to his or her patients about such matters. It works both ways, and some consideration really needs to be given to the patients who are on the other side of the debate. If the doctor refers the patient elsewhere for the services he or she will not provide, then these doctors should be free to practice the way their conscience dictates.
I agree with you almost completely, with one exception (below). Currently, there are very few doctors who actually understand natural family planning. Instead, they push hormonal and other (e.g. IUD) expensive methods which can have serious side effects.
Regarding referrals: no doctor should be required to refer a patient elsewhere for a treatment that the doctor considers to be harmful, unethical, or medically unnecessary.
At this time the issue appears to be related primarily to birth control , but when it is expanded to force all doctors to assist in killing patients through assisted suicide, their rights to not do so will already have been lost through the new policy.
J’ai la même opinion que:
« L’objection de conscience est un droit constitutionnel. Aucune politique ne peut l’enfreindre, du moins légalement. Les médecins sans conscience sont l’équivalent de zombies. Idem pour les politiciens et n’importe quel autre être humain. L’objection de conscience doit inclure l’absence de l’obligation de référer à ce qui répugne à la conscience du professionnel. La référence obligatoire, c’est la complicité forcée. »
Every human being is entitled to have a conscience and to use it, whether you are a politician, police officer, soldier, sailor, beggar man, thief. Doctors should have that right. It is based on who they are as a person that they chose the vocation of becoming a doctor. To deny who they are as human beings effectively restricts the quality of medicine they want to provide the community.
The reverse is also true for the patient, who for want of a better term is the consumer of the doctor’s services. As a result, if the restriction is placed on a doctor as to what type of medicine is being provided I do not get his full total opinion, rather the party line. Currently, if I disagree with a doctor’s type of medicine I can search out a doctor more in line with what I want. However, if doctors are going to be told to practice medicine within prescribed parameters what is to stop other restriction such as expensive procedures, or medication, or whatever treatment. An other possibility is some agency compelling doctors to issue of narcotics to drug addicts who are in a program but the addict’s doctor may think it is detrimental to his health. Is medicine to be regulated by non-doctors?
A doctor is more than a brain full of medical knowledge that dispenses treatment like a vending machine. Rather they are complete human beings who have a body, a mind and a conscience. Medicine in my opinion can not be regulated to a cookbook response to a patient or as a consumer. “give me what I want”
I feel compelled to make these comments because the College has been wise enough to go beyond requesting mere statistical data. Like so many doctors I have met they are going beyond the pure scientific data to look at what is truly being effected in the Ontario (and by extension Canadian) society, the patients they care for and the men and women who balance their understanding of medicine and themselves. Please look at the whole patient.
The most important thing to remember is that physicians by choosing this profession have agreed to fulfil their duties and obligations to their patients. That is the whole point of choosing to be a physician. Our professionalism always must put the welfare of our patients first. Being a physician is a privilege bestowed upon us by the public and which is facilitation through the CPSO our regulatory body which allwos us the privilege of self-regulation- an enormous privilege which must not be violated or taken lightly. If someone has such strong views on an issue call them religious or moral that interferes with carrying out practices that are legal and within the standard it might be worthwhild looking at a non- clinical area of medicine in which to practice which does not cause such “moral” anquish or conflicts.
‘Practices that are legal and within the standard’ today might not be tomorrow and this does not necessarily make them right for everybody.
‘Privilege of self-regulation’…personally I would much rather be regulated by an independent body, have a system where complainants put their money with their mouth instead of complaining willy nilly about anything and everything, and which allows for the defendant doctor to counter for damages and lost time/income. The current regulatory system through the College does little more than disempower us and create stress mostly without good reason in order to justify its existence.
The Human Rights Code is important, but probably less so now than when first developed as many of the issues germane to the Code are now established in law
The principles are very important and need to be clearly stated – discrimination is wrong and must be addressed when it occurs
That being said, policies such as this need to avoid the slippery slope of actually becoming discriminatory
My position is that no member of the medical community can ever deny access to a legal drug, procedure or treatment unless the treatment is not warranted for the specific medical issue. If you’re not comfortable providing access to all legal means of treatment, you should not be a doctor. Period.
This whole debate brings up an interesting question: Do we trust our medical professionals with all the training, the education, the screening they have received to exert their duties with the best care of the patient possible taking into consideration their beliefs, morals, ethics, knowledge, experience and care into considerations. Do we trust our doctor or not?
An interesting editorial appeared today in the Calgary Herald about this exact topic. (see http://www.calgaryherald.com/touch/story.html?id=10001654).
This subject not only applies to doctors, but to nurses, to lawyers, to accountants and engineers, to any professional that works within a professional code of conduct. Do we want to allow them the freedom to exert their profession to the best of their ability or do we simply want these professionals to do what we wants no matter the consequences?
As the article above clearly points out: “A free and democratic society allows consumers and providers to accept or decline each other’s business, without state coercion. “
No, I do not trust the doctor if he or she puts personal moral preferences ahead of scientifically-based decisions about legally permissible treatments.
I do not go to the doctor for moral decisions. The doctor’s moral authority is no greater than mine. I go for inbiased professional advice. That is his or her only field of authority.
The doctor is not simply a businesman among many, as the Herald seems to advocate. He or she is a legally mandated gatekeeper, and part of that mandate is a responsibility to provide the full range of services, not cherry-pick among than based on personal moral tastes.
I don’t understand why a physician who feels unable to provide particular services decides to practice in an area where s/he will be called upon to provide those services.
If you don’t want to facilitate contraception, or abortion, pick a specialty where you won’t be asked for this. If you are already a family doctor, perhaps you could re-focus your practice to geriatrics, or palliative care, or MSK conditions.
I think it’s entirely reasonable to expect professionals to perform within the full scope of their roles. If they are unwilling to do this, they should choose a different role.
We would not accept a public school science teacher refusing to teach evolution, we would expect that person to teach a different subject, or move to a private system that is supportive and accepting of their beliefs.
I hope CPSO strengthens this policy to prohibit physicians from refusing to provide care that is evidence-based and medically warranted.
In answer to your implied question (“I don’t understand why…”):
Because neither contraception nor abortion constitute a medical service. Medicine is about healing. Abortion, on the other hand, is the precise opposite: killing one of your patients is not healing. By contrast, contraception is more of a lifestyle choice, although some forms are less benign than others, and I would never argue with physician who refuses to prescribe such things.
I do not think that religious views should have any place in a doctors office – doctors should be required in all cases to provide services and treatments and procedures based on the latest science. If they can’t do that, they can chose not to become doctors. Doctors should be men of science, not men of faith. As others have said, would you want an ER doctor who was against blood transfusions? The only reason we have family doctors being allowed to refuse service to families (contraceptives, for example, or abortion) is because we don’t take the rights of women as patients seriously.
Because the code allows them to avoid giving treatment, they should very clearly provide alternate, and timely, options. And they should not be reimbursed for the full amount of the visit because the patient has been inconvenienced and now has to possibly find another doctor to perform treatment, arrange travel to another clinic, take time off work, etc all of which can prove very difficult.
I also think that they should have to state clearly somewhere what their limitations are so that patients can try to find alternate options before wasting time.
Our health system should be about the needs of the patient. Anything else seems completely unethical.
So, in your view, the doctor’s integrity should be sacrificed for your convenience.
I am an undergraduate student with a passion for healthcare. Numerous professors and physicians have noted that a career in medicine is a realistic possibility for me. I have a lengthy extracurricular resume with clinical experience and a nearly perfect GPA (9.85 on a 10.0 scale). Since elementary school, I have spent countless hours shadowing physicians, speaking with medical students, and watching procedures. In this time, I fell in love with the profession and all that it stood for. It is a wonderful juxtaposition of science and humanity.
This year, I had to decide whether or not to start studying for the MCAT. The decision required that I consider the difference between what I hope for the future of medicine and what it actually is becoming.
The political climate is changing in Canada. The concept of “human rights” is now selective, rather than inclusive. As I told one physician: the time is coming when doctors will be forced to practice on the grounds of what is popular, rather than what they believe is right. For example, physicians will have the right to practice in a manner that they deem moral, unless, of course, they have the audacity to believe that a zygote is a human being. The fallacy in this, of course, is that what is popular is not always right.
I would only like to practice in a context where I truly feel that I am doing what is right for my patients. Since this freedom appears to be “up for debate,” I am no longer pursing medicine. My professors and the physicians I have been working with consider my decision a shame, and so do I. I did not make this heartbreaking decision because I do not love medicine “enough” to become a physician anyways. It is quite the opposite, actually: I love medicine enough to believe that human rights, which include the rights of a physician, should not be stripped of it.
That said, I think it should be mandatory that a physician tell potential patients what they will and will not do because of moral restraints before they begin care. Yes—especially in rural communities with physician shortages—this may limit where patients can seek care. However, the alternative to this decision—the separation of medicine and morals—is a more daunting alternative.
Luckily, I have learned that the “team approach” to health care is being accepted more, especially in rural communities with family health teams. Possibly, this concept could be extended to regular patient care?
If, for example, a patient’s primary doctor is a wonderful fit for them but does not prescribe birth control, the doctor and patient could discuss consulting with another GP on the team that would keep updated on the patients’ medical history, consult with the patient’s primary doctor, and prescribe and renew the birth control when needed. I am not undermining the extra work and communication that this would entail, but simply am attempting to illustrate how both physicians and patients can keep their rights.
I recognize that my knowledge of medicine is limited. That said, I hope my voice is heard or, in the very least, considered.
Thank you for your time
To whom it may concern,
I’m a member of the public yet I come from a medical family. My father, uncle, grandfather, and great-uncle were all doctors. My mother is a nurse, as is my aunt. Various other members of the family are employed in the medical field as administrators and secretaries – medicine has always been the family business.
I say this because it would be an affront to my father, my grandfather, and every other person who professes to be a part of the medical profession if doctors were allowed to deny patients care because of the doctors’ own personal beliefs. That violates my understanding of the Hippocratic Oath and common decency, and I was genuinely shocked to find that such a thing would be under discussion in 2014. If that is the current process, it must be changed immediately to prevent further harm.
A doctor’s duty is to their patient, to heal them as best they can. If they cannot in their own mind reconcile their personal beliefs with the best medical advice, they should no longer practice medicine. Life and death is not a matter of debate or argument, and best practices for medicine are not determined by your own belief system. Medicine is not an exact science, but it is a science. If you cannot agree with the science, get out of the system.
And let’s be honest, this is about birth control. If it was about blood transfusions and Jehovah’s Witnesses were agitating to be allowed to prescribe everything but the transfer of blood, they would they would not be taken seriously. But somehow denying birth control to a teenager and causing unwanted pregnancies is okay? That’s absurd, and it reflects the out-of-touch patriarchy that any right-thinking person decries as the worst aspect of our society.
If you allow doctors not to prescribe treatment because of their own beliefs, you are not just damaging the patient. You are attacking the fundamental social contract of medicine, perverting its very role in our lives, and letting stupidy and ignorance reign supreme over reason and science. That is the choice you face, and the answer seems pretty obvious to me.
The “best medical advice” cannot be separated from sound moral reasoning. What you are demanding here is that every physician’s integrity be sacrificed in order to conform with your personal ideology.
Birth control is not a medical treatment. It is a lifestyle choice, and as such it is not a service that any physician should be obligated to provide. Furthermore, refusing to participate in such a lifestyle choice is not the same as “denying birth control” (which is available in many different forms and from many different sources).
It is also a logical fallacy to claim that “denying birth control” causes unwanted pregnancies. Pregnancies, both wanted and unwanted, are caused by sexual intercourse. The latter is a choice that is made by the two people engaging in sexual intercourse, and is not something that is caused by any third party (including physicians).
Finally, it is worth pointing out that, if one is engaging in sexual intercourse, pregnancy can occur whether or not one is using any form of birth control. Every existing form of birth control has a known failure rate. You can look these up.
I wonder how many physicians actually deny services based on religious reasons. Ideally, if the doctor could choose what services to provide, that would be good, as long as patients are notified up front and alternatives given. What would worry me is if patients had to travel farther, or had less access to services than other people.
For example, if there was a walk-in clinic in my community that everyone could go to, but women were denied birth control, then a large portion of women have to go farther in order to get medical services that are covered and common. As a member of that community, I have fewer options in terms of doctors than my husband. This could be really important for people who are low income, have restricted mobility or schedules, or are part of marginalized communities that already have lower access to medical services.
I think that health care centres should try to make sure that if someone comes in and needs a medical service that they can be served. This might mean making sure that there is someone on staff who can handle requests for, say, birth control. It might also mean having female doctors or nurse practitioners available that can do PAP smears.
My concern is not necessarily an individual doctor, but rather if there is a group of doctors all in the same place, so that it restricts the options available to patients and starts to affect how readily they can access services.
Can you think of a better example? Provision of “birth control” isn’t an essential medical service; it doesn’t treat or prevent any disease.
Agree with you completely. Birth control is not a medical service at all. It is a lifestyle choice.
Actually, I would beg to differ on that. I began taking birth control at 15, due to horrible primary dysmenorrhea which would cause me to lose at minimum four productive days each month. Nausea, vomiting, headaches, overall body pain and fatigue – oral contraceptives are the primary treatment for such conditions because they stop ovulation from occuring and it’s the hormones that cause ovulation that result in dysmenorrhea in some women.
Oral contraceptives are not just for contraception anymore, they are also used to treat a wide variety of hormonal issues because the benfits outweight the risks of other hormone therapies.
Right. In that case it is being used for a genuine medical purpose rather than birth control. We are talking about two completely different things here. It’s not the drug that matters, but the way it is used. Another example would be morphine. It can be used as a recreational drug, or it can be used for genuine medical purposes, such as relieving pain in late stage cancer patients.
In my earlier life, I was a newspaper reporter. I am morally opposed to gambling, including lotteries. Nonetheless, when I was asked to report on gambling and lotteries, it was my duty to do so in a professional and unbiased manner.
Doctors practising in Ontario are given the job to be professional gate-keepers to medical care. As such, it is not their role to decide, based on their own moral preferences, which legally permissible medical ingterventions patients should or should not be allowed to receive.
If a physician were to be permitted to refuse a treatment based on his or her own moral preferences — a policy that I am not supporting — then he or she should bear the full burden of that refusal, not the patient.
In practice, this means that the refusing physician should bear the responsibility of finding a second physician who will provide the service, securing an timely appointment with the second physician at a time suitable to the patient, and transporting the patient by normal means (perhaps bus fare or taxi fare) to the premises of the second physician.
Anything less is an abuse of the legally mandated role of physician.
You speak about “moral preferences” as though they have no more significance than choosing a “style”, “colour” or “flavour”. On the contrary, moral reasoning is integral to the human person, and cannot be separated from professional practice without loss of integrity.
As a patient, I want my physician to be first and foremost a person of integrity.
As the comments so far indicate, this is a complex issue.
One thing I don’t think has been addressed is the potential ambiguity of the wording as well as the current culture of ‘grocery store’ medicine (patients thinking they see a Dr. to get what they want, rather than to obtain an assessment and advice from an expert).
I frequently ‘withhold or refuse’ treatment in my family practice: e.g. I don’t prescribe antibiotics for a cold virus, I don’t prescribe narcotics to unknown patients at a walk-in clinic, I don’t request unnecessary investigations. In other words, I attempt to practice medicine with integrity according to current knowledge; I offer what is going to best for the patient’s well-being.
Now I also would ‘refuse’ to perform an abortion or assist a patient with suicide as I do not think this is in the patients’ best interest (aside from moral/religious beliefs).
The issue is not one of ‘refusing’ treatment (worded like that, no-one would agree), but of offering the best treatment. In the few cases in which this may be ambiguous, we can also get other opinions from colleagues.
Those are exactly my views.
To Whom it may concern,
As a citizen and as a member of the clergy I believe it is important that any redaction of your current policy protect the rights of physicians to refuse to provide or refer for non-emergency procedures that are contrary to their conscience. Some examples of such procedures would include: abortion, provision of contraceptives, sterilization.
It is important that all physicians operate within a context of ethics, morals and values. Without such they would be unable to provide true counsel and care for the people entrusted to them. They cannot do this if they are required to violate their conscience.
My thoughts are parallel to those of a journalist in the USA where the same issue is being addressed. If we are stripped of our freedom of conscience, what kind of a country will we inhabit? How can it be imagined that the state can dictate morality? Will we have thought police incriminating us for having values that are inconsistent with the heads of state?
I believe that even though same sex marriage is legal in Canada that it is fundamentally wrong. In my opinion marriage is about family formation including the birth of children and their socialization as new generations replace dying generations. I believe that abortion is the murder of unborn children. I believe that men having sex with men is the chief cause of HIV/AIDS problems and that such behavior is unnatural and unhealthy.
All the above statements are my opinions and not the opinions of many others. I accept the right of others to believe otherwise and to act out their choices accordingly. I request the right to act out my life in accordance with my values, not theirs. Our society is in deep trouble when the state tells us how we must think.
I think the new policy on the rights of those with mental health problems and addictions need to be addressed directly as it is very recent (3 weeks ago and has huge ramifications re the role of the MD in certifying a person with a mental health problem – who can do certify, i.e. Psychiatrists or the Gp? what is the criteria etc does it include insurance sector or does it include legal system or both?
Most physicians do not know their role or even their responsibilities in regard this.
Case examples would be good to exemplify this.
With a careful and straightforward reading of the Ontario Human Rights Code, I do not see how allowing a physician to refuse to provide treatments or procedures that conflict with the physician’s moral beliefs would be a violation of the Ontario Human Rights Code. As described in the CPSO’s current policy, the Ontario Human Rights Code prohibits discrimination in the provision of services based on the race, creed, gender, etc. of a patient. If a physician finds a treatment or procedure morally objectionable or unethical and refuses to provide it to ALL of her patients, then she is treating all of her patients equally and is not discriminating anyone. This is categorically a different situation than when a physician refuses to provide a treatment because of a patient’s race, creed, gender, etc.—which clearly should be considered discrimination. It is important not to confuse these two very different situations.
Objectively, physicians who refuse to provide certain treatments and procedures because they find them morally objectionable or unethical cannot be said to be in violation of the Ontario Human Rights Code. Therefore, there is no need to change the CPSO’s current policies such that physicians would not be given the freedom to refrain from practices that violate their consciences. If anything, the policy should be clarified such that it is made more explicit that physicians are NOT required to provide treatments or procedures that they believe are immoral or unethical.
Furthermore, forcing physicians to do things that they find morally objectionable is unnecessary to ensure patients have access to the treatments they desire and, in fact, would actually restrict access to medical care overall. For every physician who refuses to provide a controversial treatment such as oral contraceptives or abortion, there are many more who have no hesitations doing so. The assertion that patients face undue obstacles in obtaining the services they desire because some physicians refuse to provide a small number of controversial treatments is spurious at best. On the other hand, if physicians cannot practice in accordance with their consciences, many of them will have no choice but to specialize their practices more narrowly such that they would avoid facing situations where they may be forced violate their beliefs; many other physicians would leave for other jurisdictions or quit the medical profession altogether. It is no secret that in many parts of Ontario, there are physician shortages, so forcing many physicians into a situation where they would either have to limit the scopes of their practices, move to different jurisdictions, or quit practicing is not only unnecessary, but completely irresponsible from a public policy standpoint. While some people may think it’s ridiculous that some physicians would refuse to prescribe birth control or refer for abortions, let’s not forget that these physicians are generally dedicated, caring physicians who treat thousands of other conditions and the vast majority of the time have no problem complying with patient requests when there are reasonable medical indications. Why deprive the public of the valuable medical care that such physicians provide over a few controversial treatments and procedures, especially when these treatments and procedures are widely available from other physicians? Given that the debate on physician conscientious objection is often framed in terms of access to care, we must recognize the reality that if physicians’ freedom to practice in accordance with their consciences is taken away, then access to medical care overall will be negatively affected.
I would also add that, as many others on the forum have articulately explained, forcing physicians to do things that they find morally objectionable or unethical would grossly violate physicians’ fundamental right to freedom of conscience, which is enshrined in the Charter of Rights and Freedoms and is so important in a tolerant, democratic society. It would also severely undermine the integrity of the medical profession, and therefore not serve the welfare of the public in the long-run. That doctors’ consciences would stop them from doing something they believe is wrong is crucial to patients being able to trust their doctors and to ensuring that the medical system has robust safeguards against third-party manipulation.
Doctors should not be forced to perform or refer for abortions (or forced to take part in other procedures that are against their religious beliefs) in Canada. This is entrenched in our Charter of Rights and Freedoms:
“The “Fundamental Freedoms” section of the Canadian Charter of Rights and Freedoms states:
2. Everyone has the following fundamental freedoms:
(a) freedom of conscience and religion;”
Doctors have the right to follow their religious beliefs as delineated above.
I feel that physicians should have to right to refuse treatment based moral beliefs as an Ob I do not believe in c section on demand. This operations increases the complications of bleeding infection baby going to special care nursery, lacerations of the bladder bowel and the baby, and the long term complications of adenomyosis and adhesions and I am supposed to do this operations knowing these complications over a vaginal delivery in a patient with no contraindications for a vaginal delivery. At first do no harm is the oath I took when I graduated from Medical School and now I have to right to carry out that oath?
the last line should read that I now do not have the right to carry out that oath?
I am a third year pharmacy student and have found it very disheartening there are many who feel physicians should be forced to violate their conscience. My College has a “Refusal to Fill for Moral or Religious Reasons” which states as follows:
“1. A pharmacist is permitted to decline providing certain pharmacy products or services if it appears to conflict with the pharmacist’s view of morality or religious beliefs and if the pharmacist believes that his or her conscience will be harmed by providing the product or service. Objections should be conveyed to the pharmacy manager not the patient.
2. The individual pharmacist must insure an alternate source, to enable the patient to obtain the service or product that they need. Any alternate means must minimize inconvenience or suffering to the patient or patient’s agent.”
I think this is a reasonable policy and perhaps CPSO could implement something along those lines. If it was imposed on physicians that they need to go against their moral beliefs or lose their job I see it resulting in one of two negative outcomes: 1) we have physicians becoming accustomed to violating their moral integrity which is not good in a profession often faced with ethical dilemmas 2) we lose many quality, talented doctors, in a time when there already is a shortage, as they stand up for their beliefs and will not violate their moral integrity for more or less popular public opinion
That “Refusal to Fill for Moral or Religious Reasons” is unreasonable. If providing a product or service is wrong, then it is wrong no matter who provides it. An accomplice is guilty, too.
I believe that it is mistaken to frame the question as a physician’s right to refuse a particular service, e.g., the writing of a prescription for birth control.
When a physician puts a sign in her office that she will not prescribe birth control pills (on religious grounds) that sign is bound to have a chilling effect on patients’ ability to discuss with that physician issues of reproductive health and birth control.
Health promotion and disease prevention are a vital part of the family doctor’s role. Those goals, in turn, hinge upon the patient’s ability to trust that they can confide intimate information to their doctor about their sexual activity, including sex before or outside marriage.
Indeed, it’s the family doctors’ obligation to elicit such information from patients by creating a professionally non-judgemental stance , e.g., with respect to teenage patients who may be sexually active but who may not be taking precautions or adequate precautions against STDs or unwanted pregnancy. If the patient does not volunteer such information then it’s the doctor’s duty to elicit it. A doctor who sees herself in a quasi-priestly role, approving and disapproving of sexual conduct (or drinking habits or other “lifestyle choices”) is therefore unfit to practice family medicine.
To reiterate: The important issue of physician ethics is not so much the issue of whether a doctor, on religious and/or moral grounds, is unwilling to write a prescription for birth control pills (or the IUD) but whether a doctor, practicing family medicine, is unwilling or unable to create a professionally non-judgemental context in which to practice disease prevention and health promotion.
As a patient, I once had a physician who did not think it was normal to abstain from sex before marriage, and was quite judgemental toward me for being abstinent. So, this business of being judgemental cuts both ways.
On the other hand, it is certainly possible to be firm about one’s own moral convictions without being judgemental toward others.
I wonder what you believe constitutes “adequate precautions” against STDs and unwanted pregnancy. Quite frankly, I would not trust any physician who does not state unequivocally that only abstinence is adequate, and anything else falls short of being adequate.
Also, do you think it’s OK for a physician to remain silent regarding the risks of heavy drinking when dealing with a patient who regularly gets drunk?
Are you as a physician–especially if you practice family medicine–so non-judgemental that you are willing to kill a child at the request of its mother?
As a member of the public, I want to be sure that I can get a pro-life doctor whom I can trust.
In the Netherlands, because of euthanasia, many elderly people have become afraid of hospitals and doctors.
Abortion, abortifacient birth control, euthanasia, sex-change surgery–these are violence and deserve your condemnation. AS a doctor, you should do no harm. Be professional and post a sign in your office.
To be clear, we are not talking about providing health-care services where a patient’s life is at risk. No, when a discussion about conscience-protection takes place it is almost always surrounding issues such as like infant male circumcision, prescribed birth control, certain types of medications, medicinal marijuana, or an abortion procedure. In the future, this list may very well include euthanasia or assisted suicide.
Conscience-protection guidelines are vital if we are to have a well functioning and vibrant health care system. As a professor at the Centre for Medicine, Ethics and Law at McGill University said recently, “Do you really want to be treated by a doctor who doesn’t care if he thinks that he’s doing something unconscionable or unethical or immoral?”
When a persons own personal beliefs trump the rights of a society when they are paid by a society to provide medical care we may as well call each of them a Hobby Lobby. This is a slippery slope and negates the idea of separation of Church and State within the law of Canada. These doctors, being paid by the state are therefore representatives OF the state. Would this mean a Canadian Evangelical who works for the state as a social worker be able to refuse to work on Sundays despite patients needing urgent care. This is NOT the United States and nor should it EVER be. We are far better than that in recognizing that the basic needs of society override the religious beliefs of any single individual, period!
I am not pollster, but the way your poll question is posed it seems to me it will lead to a prescribed response.
It is currently worded as:
What if the question was worded, for example, this way?
Do you think a physician should be permitted the option to refer a patient elsewhere if the treatment or procedure conflicts with the physician’s religious or moral beliefs?
For sure the Yes and No percentages would be affected.
I agree. This was a leading and poorly framed question which immediately provokes a negative response.
I’m surprised the college would use such a weak question for this query.
Personal moral and religious beliefs are just that – personal. No one, and certainly not a doctor, has the right to push their beliefs on to others.
If a doctor cannot separate their personal and professional life they should not be allowed to practice medicine. No one is asking doctors to stop holding personal moral & religious beliefs, only to refrain from inflicting said beliefs on others.
So I bring my young daughter in for a medical procedure – a surgery that will render her sexual life painful and without pleasure. To respondents who say yes, doctors are not free to refuse…I say, really?
I am in absolute opposition to the proposal of requiring physicians to practice certain procedures (i.e. euthanasia, abortion) that violate their own ethical and moral values. I do not feel this would be serving and protecting the public interest to the utmost of physicians’ abilities (to which the College mandate refers). The public would be best served (again, should an abortion or euthanasia be sought) by being referred to a doctor who has no qualms about such procedures and, therefore, would be performing said procedures with the confidence, competence, and presence one would most desire from a physician at such a time. Forcing a physician to act against his/her beliefs or ethical mores is as abhorrent as asking a patient to undergo procedures (or not undergo procedures) that violate their beliefs or ethical mores. Physicians are servants of the people, however, they are not slaves. There should be equal amounts of respect and concessions for the sake of the rights of each person involved in any treatment plan.
I agree with you and I would go further and also make it very clear that no physician should be required to refer a patient elsewhere for a procedure that the physician considers to be harmful, unethical, or medically unnecessary. Forcing physicians to provide referrals in such cases would force them to cooperate with something they understand the be wrong.
The CPSO understands very well that if a procedure is wrong, then providing a referral for it is also wrong. As an example, I quote from their policy on female genital cutting/mutilation (FGC/M):
“Physicians must not perform any FGC/M procedures.”
“Further, physicians must not refer patients to any person for the performance of FGC/M procedures.”
“The performance of, or referral for, FGC/M procedures by a physician will be regarded by the College as professional misconduct.”
Few vocations cut to the essence of an individual as medicine does. A physician represents a calling that is at the pinnacle, in many ways, of personal involvement, and doctors -the good ones – bring their complete selves into their vocations. Denying the conscience rights of physicians is just another step in the direction of turning medicine into a mere instrumental function, stripping the essence of the individual from the service it provides.
Medical professionals work in what is basically a public funded health care system. Equivalent medical services should be available locally to all residents, including those living in rural areas. Denial of services on the basis of religious or moral grounds by professionals is a violation of individual rights under the Code to receive such services. In some areas where family physicians are already in short supply, it would in practice leave few options to patients but to travel long distances if even viable. This has become a major problem in some U.S. states (e.g. abortion, contraception).
CPSO should not be imposing morality on all physicians, to the point where doctors need to violate their own conscience in order to serve their patients’ need to do non-emergency procedures.
How does this apply to services provided by emergency room staff?
I personally am against doctors being able to refuse treatment. Where is the line in the sand?
To the College of Physicians and Surgeons of Ontario:
As a Canadian studying medicine in Australia I am shocked and disappointed to hear that Canadian physicians are putting their own religious beliefs ahead of the needs and rights of their patients.
As the code says:
“The right to freedom of religion is not unlimited; it is subject to such limitations as are necessary to protect public safety, order, health, morals, or the fundamental rights or freedoms of others”
Perhaps all the people excited by the American Hobby Lobby ruling have forgotten that access to reproductive health care is integral for women’s health, freedom and ability to contribute to society in an equal manner, rather than being confined to traditional gender roles. Estrogen/progesterone pills allow women to control the impact that their menstrual cycle and associated symptoms have on their lives and to make advance decisions on family planning or pregnancy prevention. Pregnancy is a medical condition with significant risks, let’s not forget that.
This also sets a terrible precedent. Will male doctors next be able to refuse to see female patients (or vice versa) because their religious convictions somehow allow them to forget their medical training taught them that a body is more than a sexual organ they should be ashamed of seeing? What about small communities that may not have clinicians with diverse beliefs? Are the residents then automatically subjected to the religious beliefs of there health care provider? Will psychiatrists who are members of the Church of Scientology be excused from prescribing psycho-active drugs? Can gay and transgendered patients be turned away too? What about people who seek help for drugs and alcohol, will they be shunned by their judgemental doctor?
And since when does a patient taking a drug mean that the clinician does to? Just because someone else is exercising their rights, doesn’t meant they are suppressing yours. I am truly appalled.
In response to your request for input on your Physicians and the Ontario Human Rights Code policy, I would like to submit my comments.
I could ever only respect a doctor who practices medicine in a way that is in complete harmony with his conscience. This is crucially important to me and I believe, most Canadians. I would not want to see a doctor who did anything against what her conscience was saying to her.
I could also not respect a doctor who tells me he or she is against abortion, or contraception, or euthanasia or any other moral situation, but would then be willing to do it anyway. The thought that ta doctor could act against his conscience is deeply disturbing to me. I believe it would also be deeply disturbing for most of the Canadian population, regardless where they stand on the actual moral issue at hand.
And freedom of conscience is a right guaranteed by our Charter of Rights and Freedoms. And for very good reason. It is how we want all good people to respond to issues of ethics and morality. We want them and expect them, to pay attention to their conscience.
In purely practical terms, doing away with freedom of conscience rights for doctors will also have the following negative outcomes.
Good doctors, after years and years of training will leave the profession. This would be a terrible situation. First, the doctor and his family suffer immensely from the loss of his/her livelihood. Second, the public would suffer since we already have a doctor shortage, and this would only make it worse.
We do not want good doctors to leave the profession. For what? So that a woman can be guaranteed to be able to obtain the birth control pill or an abortion from every single doctor in the country, when there are already (some might say too many) doctors filling those need?s Is this really what we want of our doctors? I sincerely hope not.
And I believe the only reason the issue has come up at all, is because of contraception and abortion.
It will also mean we will now have institutionalized discrimination against pro-life doctors. Just like we now have institutionalized discrimination against pro-life politicians in two of our three political parties in Canada.
Please, let us not go there.
Many years ago, the World Health Organization classified the birth control pill as a number one carcinogenic agent, just like nicotine is a number one carcinogenic agent; the association between elective abortion and breast cancer is well established and the negative and physical and psychological outcomes from abortion are numerous and very serious. In my opinion, these are the primary reasons doctors should counsel their patients to think again about using hormonal birth control and/or resorting to abortion. I believe most members of the public are not aware of the detrimental effects of the pill and what abortion does to women. I also believe the CPSO ought to do a better job of educating the public about these truths.
Excellent thoughts and comments
We practice medicine to help others live an optimally healthy life. This includes providing culturally safe care to members of the public who are of any race, religion, sex, gender, etc. Allowing physicians to choose whom they serve based on religious beliefs is medical negligence.
This is a public health care system – not private – and until it is, health care providers must provide ethical care to our ever-growing multi-cultural population.
Not providing essential health care services based on beliefs, such as birth control medication, is an extremely dangerous and slippery slope, as this can be used for other reasons than “family planning” (i.e. endometriosis, etc.). Even as such, to deny a woman or a man the support for family planning – is to place religion above the practice of evidence based health care for Ontario residents.
Nurses in Ontario cannot refuse care based on personal beliefs – nor should they be able to. There needs to be consistency in the care ethics provided by our health care practitioners.
I strongly hope that the CPSO will indeed represent the best interests of the public, for whom you serve.
Then have a parallel private system, let the almighty dollar dictate which doctors survive but please don’t force them to be your slave without giving them any other option but to get paid by the state.
As a society we facilitate promiscuity and fornication and applaud all kinds of reproductively obsolete sexual behaviour in the name of freedom and democracy. We sweep all the negative consequences under the carpet; the broken souls, the breakdown of the family unit, not to mention all the diseases. Raise your voice against it or stand up to it, and you’re vilified, accused of bigotry and close-mindedness.
Future generations will continue to suffer unless people, like your doctor, stand up for time-tested morally decent behaviour. Please allow them to be true to their conscience just as you are allowed to be true to yours.
It has come to my attention that physicians are deciding on their own to suddenly decline to offer specific services that they feel violate their religious beliefs. I feel that this is unacceptable. Personal religion has no place whatsoever in science, especially when it comes to the application of science to medicine. The ethical argument in this case is clear-cut: Science determines what is beneficial or harmful to a patient, as it is the only means we as human beings have of quantifying benefit or harm. Religion cannot make such a claim. Religious arguments as to benefit or harm come without supporting evidence, and are based on sporadic interpretations of outdated texts. This very clearly is not valid reasoning in any medical practice. Doctors who refuse to provide the most effective treatment they are able to provide, for any reason, have no right to treat patients. It’s like a soldier who ‘believes’ that every 7th bullet must be fired vertically into the air as an offering to the war-god. We would not permit that within our armed forces, now would we?
A Physician has every right to hold religious belief and to practice that belief however he/she feels is appropriate. Just not when they are providing treatment for patients. Their job is science, not religion. If they wish to make religion their job, then they may wish to become priests.
“Science determines what is beneficial or harmful to a patient, as it is the only means we as human beings have of quantifying benefit or harm.”
You seem not to understand that science provides no guidance whatsoever about what constitutes right or wrong behaviour. Science merely tells us what is physically possible. It tells us what we *can* do, but it does not tell us anything about what we *should* or *should not* do. Those decisions must be made in some other way.
science is far from having all the answers and medicine is a lot more than just science.
please help me find good physicians who has a well-formed conscience, has real concern for patients, and who will apply his good moral values with his professional knowledge…these are the doctors whom I can entrust my life/health with. All of my family and friends are looking for these kind of doctors…it is so hard to find them nowadays, they are like gems…
As well, can someone pls. exlain what Hypocrates Oath is and is it still followed by all our doctors?
The question we are given to vote on is too general, and I think favours the “nays”. Physicians take an oath to do everything they can to preserve life, and it needs to be pointed out that there are only certain procedures that are extreme (and controversial) enough for any physician to refuse to perform them. The issues are well known…abortion (easily recognized as the taking of a life), encouraging the use of contraceptives regardless of the stability of a relationship without examining other options (such as abstinence), assisted suicide, and anything of such life-terminating nature.
A lot of the conversation has centred around contraception, euthanasia and other “hot button” topics. But what of simpler cases? Some religions deny the germ theory of disease (Christian Science). Should a CS physician be entitled to refuse to prescribe antibiotics? What counts as a religious belief? Simply what someone says?
I agree. Define “belief”. Many belief systems hold to the idea that one should not interfere with the will of God. So should the Faithful physician then deny care altogether so as not to play God? Where do we draw the line? I have been in situations with children with special needs that have a “Do not resuscitate” order in effect. Not my personal belief to just let a child die without trying to save them, but I legally have to comply. This is the same in reverse.
Simply put, if a physician refuses to provide care based on a religious conviction, that person should not be a physician. Primitive superstitions do not belong in the medical profession or any other profession that requires the implementation of science.
It was religious conviction that gave us the hospitals we have today. The Hippocratic Oath prevents any harm to anyone including the unborn. Science proves the unborn have distinct DNA separate and distinct from it’s parents. Maybe we should start broadening our understanding of science and quit ignoring the science that doesn’t align with our personal value system.
You exercised your freedom of conscience when you decided to become a physician, just as I exercised my freedom of conscience when I decided to become a Medical Lab Technologist. I don’t, after the fact, get to decide providing certain health services is against my personal ethics and refuse to provide them. I don’t get to edit my job down to fit with my personal freedom of conscience. I have to provide a standard of care that fits with what the patient is entitled to, not what I am willing to provide. Setting your personal beliefs aside for a higher ethical standard is part of being a professional.
So ethics based on atheistic or secular beliefs are “higher” than those based on religion?
Your ethics may allow you to do whatever is asked of you, whether it violates your personal code of conduct or not. It’s hard to see that as “higher”. That is not what the Charter of Rights and Freedoms was supposed to be about.
Personal beliefs should not enter the professional arena. As an RECE teaching in daycares and schools, I cannot say, refuse to change a child’s diaper because it is my personal belief that they shouldn’t be in them at their age. I happen to be atheist, but I cannot deny a child who wants to say a prayer before they eat because it is their culture. The fact that it conflicts with my own personal beliefs is irrelevant. I am a professional. I behave that way while on the job.
Changing a diaper cannot be compared to performing an abortion or prescribing a drug with its intent to cause an abortion or administering drugs with the intent to kill another person….the issues covertly being discussed here under the guise of a “revised Ontario Human Rights Act”
There is a difference between a belief and a moral or religious conviction
I’d like to know if in your job was unconscionable for you to strap a child down in a bed during it’s nap or spank a child if their parents requested itor force feed a hated food.You can’t compare changing a diaper (obviously not against conscience for you with a doctor being forced to do what he considers ahrmful to patients.
I understand your desire for all patients to be treated fairly and without bias. However, as a patient, I do not think it is fair to force a physician to go against his/her religious or moral beliefs for something I want. It is not ethically, or morally right to strip away a physician’s religious beliefs and morals.
To think that Doctors would be forced to go against their religious beliefs… in Canada, is UNBELIEVABLE! Freedom of religion and freedom of conscience mean nothing if one has to be quiet and violate his ethics. A doctor must be able to follow his professional decisions, however they are informed. This must be true for doctors of every religion: Jew, Muslim, Christian, etc., otherwise it is not true for any.
Patients know that not every doctor is alike in beliefs and practices. They are people, not machines. Medical care is an art as well as a science. If the patient does not like the advice one doctor gives, they are free to find another doctor. These principles are all the more important as the issues get bigger and bigger, like abortion and euthanasia.
The most fundamental right of every human being is the right to life. Abortion violates this fundamental right.
Very sadly it would appear that medicine has become big business at the expense of ethics.
Whatever happened to ethics committees?
Self discipline, self knowledge self control.
Doctors have always been respected and leading members of the community.
There appears to be far too much interference from governments in the name of funding.
I believe no profession is closer to God than medicine and its allied professions., and this places a serious onus on the MD.,and medical communities, especially in life and death situations.
It used to be that motivation was a leading question presented to aspiring candidates
for the medical profession.
It is clear that some candidates do not belong.
Selection committees need to take a closer look at candidates.
Unacceptable pressures from governments should be resisted at all costs.
There must always be freedom of conscience
which cannot be mandated by governments.
Medical Laboratory Scientist.
The question as I understand it, is that the College of Physicians and Surgeons of Ontario wants to determine if a Doctor under his/her moral conscience is contravening the Ontario Human Rights Code.
A doctor not wishing to break his/her moral values by prescribing a drug or performing a procedure does not interfere with the Ontario Human Rights Code which protects against discrimination from race, age, colour, sex, sexual orientation or religion.
They would only be violating the Ontario Human Rights Code if they refused to offer their services to anyone because of the discriminatory categories noted above.
A physician following ones moral conscience does not violate the Ontario Human Rights Code.
The opinion of physicians who UPHOLD their Hippocratic oath should be accorded GREATER weight than the opionion of physicians who VIOLATE their Hippocratic oath
I understand that “Do no harm” is one of the fundamental principles of medical practice.
Since birth control medication, including the morning after pill, can harm a woman, and potentially kill a developing human being, the administration of these chemicals contradicts this fundamental principle and should not be forced on any physician – ever.
If we deny physicians the freedom to refuse to act against their morals, where are we going to draw the line? Then in fact physicians should be forced to do everything the public wants. What about female circumcision?
If we really want the physicians to put aside their religious or moral beliefs, we get into the same situation as the physicians in Germany seventy years ago, or in the Soviet Union or in China, North Korea, etc, not so long ago.
I always thought that we as western democracies were different from those countries because we appeal to our moral convictions and do not accept the excuse ‘Befehl ist Befehl’. Apparently that is no longer allowed according to some (many?) people.
If we go this route, then we are on an extremely dangerous way.
With euthanasia laws looming in our country, it is imperative that doctors and health care workers be allowed the freedom to refuse to participate in actions that are against their conscience, and go against the beliefs of their religion. These scenarios will only get more complicated.
Also , though I appreciate that you are interested in what the public has to say, by no means should that be the yardstick in which you make your decision. Surely, specialist in ethics, law, on both sides of the equation should weigh in. This should be a very examined and thoughtful decision as it will have profound ramifications for all physicians present and future and our society.
The Ontario Human Rights Code requires that physicians provide medical services without discrimination on the basis of the individual’s age. However, several tens of thousands of young Ontario residents annually are deliberately killed by physicians in Ontario–and taxpayers are forced to fund this killing. Where is the outrage?
Until CPSO remedies this gross transgression, its consultations are a farce and Canada is a nation of hypocrites.
There is almost no truly medically necessary procedures that pose a moral dilemma for an ethical physician. Abortion is not medically necessary, in fact it is a procedure that intentionally kills
50% of the physician’s patients. It was forbidden by the Hippocratic oath and historically by all medical societies until the last 40 years. That the College of Physicians and Surgeons of Ontario would consider forcing MDs to act against their conscience undermines their authority completely.
Absolutely not! Denying a woman the right to make a choice that suits HER is what is best. Canadians should be DENIED NOTHING. Religious affiliation is an ideological choice, one that shouldn`t be protected unlike those rights afforded to us by the very nature of how we are born! If a Doctor is paid by the public then he serves the public, PERIOD! DO YOUR JOBS and stop making excuses!
“Canadians should be DENIED NOTHING”–then why would you deny them life itself? That is the implication of your evasive language about a mother’s choice to kill her child.
Absolutely a physician has the right to refuse treatment that goes against his\her conscience,just as members of parliament must be free to vote according to their own consciences. Freedom of religion is a basic right of all Canadians as is freedom of speech. In this case the patient has the right and opportunity to consult another physician and the doctor has a right to refuse to prescribe a drug that goes against the moral beliefs they hold.
The problem with protecting religious beliefs is it gives various people an excuse to deny service based on Bigotry, disguised as religious observance. Religion is a choice of ideology, one that in NO WAY should be placed above human rights based on the human condition!
Freedom of conscience is one of the very few valid human rights, and it IS based on the human condition.
Doctors are not second class citizens whose rights and morals are inferior to those of a patient. A patient must not be able to force his or her morality onto the doctor coerce a doctor to against his or her conscience. Forcing doctors to act against their conscience is intolerant bigotry.
I vote YES
Physicians must be able to act according to their own beliefs when treating patients. We cannot and should not force physicians to perform procedures which are not in accord with their personal religious beliefs.
Any Physician should have the right to Refuse a medical service . If it conflicts with his conscience.
I find the threat of removing the right to act according to conscience frightening. Do we really want to see our protective conscience clause removed and consequently see Canada becoming a dictatorship.
Further to that, I would like to have access to physicians who practice medicine according to their conscience and in line with my conscience choices. Please do not remove my freedom of choice.
Physicians must be allowed to practice freely, according to their conscience. We are not communist Russia, although they now see the folly of their pro-abortion policy and are advocating for no abortions. Physicians who protect life, have the courage to speak the truth with clarity & charity are to be honoured for their integrity and for providing evidence-based research showing the harm that artificial contraceptive pills,IUDs etc. do to women. Let’s protect women & our future. The truth will set you free indeed.
If we are supposedly living within a society tolerating all viewpoints why is a Christian view not being tolerated?
Let’s get right to the heart of the issue…..The issues in question are primarily three…. euthanasia, abortion and artificial contraception.
The most fundamental principle underlying all medical care is respect for human life. Many physicians view human life as starting at conception and proceeding through to natural death. Many people will argue against this viewpoint but this is where there is a strong divergence of opinion within our society, and among physicians it is no different. Are not both views valid and to be tolerated equally?
1. Many physicians will not participate in euthanasia as they view it as killing…even if the patient themselves requests it. A lethal dose of morphine prescribed and administered by a physician in a “controlled environment” is still killing… no matter what the reason. What happened to “primum non nocera”…..above all do no harm? I am certain many older patients would never trust a physician who actively participates in euthanasia to provide the best and necessary care for them in their advanced years.
2. Abortion, as well is viewed by many physicians as killing a human being….46XY or 46XX….a human…not a dog or a cat. Abortion can be performed surgically (a D and C) and by oral medications (such as RU-486 also known as Mefipristone a drug which will kill the developing baby at less than 12 weeks gestation by blocking the action of progesterone, a hormone necessary for the developing baby to continue growing in the womb). A medication with the same mechanism of action has been recently released in Canada for the treatment of uterine fibroids (Ulipristal). It has the potential to be prescribed “off label” as an “abortion pill”. If one views abortion as killing are physicians then compelled to be “accessories to the crime” by being forced to prescribe the medication? Do physicians not have the right to refuse to provide “treatment” which is against our conscience? We are not discriminating against the human person in front of us on the basis of race, religion, gender, or ethnicity….but are unwilling to go against our conscience denying the principle of “respect for human life from conception through to natural death”. Very few people have very limited access to medical care in Ontario to the point that they cannot find the “services” they want from other physicians.
3. Many methods of artificial birth control can also work by preventing implantation and thus are viewed by many physicians as abortifacients. The progesterone only pill Micronor and the IUD Mirena render the uterine lining so thinned out that if fertilization happens, then the baby cannot implant in the uterus. The birth control pill also can work the same way. When the birth control pill was released in the early 1960′s it contained huge amounts of estrogen and progesterone….and in those massive doses ovulation was indeed supressed. Over the years the levels of estrogen have fallen dramatically and the progestins are now much more potent. The pill in its present form does not always inhibit ovulation but renders the endometrium so atrophic that implantation is much less likely. Many women ovulate on “the Pill”, and if you believe life begins at conception then the birth control pill can be abortifacient, and thus the reason for some physicians refusing to prescribe it.
If you don’t believe what I have written regarding birth control and its actions see the latest pamphlet from the American College of Obstetricians and Gynecologists entitled “Birth Control Methods: an illustrated guide… item AA528 from http://www.sales.acog.org.
Many physicians have a “moral compass” believing that life begins at conception and ends at natural death. I personally object to the CPSO (hiding behind a revised Ontario Human Rights Code) potentially compelling me or any other physician to comply with a procedure I find morally unacceptable and that is a violation of my conscience or the conscience of other physicians. Leave the present Ontario Human Rights Code as it is.
I strongly disagree that doctors should have to provide non-emergency care that violates their own conscience
Religious beliefs should never trump any basic human right in canada ie. unhindered access to contraceptives etc. contraceptives aren’t illegal and, coupled with a modern and informed sexual education with Iron Age ideologies removed will actually lower the rate of abortions (I digress).
If a physician, and I’ll also state my gratitude and appreciation to every individual who dedicated his or her life to this profession, has an issue with some kind of medical treatment or practice due to religious belief, the rights of the patient should come first. This religious issue comes up in so many areas of social justice and it is used as a method to justify bigoted opinions everyday. We are not the United States. This is a secular country and our health system should place the patients first. Religion should always be a distant second when the choice is between unproven faith in religion vs the real and tangible rights of another human being.
“contraceptives… will actually lower the rate of abortions”
Although this claim is widely believed, it is relatively straightforward to demonstrate that it is false. Because every method of contraception has a failure rate (you can look these up– see below), the widespread availability of contraception actually fuels the demand for abortion. It leads many more people than would otherwise do so to have sex in situations where they cannot possibly accept a child.
If you look up the relevant data and do the math (see below), you can calculate how many unplanned pregnancies would occur each year if all women of childbearing age were sexually active and used contraception. What you find is that, because of contraceptive failure, the rate of unplanned pregnancies that would occur in this scenario is essentially the same as the current actual rate of unplanned pregnancies. In other words, further saturating society with easily available contraceptives will not reduce the rate of unplanned pregnancies.
About half of these unplanned pregnancies currently end in abortion. Further promotion of contraception leads more people to believe that they can separate sex from procreation, and therefore to have sex in situations where they cannot possibly accept a child. But since this “separation” fails at a predictable rate, having more people believe in it and act accordingly leads to more abortions, not fewer.
In what follows, I use U.S. data, which is easy to find. I am confident that Canadian or Ontario data would lead to the same conclusion. If anyone knows where to find the relevant data for Ontario and/or Canada, please point it out.
First of all, CDC data (see http://www.cdc.gov/nchs/data/ad/ad350.pdf) indicates that:
“Contraceptive use in the United States is virtually universal among women of reproductive age: 98 percent of all women who had ever had intercourse had used at least one contraceptive method.”
We will need the distribution of contraceptive usage by method in the United States:
We will also need data on the failure rates of various methods of contraception:
Combining the data from the above sources to obtain a weighted average failure rate, I obtain 5.9% for “typical use”. Available demographic data indicate that the U.S. population includes roughly 50 million women between the ages of 20 and 44. If all of them were using contraception, this would imply close to 3 million unwanted pregnancies per year resulting from contraceptive failure.
By comparison, data published by the Guttmacher Institute (see http://www.guttmacher.org/pubs/psrh/full/3809006.pdf) says that:
“In 2001, 49% of pregnancies in the United States were unintended. The unintended pregnancy rate was 51 per 1,000 women aged 15–44, meaning that 5% of this group had an unintended pregnancy.”
This lines up pretty well with my quick estimate above.
The same paper lists the number of unintended pregnancies in the U.S. as 3.1 million in 2001, which again lines up pretty well with my estimate above.
The main take-away message here is this: promoting contraception will *not* bring down the rate of unintended pregnancies from what it is now. It will, however, further entrench the “contraceptive mentality” which says that one can and should separate sex from procreation. This leads more people to have sex in situations where they are not remotely prepared to accept a child. When those people have unintended pregnancies, they typically resort to abortion as a “solution”. More people behaving that way means more abortions.
A medical professional’s job relates to health care, not religion. Medical treatment should reflect best healthcare practices and the patient’s needs, not the personal beliefs of the practitioner.
If someone has that much trouble with exactly ONE facet of the medical profession (i.e., women and birth control), they require evaluation for discriminatory practices. There’s a whole slew of medical practices that contravene various religious beliefs, and it’s a violation of basic human rights to affirm that this one Christian belief should be given supremacy over all people.
Brilliantly stated! I`ll be quoting you if you don`t mind!
Nonsense! Birth control, abortion, IVF, and euthanasia are no more medical practices than sexual assault is a sexual practice.
I’ve noticed that many of the same people who don’t believe in the existence of God also do not believe in the existence of pre-born people. Many of these same people also demonstrate a trust in the ability of “science” to find solutions to ethical problems.
Like Gulliver, we should be repulsed by yahoos, not try to devolve into them. Why should secular humanist beliefs continue to erode and supplant the Christian beliefs on which Western civilization and Canada were founded?
Why would you want to take away the conscience
of a caring person, Dr. or not. This country is not a dictatorship yet. Shades of Hitler
I strongly support the right of doctors to follow their own moral and/or religious beliefs in their medical practice. When this is taken away we lose our own personal rights for all in matters of most deeply held moral convictions. It also goes against the Canadian charter of rights Section 2 – the rights of your freedom of conscience
Yes, but as it stands they could deny practice to anyone for any reason given this loop hole. This opens the door for Muslim Doctors turning away Gay people, prostitutes, etc …
This is just the beginning. The doctors rights should NEVER take precedence over the that of the patient. In fact, the patients rights should always COME FIRST!
Protecting religious choice should never have been, its a loop hole for bigotry!
Don’t be ridiculous. We are talking about the physician’s right to decide what *actions* he/she will or will not take. We are not talking about the right to decide which patients he/she will or will not treat.
We live in a free society and that includes physicians. The backbone of this country is from the peoples who founded it, they gave us a just society, recognizing authority and laws to protect the innocent. New voices want to take away hundreds of years of tried and true ways that protected the vunerable and those that cannot protect themselves. Canada could do without abortions – we need people to fill our schools and create jobs for housing, funiture etc., – we have the room.
We fought the second world war against a monster who co opted doctors to perform unethical practices against their freedom of conscience. It is unthinkable to force the medical community to do that today in Ontario. Freedom is our most fundamental right. It would not only be illegal but totally irresponsible.
First off, Abortions today are NOT considered an … an ethical Patrice … its a legitimate one, one that`s needed!!! Religion should always, ALWAYS take a back seat to the rights of the patient …. ALWAYS!!!!!!!
No, religious freedom *is* a human right. Not only is it a human right, but it is the very first right listed in our Charter of Rights and Freedoms. See for example:
I emphatically support the right of doctors to follow their own moral and/or religious beliefs in their medical practice. Patients who attend these doctors know their doctor’s ethical stand and choose to continue seeing them. Should they not agree with the doctor’s moral ethics, they have the freedom of choice to move on to another doctor. Let’s keep Canada a fully democratic country and not try to force anyone do go against their moral beliefs.
According to the College’s own words(Physicians and the Ontario Human Rights Code) “Personal beliefs and values and cultural and religious practices are central to the lives of physicians and their patients.” To deny a physician the right to exercise what is central to their being is to deny them their right s a a human being to act freely according to conscience.As a result you would be forcing a docor to violate their own conscience or give up practicing medicine altogether. Where is the balance in this? Patients are not denied treatment as a whole if they are asked to go to another doctor. We accept this often in questions of competency. A doctor is the best judge of whether he can provide service according to his her conscience.
Hi CPSO. It is hard for me to see the need for this change. What is the current public health need that demands such a substantial denial of doctors’ freedom of conscience? This looks to me like an attempt to enforce the moral views of the college on certain of its doctors. It is ironic that your effort to enforce your morality is couched in the language of neutrality—at least to me this looks like a prochoice power grab.
Although it seems nice that you are asking for public input before forcing doctor’s to act against their conscience and religion, you shouldn’t even be asking. Freedom of conscience and religion are enshrined in both the Constitution and the Charter. If most people want to strip Christians of their rights, we are protected against that kind of populist bullying. Please uphold the law. Thank you.
Doctors are people just like any one of us and must have the right to follow their conscience just as we all expect. Today some in our society do not believe in the right to life of everyone (except themselves) and I am referring to the current practice of abortion and in some cases, euthanasia and assisted suicide. While these are definitely practices which are forms of murder, there is all the more reason that doctors who are truly dedicated to do no harm and only advise the safest method of treatment they can, should not be forced by the Medical Association to act against their consciences. It has also been proven that the abortifacient drugs have been harmful to some women who have taken them, they are still being pushed by those who have little or no regard for the lives of others. We truly need doctors who will not sacrifice their patients’ well being by prescribing harmful drugs or procedures even if asked for them.
Many people feel that when we chose medicine as vocation, we should have known that whatever the public wants, we comply. But we deal with individuals, not the “public” A case was discussed on the radio where in Toronto a barber had a sign refusing service to females (on religious grounds, I suppose)- but female made a complaint and some callers felt that if he gets Canadian money, he should serve all Canadians. Is that how low we go in Canada?
Then how far do we or will we go in medicine? Quebec passed a law allowing euthanasia under circumstances. Should a similar law be passed in Ontario, do any and all of us will be obligated to perform euthanasia on demand? There is a principle of escalation here. Prescribing contraceptives is less controversial. Abortions are more so. Active euthanasia is even more difficult. But are all physicians in Ontario obligated to do all, as some writers claim that being a physician should set our moral values aside? And a small town solo doctor should be obligated to perform euthanasia on demand? Or be he or she obligated to perform abortions as he or she is the only doctor in the area? Where is the line?
Legion of MaryThe human has rights and we don’t accept codes to make division inside the human specially in their believes, in their faith and in their values.
When I received my MD and licence to practice in Ontario, physicians were not expected to act beyond their moral values (and contrary to many areligious people, morals and religious beliefs are not synonymous – some of our judgements and decisions are based on moral values). So when later in life some members of the public demand action on their terms that does not agree with my moral values, do they think that I should hang up my sign and resign from the medical profession? If societal attitudes have changed and some members of the public now demand action that was not in effect when I received my MD, then what are my options? Change my moral values or quit medicine? This leads to the next generation. Societal values do change. Medicine did things we would not do today – e.g. forced sterilization, lobectomy, etc. of vulnerable people. Do some of your correspondents have that high opinion of themselves that they KNOW what is right? Had they corresponded with CPSO 30 years ago, would they have demanded that every physician be obligated to perform involuntary sterilizations and frontal lobotomies because that was approved by and forced by some segments of the public? Are we physicians obligated to change our moral values as society changes theirs? If so, then any newly licenced physician must take an oath that he/she will perform any publically demanded procedure in the future – regardless of his/her moral values – that may even include forced implantation of computer chips in the brain of every newborn, amputation of the arm of any thief, forced surgical procedures on people exiled from Earth and transferred to a spatial colony, etc. We cannot imagine what the future will bring. Those who demand adherence to their values even when clashes with mine are demanding that with my MD I should abide by their demands – but this was not the case when I received my MD. So any future physician should accept that society may demand their participation in yet unknown but possible future medical actions, unacceptable to the physician, but demanded by certain segments of the public? Do we know what our future is? Did Germany know in 1923 what Hitler will do in 1941? Was it obligatory for all German physicians receiving their MD in 1921 to participate in the medical atrocities demanded by Hitler? Is it mandated that all qualified physicians perform late pregnancy abortions or sex-selection abortions in 2014 because some segments of society demand it? Over time all societies change their moral values. Today’s moral values in Ontario may not be the same as they will be in 2044. Is it mandated that each and every physician changes his/her moral values on schedule with the changes occurring in society? Those who see the world as absolute and unchanging need to have a perspective on change, and not just a snapshot of today alone. We are not the same as we were 30 years ago and life will not be the same 30 years from now. Yet I believe that my moral values have not changed over the years and will not change in the future. Thus will I be disqualified from practicing medicine in 2022 because society has changed its values and demands things that are not even thought of today?
Doctors should never deny healthcare for non-medical reasons.
Doctors shouldn’t even have the option to consider denying healthcare for non-medical reasons.
As a medical student, I ask that the CPSO maintain its current policy and continue to advocate for freedom of conscience for physicians. I am gravely concerned that the possibility of being denied such a freedom is even being considered – I, for one, would be extremely uncomfortable if I were forced to perform procedures that I felt were morally unacceptable. In a country where we value diversity (cultural, religious), it is important that we respect each other’s values. Physicians should be able to provide care as humans, not robots. I hope that the CPSO will defend physicians’ ability to practise medicine with integrity and a clear conscience.
If a woman has the right to choose then physicians should also have the right to choose the services they provide based on ethical values.
One of man’s most important assets is a conscience to guide his actions in all aspects of his life.
No government can take away this basic human right.
I believe that all physicians & surgeons of Ontario or any province should have the right to refuse their services if they feel it is morally and/or spiritually against their beliefs
Every person, physician or other, should be allowed freedom of Religion. It is a basic constitutional right and to force a person to act against his intrinsic values is to cause that person great anguish and moral concern. Religious and moral values must be upheld or Canada cannot be considered a democracy.
I was totally dismayed and appalled to read articles in the news concerning a physician’s right under the current CPSO policy to deny treatment to a patient in Ontario because of the Physician’s moral or religious ideological beliefs. The three physicians named all work at walk in clinics that serve all Ontario residents regardless of race, religion, sexual orientation, etc. Ontario residents who rely on Walk In Clinics and patient health centers for their primary care should not have to deal with physicians who deny patient care because of their so called constitutional right to refuse treatment based on their particular views of morality. This policy is totally wrong and is contrary to my rights as an individual guaranteed by the same charter that they uphold for their justification of denial. Since we the taxpayers of Ontario are the employers of these physicians, they should have no right to impose their religious beliefs to decide whether or not any individual wishes to prevent a pregnancy by any artificial means of birth control. Will these same Physicians be now allowed to refuse treatment to the LBGT community, or the Muslim community, or anyone who is not of their religious persuasion?
This prescription medication has been available to women since the early 60′s and all of a sudden it is an issue on moral grounds. This type of prejudice and hypocrisy has no place in our heath care system. It would be my suggestion that employment in a walk in clinic or family practice that serves the general public be denied to any physician who elects to deny treatment based on his/her religious values. I think this is a very slippery slope and by allowing one religious ideology to dictate policy we are subject to many ideologies demanding their rights to deny treatment.
Thanks for receiving my comments on this important issue.
I would like to say that it is important not to force doctors to provide treatment or information about treatment that opposes their moral or religious convictions. Such would be a violation of human rights and religious freedoms. This means that doctors should not be forced to prescribe birth control pills, give information about or perform abortions, or other such practices. On the contrary, the tearing of an unborn child limb from limb and throwing him or her in a trash can should be seen as the worst form of violation of human rights and abuse against justice. Doctors should not be forced to perform or recommend such barbarous acts, but on the contrary, should be given the right to oppose them by discouraging patients from having abortions or taking birth control pills. To be morally responsible means to act and speak according to your convictions, and it should be unthinkable that doctors should be silenced and hindered from doing so.
Your religious freedom does not supersede another human beings HUMAN RIGHTS! If they are a publicly funded Doctor, to bad about it … you serve ALL THE PUBLIC regardless of religious affiliations!
The thing is, religious freedom *is* a human right. See for example:
“Every time I hear someone speak in support of slavery I am filled with the urge to see it tried on them personally”. Every time i hear someone speak in support of abortion I am filled with the urge to see it tried on them personally! I challenge you to go to an abortuary and watch an innocent & helpless human being (preferably a late term female baby) being decapitated & dismembered. Film that and show it to your students mr trudeau and explain how murdering this female human is “women’s rights”? How is a few months of an unwillingly pregnant woman’s career, social life, schooling, figure or comfort more valuable than an entire lifetime of another innocent & helpless human? The fact is, if a woman does not want to be pregnant, there is ample CHOICE in avoiding pregnancy. Ask any grade 1 class (after explaining what abortion is) if it’s wrong or right, A 5yr OLD HAS MORE SENSE THAN YOU!! Ask any scientist or biologist if an unborn baby is a LIVING HUMAN BEING, They are, it’s a FACT. your uninformed & misguided, immoral & inhumane verbal diarrhea on this matter is an insult to every decent person on this planet. Are you man enough to go watch a MURDER at an abortuary?
i highly doubt it, YOU CAN’T HANDLE THE TRUTH!!!
The issue here is not about abortion . it is about preventing an unwanted pregnancy so that abortion will not be necessary. In Canada the number of late term abortions is very small and is almost always of a medical not personal choice. I have that right to my choice of birth control under the same charter of rights that protects my religious views and expect that any physician working at a walk in clinic that serves all people, not just those who follow the physicians preferred method, should have to prescribe for me oral contraceptives.
“…and expect that any physician…should have to prescribe for me oral contraceptives.”
The right to make choices for yourself is one thing, but what you are claiming here is the right to coerce others into giving you what you want.
I have to trust a doctors judgement.For example, If they are not positive about giving artificail birth control out, I can always go somewhere else. For years, many people were suspicious about natro-paths… It should be choice who you see. If Iam not pleased with someone I should go somewhere else. I want to deal with principled health care providers.
Marian Montessori SchoolI’m appalled to know that the Physicians who are responsible for healing us, people who are doing the work of God, healers and care givers are denied decisions based on higher values given by God.
It is outrageous that they are denied the right to make decisions based on their God given inspirations, decisions based on a higher moral and right to life for the unborn and all at their mercy.
It breaks my heart as a teacher and caregiver, that our unborn, our children, adults and seniors should have to be in the hands of such merciless decision makers!
Have you really read the bible and the treatment of women by the men of the bible as dictated by a supposedly loving God of all creation. The biblical history is one of a vengeful jealous God who gives orders to kill innocent women and children who are not of the tribes of Israel. He condones rape . murder and adultery. READ it and start thinking about what are really untruths written by men who did not have a clue how the human body functions, The Catholic Church, among others, has a violent history. What better way to increase your numbers than to make it a sin to use artificial methods of birth control which, for millions of women and children, has resulted in poverty and death for both the Mother and Child.
If you wish to write a credible critique, you really need to inform yourself about the subject of your critique.
The challenge you will encounter, if you really dig into it, is that Catholic morality is based on a solid rational foundation called Natural Law. Although you may find it easy to take facile pot shots at some aspects of Catholic history (and quite frankly, what 2000-year-old organization hasn’t made mistakes that are easy to criticize), you will find that taking on Natural Law requires considerably more intellectual effort.
Besides which, artificial methods of birth control are simply not needed. As a being with a rational nature, you already possess the means to fully control your fertility, because you have the capacity to control your own behaviour. There is no need to relinquish that control to someone else’s technology. Hormonal methods, in particular, are extremely intrusive and insidious in their side effects.
Finally, it is worth pointing out increasing our numbers is precisely what we need here in Canada, where our total fertility rate is well below replacement levels. See for example:
Not true, July 20 commenter.
God is loving, but He is also holy. He is longsuffering, but ultimately He does not condone sin. All of the Old Testament points forward to the Atonement in the New.
Only He has the authority to decide the time of death of even the smallest human being.
Stop applying the beliefs of your Religious affiliation on the rest of the public! Some of us have evolved beyond the notion of God!
Evolved? Hardly. Your implication that atheism is somehow superior has no rational basis. Furthermore, the original poster was most certainly not applying their religious beliefs to “the rest of the public”. He/she was simply defending the physician’s freedom of conscience. That he/she chose to express this in religious terms is entirely beside the point.