“My conscience is at the base of every medical decision I make, every day,” the Ottawa family physician told The Catholic Register. “The very thought of me being asked to put it aside makes me sick.”

Tanguay is not given to metaphorical exaggeration. When the College of Physicians and Surgeons’ new human rights code policy was first proposed in 2014, Tanguay spent three weeks struggling to sleep and feeling physically ill.

“To stay silent was the worst,” she said. “This is at the basis of a doctor’s relationship (with patients) and it will be completely affected.”

Tanguay is one of five doctors whose names have been included in a Charter of Rights and Freedoms court challenge to a new CPSO policy which would require doctors to refer patients, even if their conscience says no, for any legally available medical service. The suit was filed by the mostly Evangelical Christian Medical and Dental Society with the support of the Canadian Federation of Catholic Physicians’ Societies. Tanguay is a member of Ottawa’s Sts. Cosmas and Damian Society for Medical Ethics, one of the bodies represented by the CFCPS.

The Charter challenge in Ontario Superior Court won’t be Tanguay’s first legal tangle with Ontario’s doctor-licensing body. She spent a good deal of 2014 huddled with her lawyer, defending herself from an anonymous accusation from people who were never patients in her practice.

“There was no patient-based complaint whatsoever,” said Tanguay.

Tanguay’s professional college launched an investigation into her on the basis of two e-mails to the college commenting on an Ottawa Citizen newspaper article. The Citizen had written about Tanguay’s refusal to refer for abortion and contraception after pictures had appeared on Facebook and Twitter showing a sign on the receptionist’s desk during walk-in clinic hours at her practice. The sign advised patients that the doctor on duty would not refer for abortions or prescribe chemical birth control and advised patients who want those services to come back another day or seek out another doctor.

The three-month investigation into Tanguay concluded she had not violated any existing college policy, but still advised her to be less insistent on her conscience rights.

“Making a blanket statement that a physician does not refer for certain services is not in accordance with College expectations,” said the Aug. 15 “analysis and conclusions” from the CPSO’s Inquiries, Complaints and Reports Committee.

The CPSO committee wanted Tanguay “to be more proactive in providing patients with detailed information about where and how they may access care which is not restricted.”

“The CPSO is there to protect people from doctors who are incompetent. I’m far from that,” said Tanguay. “It’s a false accusation and putting my judgment in question because of the way they portray things, which is inaccurate.”

Tanguay has patients who have opted for abortions and who continue to use the pill, rather than the doctor’s preferred natural method of family planning.

“You do not need a referral in Canada to get an abortion. Some of my patients go and have their abortions. We discuss the thing and they decide to go ahead,” Tanguay said. “I keep following them and there is no problem. It’s a non-problem.”

Tanguay explains fully all the options, all the side effects and all the possible complications. She is clear up-front about what she will and will not do. She does not discuss religion with patients or pass judgment on them.

“I totally respect the fact that if you want to have it you can decide,” she said. “But I would like you to respect the fact that I wouldn’t like to have my name at the bottom of a prescription that will make me uncomfortable as a doctor. As a doctor, I don’t want to be responsible for this and it’s not something I want to participate in.”

Under the new CPSO human rights code policy Tanguay wouldn’t get off with a couple of lines of advice. The new policy requires she make an “effective referral” for services she objects to on moral or religious grounds.

The new policy constitutes “discrimination totally based on the religion and the conscience of those doctors, which is illegal in Canada,” Tanguay said. She’s in for the long haul on the court challenge, which is likely to be appealed up through the courts however it’s decided.

“If the decision goes against me, I will go to the next level of court. And if it goes against me again we will go to the Supreme Court. And I will not change what I am doing,” she said. “What I am doing right now is giving patients what they need and not necessarily what they want. I give them their autonomy to decide and they can get it with my colleague the next day. I’m not obstructing anything.”

Tanguay believes the new CPSO policy is a rubber stamp on a pro-abortion agenda. The trouble is, as written, the new policy now extends to euthanasia, she said.

“If I cannot believe it’s a good thing for a patient to be euthanized, then I cannot refer and be an accomplice to murder,” she said.

The Christian Medical and Dental Society of Canada has raised $60,000 to meet an expected $150,000 legal bill, said executive director Larry Worthen.