Nova Scotia: make a call for conscience


Nova Scotia Call for Conscience 2018

Coalition for HealthCARE and Conscience

Over recent months, it has become increasingly clear that the conscience rights of Nova Scotia doctors are not being adequately protected.

A leading Nova Scotia medical regulator recently told doctors they must participate in euthanasia by making an “effective referral” even if this would require them to violate their conscience. It was made clear that the penalty for refusing to comply could be discipline for “unprofessional conduct”. Performing or referring for assisted suicide and euthanasia involve killing a patient. This is directly opposed to the teachings of many faiths and the traditional Hippocratic oath. Most health care professionals embarked on their careers to heal people, not kill them. No Nova Scotian should be required to be involved against their will.

Other provinces have found ways to provide access without forcing people to act against their moral convictions.

We need to let the Minister of Health of Nova Scotia know that we need legislation to protect conscience rights in our province. In November, Manitoba legislators passed a Bill which said that Manitoba health care professionals could not be compelled to participate in assisted suicide. We need a similar bill here in Nova Scotia. Please write the Minister of Health using the form below. The letter will automatically be sent to the Premier and the leaders of the opposition parties. Conscience rights are an all party issue. We need our legislators to show their support for Nova Scotia health care professionals.

Take action here. Write to the Government of Nova Scotia.

Answering Physicians Top 5 Legal Questions

In 2017, the medical students’ forum hosted by Canadian Physicians for Life included a question and answer session about legal issues. Albertos Polizogopoulos is lead counsel in the constitutional challenge to the College of Physicians and Surgeons of Ontario (CPSO) policy that demands effective referral for all morally contested services, including euthanasia and assisted suicide.  Phil Horgan, a Toronto lawyer, is President of the Catholic Civil Rights League, which jointly intervened in the case with the Faith and Freedom Alliance and Protection of Conscience Project.  Questions have been listed below with the corresponding time segments.  Links have been provided to background material concerning subjects covered in the answers.

1. How can physicians best disclose to their patients their conscientious objections?  (00:00-11:18)

2. What happens when a patient reports a physician to their college for exercising their right to conscientious objection?  (11:18-20:00)

3. How can conscience and religious rights be exercised, practically speaking?  (20:00-23:33)

4. Is there a sense that other provinces are just waiting to see what is going to happen with these current cases going on in Ontario? (23:33-34:35)

5. Can you comment on institutions?  Do they have rights themselves?   (34:45-40:15)

Obliged to Kill

The Assault on Medical Conscience

The Weekly Standard
Reproduced with permission

Wesley J. Smith*

A court in Ontario, Canada, has ruled that a patient’s desire to be euthanized trumps a doctor’s conscientious objection. Doctors there now face the cruel choice between complicity in what they consider a grievous wrong – killing a sick or disabled patient – and the very real prospect of legal or professional sanction.

A little background: In 2015, the Supreme Court of Canada conjured a right to lethal-injection euthanasia for anyone with a medically diagnosable condition that causes irremediable suffering – as defined by the patient. No matter if palliative interventions could significantly reduce painful symptoms, if the patient would rather die, it’s the patient’s right to be killed. Parliament then kowtowed to the court and legalized euthanasia across Canada. Since each province administers the country’s socialized single-payer health-care system within its bounds, each provincial parliament also passed laws to accommodate euthanasia’s legalization.

Not surprisingly, that raised the thorny question of what is often called “medical conscience,” most acutely for Christian doctors as well as those who take seriously the Hippocratic oath, which prohibits doctors from participating in a patient’s suicide. These conscientious objectors demanded the right not to kill patients or to be obliged to “refer” patients to a doctor who will. Most provinces accommodated dissenting doctors by creating lists of practitioners willing to participate in what is euphemistically termed MAID (medical assistance in dying).

But Ontario refused that accommodation. Instead, its euthanasia law requires physicians asked by a legally qualified patient either to do the deed personally or make an “effective referral” to a “non-objecting available and accessible physician, nurse practitioner, or agency .  .  . in a timely manner.”

A group of physicians sued to be exempted from the requirement, arguing rightly that the euthanize-or-refer requirement is a violation of their Charter-protected right (akin to a constitutional right) to “freedom of conscience and religion.”

Unfortunately, the reviewing court acknowledged that while forced referral does indeed “infringe the rights of religious freedom .  .  . guaranteed under the Charter,” this enumerated right must nonetheless take a back seat to the court-invented right of “equitable access to such medical services as are legally available in Ontario,” which the court deemed a “natural corollary of the right of each individual to life, liberty, and the security of the person.” Penumbras, meet emanations.

And if physicians don’t want to commit what they consider a cardinal sin, being complicit in a homicide? The court bluntly ruled: “It would appear that, for these [objecting] physicians, the principal, if not the only, means of addressing their concerns would be a change in the nature of their practice if they intend to continue practicing medicine in Ontario.” In other words, a Catholic oncologist with years of advanced training and experience should stop treating cancer patients and become a podiatrist. (An appeal is expected.)

This isn’t just about Canada. Powerful political and professional forces are pushing to impose the same policy here. The ACLU has repeatedly sued Catholic hospitals for refusing to violate the church’s moral teaching around issues such as abortion and sterilization. Prominent bioethicists have argued in the world’s most prestigious medical and bioethical professional journals that doctors have no right to refuse to provide lawful but morally contentious medical procedures unless they procure another doctor willing to do as requested. Indeed, the eminent doctor and ethicist Ezekiel Emanuel argued in a coauthored piece published by the New England Journal of Medicine that every physician is ethically required to participate in a patient’s legal medical request if the service is not controversial among the professional establishment—explicitly including abortion. If doctors don’t like it? Ezekiel was as blunt as the Canadian court:

Health care professionals who are unwilling to accept these limits have two choices: select an area of medicine, such as radiology, that will not put them in situations that conflict with their personal morality or, if there is no such area, leave the profession.

For now, federal law generally supports medical conscience by prohibiting medical employers from discriminating against professionals who refuse to participate in abortion and other controversial medical services. But the law requires administrative enforcement in disputes rather than permitting an individual cause of action in civil court. That has been a problem in recent years. The Obama administration, clearly hostile to the free exercise of religion in the context of health care, was not viewed by pro-life and orthodox Christian doctors as a reliable or enthusiastic upholder of medical conscience.

The Trump administration has been changing course to actively support medical conscience. The Department of Health and Human Services recently announced the formation of a new Conscience and Religious Freedom Division in the HHS Office for Civil Rights, which would shift emphasis toward rigorous defense of medical conscience rights.

Critics have objected belligerently. The New York Times editorialized that the new emphasis could lead to “grim consequences” for patients—including, ludicrously, the denial by religious doctors of “breast exams or pap smears.”

The American College of Obstetricians and Gynecologists joined the Physicians for Reproductive Health to decry the creation of the new office – which, remember, is merely dedicated to improving the enforcement of existing law – warning darkly that the proposal “could embolden some providers and institutions to discriminate against patients based on the patient’s health care decisions.”

The Massachusetts Medical Society joined the fearmongering chorus, opining that the new office could allow doctors to shirk their “responsibility to heal the sick.” Not to be outdone in the paranoia department, People for the American Way worried the new office might mean that “other staff like translators also refuse to serve patients, which could heighten disparities in health care for non-English-speaking patients.”

The Ontario court ruling is a harbinger of our public policy future. Judging by the apocalyptic reaction against the formation of the Conscience and Religious Freedom Division, powerful domestic social and political forces want to do here what the Ontario court ruling – if it sticks on appeal – could do in that province: drive pro-life, orthodox Christian, and other conscience-driven doctors, nurses, and medical professionals from their current positions in our health-care system.

Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism and a consultant to the Patients Rights Council.

Physicians seek leave to appeal Ontario court ruling against physician freedom of conscience


Physicians and physician associations are seeking leave to appeal a decision of the Ontario Divisional Court to the effect that physicians must collaborate in providing procedures and services to which they object for reasons of conscience, even if that means collaborating in euthanasia and assisted suicide.  The appeal will be costly.  Faye Sonier, Chief Executive Office of one of the associations that brought the challenge, has issued a plea for donations to support the appeal by Canadian Physicians for Life, the Christian Medical and Dental Society, and the Canadian Federation of Catholic Physicians’ Societies.

Plea for donations to support the appeal of the Ontario Divisional Court decision

The time has come to further our fight to defend the conscience rights of doctors in Ontario. I’m asking you to support our efforts in this fight by making a donation today

As you know, the College of Physicians and Surgeons of Ontario (CPSO) decision was released on January 31. The court found the religious freedom rights of Ontario doctors are significantly violated by the CPSO’s policies, but that those violations can be justified to ensure patient access to healthcare. 

After lengthy consultation with the parties involved in our legal coalition and with over a dozen constitutional lawyers, we’ve decided to request permission from the Ontario Court of Appeal to appeal the decision.

We are pursuing an appeal as the decision was troubling and problematic on many fronts. We have numerous grounds of appeal from which to choose and we will narrow our focus in the coming days.

This is an important step in a process:

  • to ensure that policies that serve only to restrict the constitutional freedoms of physicians do not go unchallenged;
  • to dissuade other provinces from acting similarly;
  • and to communicate that patient access to healthcare is not hindered by maintaining the respect for conscientious objectors in the medical field.

The three physician groups involved in this legal fight, Canadian Physicians for Life, the Christian Medical and Dental Society, and the Canadian Federation of Catholic Physicians’ Societies, are joining together to raise the $125,000 needed for this next step of litigation.

We’re coming to you to ask for your financial support.

Much of the legal costs will be accrued up front as we must conduct research and prepare our written arguments to file the legal documents requesting the opportunity to appeal.  One-time donations made here will directly support this legal fight.

Physicians for Life is a registered charity and issues tax receipts.


Faye Sonier
Executive Director & General Legal Counsel

P.S. Thank you so much for enabling CPL to continue this battle to defend conscience rights by making your donation today. This case is urgent, and we need funds as soon as possible to ensure that our legal counsel can be in the best position possible to further this fight.