“It means a whole class of persons are not going to be able to practise medicine because of their religious beliefs,” said Deacon Larry Worthen, who heads up the organization representing Evangelical and Roman Catholic doctors.
The Ontario College of Physicians and Surgeons is proposing guidelines that would force objecting doctors to refer for assisted suicide and voluntary euthanasia.
“Where a physician declines to provide physician-assisted death for reasons of conscience or religion, the physician must not abandon the patient. An effective referral to another health-care provider must be provided,” reads the proposed guideline.
“If this policy goes through, it’s going to require that doctors be coerced into doing things that go against their moral beliefs, contrary to the Charter of Rights and Freedoms,” Worthen said.
The guideline document is currently up for consultation and the College of Physicians and Surgeons is inviting public, physician and institutional comment on its web site, cpso. on.ca. In the absence of legislation, the guidelines would be binding on Ontario doctors as of Feb. 6, when the Supreme Court of Canada’s ruling striking down parts of the Criminal Code that prohibit assisted suicide comes into effect.
The federal government has applied to the court for a six-month extension on that deadline.
“A consultation is open. Anyone ... can weigh in on how they feel we did in this first draft,” said college president Joel Kirsh.
When the issue of referrals came up on abortion earlier this year, the college went ahead with a policy requiring objecting doctors to provide an “effective referral,” even if participating in abortion through referral violates a doctor’s religious or moral convictions. The online response on the college’s Professional Obligations and Human Rights policy was overwhelmingly against forcing doctors to refer, but the College of Physicians and Surgeons held that its internal polling showed a majority of Ontarians favoured the referral option.
“Online commentary is assessed for the quality of the interventions, not on a quantitative basis,” said Kirsh.
The college is cautious about “polarized or opposite viewpoints to what’s being put out for consultation,” he said.
“The consultation process can generate input. It’s not meant to poll the public or get a sense of the profession because it’s not a rigourous way of polling people,” he said.
The public has never seen the polling data — the questions asked or the sampling methodology — behind the forced referral policy, said Worthen.
The Christian Medical and Dental Society is suing the College of Physicians and Surgeons to nullify its policy that forces doctors to refer for abortion. The proposed Interim Guidance on Physician-Assisted Death applies the same forced referral policy to voluntary euthanasia.
The CMDS is organizing opposition to the guidelines at a new web site, moralconvictions.ca.
Recent polling for the College of Physicians and Surgeons on assisted suicide came up with strong support for doctor-administered death and for forcing doctors to refer for the service despite their religious and moral convictions. The poll by The Strategic Council for the CPSO showed 65 per cent of Ontarians “strongly support” assisted dying with another 21 per cent “somewhat” in favour. Asked what should happen when a doctor objects for moral or religious reasons, 69 per cent said physicians “must make an effective referral.”
But a CMDS-sponsored poll came up with the opposite result. Abingdon Research (now known as the Torch agency) found in May that only 31 per cent of Canadians favour forcing doctors to refer against their conscience. The majority (54 per cent) wanted doctors to provide information but leave it up to patients to “refer themselves.” Another 16 per cent flatly rejected any referral for assisted suicide.
The Canadian Medical Association has consulted on legal euthanasia with the CMDS, the Canadian Federation of Catholic Physicians’ Societies and the Canadian Physicians for Life to come up with a policy that respects a doctor’s religious and moral freedom but also provides timely access to legal procedures, including legal forms of euthanasia.
“We propose that each provincial or territorial department of health create a mechanism that allows for patient access to an assessment for assisted death, but which does not erode caregivers’ conscience protections,” reads a position paper issued by the CMA in August. “It is possible to protect conscience rights of physicians while respecting patient autonomy.”
The Christian Medical and Dental Society, the Canadian Federation of Catholic Physicians’ Societies and Canadian Physicians for Life has run the proposed central referral service by Evangelical ethicists and Catholic moral theologians. The theologians unanimously approved, said Worthen.