Professor David Oderberg joins Protection of Conscience Project Advisory Board

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Protection of Conscience Project

The Protection of Conscience Project welcomes David S. Oderberg, Professor of Philosophy at the University of Reading, UK to the Project Advisory Board. Professor Oderberg joined the university after completing his doctorate at Oxford in the early 1990s. He is the author of many articles in metaphysics, ethics, philosophy of religion, philosophy of science, and other areas. He is also the author of several books including Moral Theory and Applied Ethics (Blackwell, 2000) as well as co-editor of collections in ethics such as Human Values: New Essays on Ethics and Natural Law (Palgrave, 2004) and Human Lives: New Essays on Non-Consequentialist Bioethics (Palgrave, 1997).

Prof. Oderberg has been working on freedom of conscience in health care over the last few years, with a recent article in the Journal of Medical Ethics on co-operation, and a forthcoming policy monograph to be published by the Institute of Economic Affairs. He is Editor of Ratio, an international journal of analytic philosophy, and Senior Fellow of the Higher Education Academy. In 2013 he delivered the Hourani Lectures in Ethics at SUNY Buffalo, and has a book forthcoming based on those lectures, to be called The Metaphysics of Good and Evil. [Faculty Profile] [Website]

Contact:
Sean Murphy, Administrator
Protection of Conscience Project
protection@consciencelaws.org


The Protection of Conscience Project is a non-profit, non-denominational initiative that advocates for freedom of conscience in health care. The Project does not take a position on the morality or acceptability of morally contested procedures. Since 1999, the Project has been supporting health care workers who want to provide the best care  for their patients without violating their own personal and professional integrity. 

 

 

Protection of Conscience Project welcomes new advisor from Scotland

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Protection of Conscience Project

The Protection of Conscience Project welcomes Dr. Mary Neal, PhD, LLB Honours, LLM to the Project Advisory Board. Dr. Neal is Senior Lecturer in Law, University of Strathclyde, Glasgow.  She researches, writes, and teaches in the fields of Healthcare Law and Bioethics, focusing on beginning and end-of-life issues.  In 2014-15, she was Adviser to the Scottish Parliamentary Committee scrutinising the Assisted Suicide (Scotland) Bill, and she is a current member [2018] of the British Medical Association’s Medical Ethics Committee. She has published a wide range of academic articles and blogs on a range of topics including, most recently, conscientious objection by healthcare professionals; the nature of ‘proper medical treatment’; the role of the emotions in end-of-life decision-making; and the conceptual structure and content of human dignity.

Dr. Neal was a co-editor of and contributor to the recent volume Ethical Judgments: Re-writing Medical Law (Hart, 2017). Her works-in-progress include articles and book chapters on conscientious objection; the idea of ‘vulnerability’ in healthcare; physician-assisted suicide; and the role of dignity in human rights discourse. Among other research activities, Dr. Neal is currently leading two funded projects relevant to the issue of conscientious objection in healthcare. One is a British Academy/Leverhulme-funded project exploring conflicts between personal values and professional expectations in pharmacy practice. The other is a multi-disciplinary network of academics and healthcare professionals (the ‘Accommodating Conscience Research Network’, or ‘ACoRN’), funded by the Royal Society of Edinburgh, and beginning with a series of roundtables exploring various aspects of conscientious objection in healthcare. Dr Neal is also a spokesperson for the Free Conscience campaign supporting the Conscientious Objection (Medical Activities) Bill currently before the UK Parliament.[Faculty Profile]

Contact:
Sean Murphy, Administrator
Protection of Conscience Project
protection@consciencelaws.org


The Protection of Conscience Project is a non-profit, non-denominational initiative that advocates for freedom of conscience in health care. The Project does not take a position on the morality or acceptability of morally contested procedures. Since 1999, the Project has been supporting health care workers who want to provide the best care  for their patients without violating their own personal and professional integrity. 

Canadian court rules that state can compel participation in homicide and suicide

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Protection of Conscience Project

Three judges of the Ontario Superior Court of Justice Divisional Court have unanimously ruled that, notwithstanding religious convictions to the contrary, Ontario  physicians can be forced to help patients access any and all services and procedures, including euthanasia and assisted suicide.

“In the end,” observed Project Administrator Sean Murphy,  “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.”

The Protection of Conscience Project jointly intervened in the case with the Catholic Civil Rights League and Faith and Freedom Alliance on the issue of freedom of conscience.  The court acknowledged the submission, but explicitly limited its ruling to the exercise of freedom of religion.  It did not address freedom of conscience.

The court approved the reasoning of the College of Physicians and Surgeons of Ontario, the state medical regulator.  The College argued that “physicians must be prepared to take positive steps to facilitate patient access” to euthanasia and assisted suicide, and that there is “no qualitative difference” between euthanasia and “other health services.”

With respect to options of objecting physicians, the court observed that they are free to change their field of practice in order to avoid moral conflicts.  The judges added that those who fail to do so are to blame for any psychological distress they might experience if compelled to violate their convictions.  It appears that they were unconcerned that this might further reduce the number of family and palliative care physicians, noting that there was “no evidence” that coercive policies would adversely affect physicians “in any meaningful numbers.”

Dr. Shimon Glick, advisor to the Project and Professor Emeritus of the Faculty of Health Sciences at Ben Gurion University of the Negev in Israel, described the ruling as “sad.”  Commenting on the decision, Project Advisor Professor Roger Trigg of Oxford said, “once the perceived interests of the State override the moral conscience of individuals  – and indeed of professionals- particularly in matters of life and death, then we are treading a slippery slope to totalitarianism.”

“Even the first steps- that may not seem important to some,” he warned, “are taking us in that direction.”

Professor Trigg’s warning was echoed by Professor Abdulaziz Sachedina, a leading Islamic scholar and philosopher who also serves on the Project Advisory Board.  Professor Sachedina asked, “Are we  going to submit to “totalitarian ethics” reflected in such court decisions, making suicide a tempting option without any regard to conscientious objection?”

The decision concluded legal proceedings launched jointly by five Ontario physicians, the Christian Medical and Dental Society of Canada, Canadian Physicians for Life, and the Canadian Federation of Catholic Physicians’ Societies.  They are considering the possibility of appeal.

Contact:
Sean Murphy, Administrator
Protection of Conscience Project
E-mail: protection@consciencelaws.org


The Protection of Conscience Project is a non-profit, non-denominational initiative that advocates for freedom of conscience in health care. The Project does not take a position on the morality or acceptability of morally contested procedures. Since 1999, the Project has been supporting health care workers who want to provide the best care  for their patients without violating their own personal and professional integrity. 

 

 

Physician, expert in Jewish medical ethics joins Protection of Conscience Project Advisory Board

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Protection of Conscience Project

Professor Shimon Glick, MD,  of the Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel, has joined the Protection of Conscience Project Advisory Board.

Professor Glick was born in Brooklyn in 1932 and received his medical training in the United States, specializing in internal medicine and endocrinology. He immigrated to Israel in 1974 to become a founding member of the Faculty of Health Sciences (FOHS) at Ben Gurion University of the Negev and head of the Internal Medicine Department at Soroka Medical Center. He and his colleagues instituted the practice of “early clinical exposure,” insisting that students meet patients in their first week at medical school, even before beginning traditional academic studies. “The students don’t just treat patients. They talk to them and learn what it’s like to be sick,” he explains. Students also take their medical or Hippocratic oath when they begin their studies, rather than taking the oath when they finish.

Professor Glick became chair of Israel’s first Internal Medicine Division and served as Dean of the FOHS between 1986 and 1990. During his tenure, he played a key role in formulating the admissions process for medical students – a process based not only on achievements but also the candidates’ character. Professor Glick headed the Prywes Center for Medical Education and the Jakobovits Center for Jewish Medical Ethics, two domains that were assigned a central role in the professional education of students in the Faculty. He was also instrumental in the instruction on doctor-patient communications for first year medical students. In addition, Professor Glick has served as ombudsman for Israel’s Ministry of Health. He is widely recognized as an expert in medical ethics, with a particular focus on Jewish medical ethics, and is at the forefront of the efforts to bring a Jewish perspective to bear on the most important issues of modern bioethics.

In 2014, in recognition of his contributions to medical education and practice, Professor Glick received a Lifetime Achievement Award as part of the Nefesh B’Nefesh Bonei Zion Awards. The award recognizes outstanding Anglo Olim – veteran and recent – who encapsulate the spirit of modern-day Zionism by contributing in a significant way towards the State of Israel.

Professor Glick is blessed with 46 grandchildren and (at last count) 77 great grandchildren.  He continues to teach at the Joyce and Irving Goldman Medical School and the Medical School for International Health (MSIH).  [Faculty Profile]

 

Project comment on Quebec euthanasia statistics

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Protection of Conscience Project

LifeSite News has published an article concerning Quebec euthanasia statistics collated by the Project.

During the interview that led to the publication of the article, the Project Administrator expressed concern that a significant increase in the volume of cases in the last half of 2016 could increase pressure on physicians and other health care workers who do not wish to participate in the procedure.  Such pressure was generated across Canada by the exponential increase in the number of abortions following liberalization of the abortion law in 1969, from under 300 in eleven years[1] to over 11,000 in the first year after the change in the law.[2]  The number of euthanasia and assisted suicide cases in the first year of legalization seems unlikely to exceed 20%  of that number, but this is still sufficient to warrant concern about pressure on objecting health care workers.

The statistical returns disclose some wide differences between different regions or reporting agencies, and sometimes between reporting agencies in the same administrative region.  For example: the number of euthanasia requests per 100,000 population is reported to be much higher in the Quebec City area than in the rest of the province, while the number of euthanasia requests per 100,000 palliative patients reported in Lanaudiere and Laval is much higher than in the Montreal Region.  Euthanasia is reported to be provided per 100,000 population in the Quebec City area at a rate three times that of Montreal.

The Administrator explained that the statistics were primarily useful in raising important questions about the reasons for such variations or trends, such as differences in the quality or accessibility of palliative care or the nature of patient illnesses.

Note

1. Waring G. “Report from Ottawa.” CMAJ Nov. 11, 1967, vol. 97, 1233 (Accessed 2016-06-15).

2. In 1970, the first year under the new rules, there were more than 11,000. In 1971 there were almost 39,000. “Therapeutic abortion: government figures show big increase in ‘71.” CMAJ May 20, 1972, Vol. 106, 1131 (Accessed 2016-06-15)

[Release revised 2017-03-14]

Protection of Conscience Project to intervene in lawsuit against state medical regulator

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Protection of Conscience Project

The Protection of Conscience Project has been granted joint intervener status in a constitutional challenge to policies of the College of Physicians and Surgeons of Ontario.

The Project is intervening jointly with the Catholic Civil Rights League (CCRL) and Faith and Freedom Alliance (FFA) in a lawsuit against the College launched by Ontario physicians and national physician organizations.

The joint intervention will defend freedom of conscience in the face of demands by the Ontario College of Physicians that physicians who refuse to kill patients or help them kill themselves must send them to a colleague willing do so.

“Unlike the CCRL and the FFA, the Project does not take a position on the acceptability of euthanasia or assisted suicide,” said Sean Murphy, Project Administrator.

“However, all three groups agree that those who object to the practices for moral, ethical or religious reasons should not be forced to provide or collaborate in them.”

The intervention will attempt to assist the court in defining a principled approach to the nature and scope of freedom of conscience.

Federal government policy a factor

The deliberate decision of the federal government to support coerced participation in homicide and suicide contributed to the Project’s decision to intervene.

“The federal government knew full well that the Ontario College was threatening to punish physicians who refuse to be parties to euthanasia and assisted suicide when it introduced Bill C-14 to set the groundrules for the procedures,” said Murphy.

“It could have prevented coercion by exercising its jurisdiction in criminal law. It could have made it a crime to force someone to be a party to homicide or suicide. It was repeatedly asked to do so. It steadfastly refused.”

Instead, Murphy said, “the Government of Canada chose to enable coercion, and to defend its support for coercion as ‘cooperative federalism.’”1

In contrast, the Project insists upon a foundational principle of democratic civility: that no one and no state institution may compel unwilling citizens to be parties to killing other people. Neither the state nor its agents nor others in positions of power and influence can legitimately order unwilling citizens to become parties to homicide and suicide, and punish them if they refuse.

The case is currently set for a hearing in mid-June.

Contact:
Sean Murphy, Administrator
Protection of Conscience Project
protection@consciencelaws.org


Notes

  1.  Minister of Justice Jody Wilson-Raybould, House of Commons Debates, Vol. 148, No. 055, 1st Session, 42nd Parliament, 13 May, 2016, p. 3312 (10:55)

Project asks Canadian MPs, Senators to stop coercion in homicide, suicide

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Protection of Conscience Project

“If it is ‘unacceptable’ for Members of Parliament to use physical force against each other, surely it is “unacceptable” for state institutions or others to use the force of law to compel people to be parties to inflicting death upon others, and to punish those who refuse.”

That is the message over 400 Canadian Members of Parliament and Senators returning to Ottawa will find on their desks in a letter from the Protection of Conscience Project.  The letters began to arrive Friday morning and should be waiting for MPs and Senators returning to Parliament to resume sitting on Monday.

The Project is proposing an amendment to the government’s Bill C-14, which is intended to allow medical and nurse practitioners to provide euthanasia and assisted suicide in accordance with the ruling of the Supreme Court of Canada in Carter v. Canada (Attorney General).

“Writing directly to individual legislators is a very unusual step,” said Sean Murphy, Administrator of the Protection of Conscience Project.  The letter was sent because of the gravity of the issue, and because the Project’s submission on Bill C-14 – like many others – was not distributed to members of the Standing Committee on Justice and Human Rights before it concluded its deliberations on the bill.

“Ironically, perhaps,” states the letter, “what the Protection of Conscience proposes is not a protection of conscience amendment.”

“Instead, the amendment is limited to the criminal law, which is strictly and fully within the jurisdiction of the Parliament of Canada.”

In making the argument that the criminal law should prohibit coerced participation in homicide and suicide, the letter refers to the conduct of Prime Minister Justin Trudeau the House of Commons on 18 May, which caused an uproar in the House and delayed debate on Bill C-14.

“The delay caused by the Prime Minister has made it possible to make this one last effort to reach legislators,” said Murphy, “and his conduct has enabled the Project to make its point in a very practical way.”

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Contact:
Sean Murphy, Administrator
protection@consciencelaws.org

Project proposes amendment to Canadian euthanasia/assisted suicide bill to stop coercion, intimidation

Amendment to Bill C-14 to prevent coerced participation in inflicting death

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Protection of Conscience Project

The Protection of Conscience Project has proposed an amendment to Bill C-14 to prevent coercion, intimidation or other forms of pressure intended to force citizens to become parties to homicide or suicide.  The amendment is set out in a submission to the Standing Committee on Justice and Human Rights.

Bill C-14 is the bill proposed by Canada’s Liberal government to implement the 2015 decision of the Supreme Court of Canada in Carter v. Canada (Attorney General. It will legalize assisted suicide and euthanasia administered by medical an nurse practitioners.  However, the Bill as introduced does nothing to prevent intimidation and coercion of objecting health care workers to force them to participate in or facilitate the procedures by referral or similar means.

The Project’s proposed amendment is an addition that does not otherwise change the text of  Bill C-14. Nor does it touch the eligibility criteria proposed by Carter, nor the criteria or procedural safeguards recommended by the Special Joint Committee or Provincial-Territorial Expert Advisory Group.  It simply establishes that, as a matter of law and Canadian public policy, no one can be compelled to become a party to homicide or suicide, or punished or disadvantaged for refusing to do so.

The Protection of Conscience Project does not take a position on the acceptability of euthanasia or physician assisted suicide or the merits of legalization of the procedures. The Project’s concern is to ensure that health care workers who object to providing or participating in homicide and suicide for reasons of conscience or religion are not compelled to do so or punished or disadvantaged for refusal.

“Coercion, intimidation or other forms of pressure intended to force citizens to become parties to homicide or suicide is both an egregious violation of fundamental freedoms and a serious threat to society that justifies the use of criminal law,” states the submission.

“Other countries have demonstrated that it is possible to provide euthanasia and physician assisted suicide without suppressing fundamental freedoms.  None of them require ‘effective referral,’ physician-initiated ‘direct transfer’ or otherwise conscript objecting physicians into euthanasia/assisted suicide service.”

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Contact:
Sean Murphy, Administrator
Protection of Conscience Project
Email: protection@consciencelaws.org

Conscientious refusal to kill deserves the protection of law. Bill C-14 doesn’t provide it.

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Protection of Conscience Project

In light of the assisted suicide/euthanasia bill introduced by the government of Canada (Bill C-14),1 it is necessary to emphatically reaffirm that conscientious refusal to kill people is a manifestation of essential humanity that deserves the protection of law.

Notwithstanding the assurances of Canada’s Minister of Health,2 Bill C-14 does not provide that protection. The government is deliberately ignoring the ongoing coercion of health care providers to compel participation in euthanasia, and Bill C-14 will allow coercion to continue.

The bill follows upon a report from a parliamentary Special Joint Committee formed to advise the government on a legislative response to the Supreme Court ruling in Carter v. Canada.3 Bill C-14 does not incorporate the Committee’s more radical recommendations. It does not, for example, make euthanasia and assisted suicide available as therapies for mental illness.4

However, it does indicate that the government intends to pursue this and other Committee recommendations.5 Two of them assert the authority of the state to command the use of deadly force: not merely to authorize it, but to command it.

The Special Joint Committee recommended that physicians unwilling to kill patients or help them commit suicide should be forced to find someone willing to do so. It also recommended that publicly funded facilities, like hospices and hospitals, should be forced to kill patients or help them commit suicide, even if groups operating the facilities object.6

The federal government cannot do this because the regulation of health professions and health care institutions is within provincial jurisdiction. Hence, the Committee urged the federal government to “work with the provinces” to implement this coercive regime.6 Translation: get willing hands in the provinces to do the dirty work of coercion – and take the heat for it.

Now, the federal government can prevent such coercion because it has exclusive jurisdiction in criminal law. It can enact a law to prevent powerful groups, professions, or state institutions from forcing people to be parties to homicide and suicide. It can prevent those in power from punishing health care providers who refuse to arrange for their patients to be killed or helped commit suicide.

The federal government can do this, but Bill C-14 does not do it. Instead, it makes possible the coercive regime recommended by the Special Joint Committee.

And this is deliberate, because the Prime Minister and Minister of Health know full well that coercion and intimidation to force participation in euthanasia and assisted suicide are already occurring in Canada, notably in Quebec7,8,9,10 and Ontario.11 ,Their bill “works with” willing hands in Ontario and Quebec by allowing coercion and intimidation to continue – and to spread.

It is true that the bill’s preamble states that the government will “respect the personal convictions of health care providers.”

But – aside from the fact that preambles have no legal effect12 – what is that worth?

After all, the Special Joint Committee claimed that respect for freedom of conscience is exemplified by their recommendation that, “at a minimum,” objecting physicians should be forced to find colleagues willing to kill their patients.6 Behind this Orwellian perversion lies the Committee’s more astonishing premise: that the state can legitimately order people to become parties to homicide and suicide, and punish them if they refuse.

That is outrageous, indefensible and dangerous. It is not a mere “limitation” of fundamental freedoms, but an egregious attack on them. It is a grave violation of human dignity that deserves only the utter contempt of a free people.

The Prime Minister and a great many people in positions of power and influence need to be reminded of this as we approach the deadline for the proclamation of Bill C-14: the anniversary of the Allied landings at Normandy.

Whatever else it might decide about euthanasia and assisted suicide, parliament should make it the law of the land that no one and no institution in Canada can be forced to be a party to homicide or suicide, and no one will be punished or disadvantaged for refusing to do so.”13

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Contact:
S.T. Murphy, Administrator
protection@consciencelaws.org


Notes
1. Bill C-14, An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying) (Accessed 2016-04-20) (Hereinafter “Bill C-14”).

2. “’Under this bill, no health care provider will be required to provide medical assistance in dying,’” Health Minister Jane Philpott told reporters Thursday. Laucius, J. “Groups worry new assisted-dying legislation doesn’t protect physicians’ consciences.” Ottawa Citizen, 14 April, 2016 (Accessed 2016-04-14) Emphasis added.  The statement does not mean that health care providers cannot be forced to become parties to homicide or suicide.

3. Carter v. Canada (Attorney General), 2015 SCC 5 (Accessed 2015-06-27)

4. Medical Assistance in Dying: A Patient-Centred Approach. Report of the Special Joint Committee on Physician Assisted Dying (February, 2016) (Hereinafter “SJC Report”) p. 13-14; Recommendations 3,4, p. 45. (Accessed 2016-03-09).

5. Bill C-14, Preamble, final paragraph.

6. SJC Report, Recommendations 10-11, p. 36.

7. Supreme Court of Canada, 385591, Lee Carter, et al. v. Attorney General of Canada, et al. (British Columbia) (Civil) (By Leave): Robert W. Staley (Counsel for the Catholic Civil Rights League, Faith and Freedom Alliance, and Protection of Conscience Project) Oral Submission, [455:48/491:20].

8. Canadian Press, “Gaétan Barrette insists dying patients must get help to ease suffering.” CBC News, 2 September, 2016 (Accessed 2016-04-20).

9. Robert Y. “L’objection de conscience.” Collège des médecins du Québec, 10 November, 2015. (Accessed 2016-04-20).

10. The Canadian Press, “Justin Trudeau, Philippe Couillard hail era of co-operation after meeting in Quebec City: Prime Minister praises Quebec’s approach on controversial topic of medically-assisted deaths.” CBC News, 11 December, 2015 (Accessed 2016-04-15).

11. College of Physicians and Surgeons of Ontario, Interim Guidance on Physician Assisted Death (January, 2016) (Accessed 2016-04-15).

12. University of Alberta, Centre for Constitutional Studies, The Constitution: Preamble (Accessed 2016-04-15).

13. Submission of the Protection of Conscience Project to the Special Joint Committee on Physician Assisted Dying (31 January, 2016)

Canadian parliamentary committee recommends mandatory participation in euthanasia, assisted suicide

Federal committee wants provincial governments to address most contentious issue

News Release

Protection of Conscience Project

A special joint committee of the Canadian House of Commons and Senate has produced a first report concerning legalization of euthanasia and physician assisted suicide.

The report recommends that physicians who, for reasons of conscience, are unwilling to kill patients or help them to commit suicide  should be compelled to find someone willing to do so.  It also recommends that all publicly funded facilities – not excluding objecting denominational institutions – be compelled
to provide euthanasia and assisted suicide.  This goes beyond recommendations made by others to the effect that objecting institutions should at least allow an external provider to perform the procedures on their premises.  It also ignores the advice of the Canadian Medical Association, which told the Committee that euthanasia and assisted suicide could be provided without suppressing freedom of conscience by forcing objecting physicians to refer for the procedures.

The main report is followed by a dissenting report signed by four Conservative (C) Members of Parliament.  With respect to freedom of conscience, the dissenting report erroneously states, “Quebec physicians are free to act according to their conscience,” and recommends Quebec legislation that is purported to accommodate freedom of conscience and religion.  The Quebec model has been rejected by many objecting physicians because it requires them to become parties to homicide by referring a patient to an administrator, who will arrange for euthanasia.

A supplementary opinion filed by two New Democrat (NDP) Members of Parliament states that legislation “must ensure that every eligible patient’s right to access medical aid in dying is upheld, and protect any healthcare professional who objects for reasons of conscience from disciplinary action.”  However, the authors of the supplementary opinion do not dissent from the main report, so they must mean that objecting physicians should be disciplined if they refuse to arrange for someone to kill patients or help them commit suicide.

In Canada, the federal government has no jurisdiction over the regulation of medical practice or the operation of hospitals.  In effect, then, the committee wants the federal government to pressure provincial governments to force unwilling physicians, health care workers and institutions to become parties to homicide and suicide.  This is arguably more contentious than the legalization of assisted suicide and euthanasia, so it is politically advantageous for the federal government to pass this particular buck to the provinces.

The federal government has full jurisdiction to prevent people from being forced to become parties to homicide and suicide, and this was recommended to the Committee by the Protection of Conscience Project and others.  Instead, the Committee has taken the opposite tack, insisting that the state should impose and enforce an obligation to kill, even upon those who believe that killing people or helping them to commit suicide is gravely wrong.

Contact:

Sean Murphy, Administrator (protection@consciencelaws.org)