Dying With Dignity, Canada believes an Ontario Divisional Court decision that compels doctors to refer for euthanasia and assisted suicide may become a springboard to court challenges aimed at the conscience rights of institutions which refuse to assist in the death of patients.

“It’s really interesting. I think that the question is going to be debated in the coming days and weeks, if not months, by lawyers,” Dying with Dignity CEO Shanaaz Gokool told The Catholic Register.

In a unanimous Jan. 31 decision, a panel of three judges agreed that the religion rights of doctors under the Charter are violated by a policy which demands a formal referral for assisted suicide and other procedures. But the judges nonetheless ruled against the doctors because, they said, there is a greater public interest in ensuring “equitable access to such medical services as are legally available.”

Catholic Civil Rights League president Phil Horgan hopes the decision is appealed because, he said, there is a danger that the ruling could be expanded to include Catholic and other institutions.

“It’s obviously a concern going forward,” said Horgan. “That’s a further reason, because these cases have impact, that there needs to be a review by a higher level of court, in my view.”

The CCRL was an intervenor on the side of the Christian Medical and Dental Society and five named doctors in a suit filed against the College of Physicians and Surgeons of Ontario, which insists that doctors who oppose assisted death provide a referral for patients who wish to die. Seeking an appeal is up to the CMDS. Their decision is expected the week of Feb. 11.

“The ruling effectively gives the state the power to compel citizens to be parties to homicide and suicide, even if they believe it is wrong to kill people or help them kill themselves,” said Protection of Conscience Project administrator Sean Murphy in a press release.

CMDS executive director Deacon Larry Worthen said Justice Herman J. Wilton-Siegel, writing on behalf of the panel, accepted several aspects of the doctors’ argument. “So the cup is half full,” he said.

“He accepted that it violates our right to religious freedom; that there were other less intrusive means of ensuring access. He accepted that the disruption on physicians was not trivial or insubstantial. He acknowledged that it would mean that doctors would have to possibly leave medicine or change practice.”

The idea that “equitable access” outweighs freedom of religion leaves Worthen scratching his head.

“It’s not the responsibility of each, individual physician to ensure access to every possible treatment. That would be completely unreasonable,” Worthen said.

The assertion that the Charter of Rights and Freedoms protects a right to “equitable access” as “a natural corollary of the right of each individual under section seven to ‘life, liberty and security of the person’ ” is something rather novel and may be grounds for an appeal, said CMDS lawyer Albertos Polizogopoulos.

Dr. Ramona Coelho, a family doctor in London, Ont., doesn’t understand why a court case over her religious freedom was necessary. In Alberta, where doctors are not compelled to give referrals against their conscience, doctors have a centralized referral system which patients can access.

“What’s ridiculous about this whole thing is that everyone else has a better solution that doesn’t infringe on patient access and doesn’t infringe on our Charter rights,” said Coelho.

The Canadian Medical Association, the Ontario Medical Association and the American Medical Association all submitted briefs advising against forced referral.

If, after this decision, doctors retire early or step away from family medicine to avoid conflict with CPSO referral rules, patients will suffer, Coehlo said.