A draft policy of the College of Physicians and Surgeons of Ontario demands that physicians must provide services to prevent imminent “harm, suffering and/or deterioration,” even if doing so is contrary to their moral beliefs.

A draft policy of the College of Physicians and Surgeons of Ontario demands that physicians must provide services to prevent imminent “harm, suffering and/or deterioration,” even if doing so is contrary to their moral beliefs. Critics of the new policy fear that they will be forced to violate their conscience.

The draft policy says:

The Canadian Charter of Rights and Freedoms (the “Charter”) protects the right to freedom of conscience and religion. Although physicians have this freedom under the Charter, the Supreme Court of Canada has determined that no rights are absolute. The right to freedom of conscience and religion can be limited, as necessary, to protect public safety, order, health, morals, or the fundamental rights and freedoms of others. Where physicians choose to limit the health services they provide for moral or religious reasons, this may impede access to care resulting in a violation of patient rights under the Charter and the Code.

Although euthanasia is not legal in Canada at the moment, should the Supreme Court legalize it, the policy will require objecting physicians to lethally inject patients themselves if a delay would result in “harm” or “suffering.” In less urgent circumstances, the policy will require physicians unwilling to kill patients to promptly refer them to “a non-objecting, available physician or other health-care provider.”

However, many physicians who object to abortion or euthanasia for reasons of conscience would also object to referral. Dr Charles Bernard, President of Quebec’s Collège des médecins, has explained that mandatory referral effectively nullifies freedom of conscience: “It is as if you did it anyway.”

Prominent academics and activists want to force objecting physicians to provide or refer for abortion and contraception. They and others have led increasingly strident campaigns to suppress freedom of conscience among physicians to achieve that goal. The College’s draft policy clearly reflects their influence.

The Protection of Conscience Project, a lobby group, insists that “it is incoherent and contrary to sound public policy to include a requirement to do what one believes to be wrong in a professional code of ethics. It is also an affront to the best traditions of liberal democracy, and, ultimately, dangerous”.

The College Council has tentatively approved the policy, but will accept public input until February 20 before imposing it on Ontario physicians.

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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