Critics call bill aimed to protect health workers unwilling to offer assisted death ‘one-sided’

CBC: The Current

Interviewer/host: Piya Chattopadhyay

SOUNDCLIP

VOICE 1: Bill 34 is being introduced by the Manitoba government to protect conscience rights for health care professionals, so that health care providers would not be required to participate in assisted suicide.

VOICE 2: While I cannot participate in assisted suicide for a couple of reasons. The first is I made a vow as a medical student 40 years ago that I wouldn’t kill patients, okay? And I’m not willing to cross that line.

PC: It has been less than 18 months now since medically assisted dying became legal in Canada. And health care workers are still adapting to that paradigm change. We just heard part of a video produced by the Coalition for Health Care and Conscience. It’s a national umbrella organization of religious groups, and as you heard it is lobbying for Bill 34 a proposed piece of legislation in Manitoba that was drafted to help health care workers with conscientious objections to helping end patients’ lives. Here’s Manitoba’s health minister Kelvin Goertzen. . . [Full episode transcript]

 

 

Waiting to die: Winnipeg man says faith-based hospital delayed access to assisted death

Timeline of events provided to CBC suggests Misericordia Health Centre delayed transfer of medical records

CBC News

Holly Caruk, Bruce Hoye

An 88-year-old Winnipeg man wants to end his life after being confined to a bed for several months with no chance of recovering and says the faith-based hospital where he now lives is delaying that request.

Cheppudira Gopalkrishna says the Misericordia Health Centre did not help him with his initial request to access the province’s Medical Assistance in Dying (MAID) services, and has since delayed the process further by taking too long to transfer his medical records and delaying an in-person assessment by the MAID team.

“I wouldn’t say [my request was ignored, but it wasn’t placed in the highest priority,” he said from his hospital bed.

The former school teacher has been at the Misericordia for several months, after his health declined significantly over the last year and a half. Gopalkrishna says he’s been told by doctors he has a form of Lou Gehrig’s disease, also known as ALS, and has lost almost all of his mobility.

Misericordia describes itself on its website as being affiliated with the Roman Catholic Archdiocese of Winnipeg. . . .[Full text]

 

Health minister defends hospital’s right not to allow medically assisted deaths

Winnipeg Sun

Joyanne Pursaga

Manitoba’s health minister stepped up to defend a Winnipeg hospital Tuesday, over its hotly criticized reversal on providing medically assisted deaths.

Minister Kelvin Goertzen said the province won’t oppose St. Boniface Hospital’s faith-based decision not to allow medical assistance in dying (MAID), even after saying it would in some cases.

“We think that we’ve struck the right balance by ensuring that there is access to MAID but also ensuring that those individual rights and those hospitals that are uncomfortable with the procedure can also have their rights respected as well,” said Goertzen.

On May 29, St. Boniface Hospital voted to allow medically assisted deaths under undefined “special circumstances.” But the hospital’s owner, the Catholic Health Corporation of Manitoba (CHCM), then appointed 10 new board members to cast a June 12 vote that completely banned assisted deaths once again, meaning patients who want them will still have to be transferred. . . [Full text]

 

Critics decry St. Boniface Hospital for banning medical-assisted deaths

‘They’re not taking into account people’s end-of-life comfort,’ says ethics professor Arthur Schafer

CBC News
St. Boniface General Hospital’s decision to forbid medical-assisted deaths is drawing condemnation from end-of-life care advocates and an expert on medical ethics.

Arthur Schafer, a founder of the University of Manitoba’s Centre for Professional and Applied Ethics, described the recent board decision to ban medical-assisted deaths as “fundamentally wrong.” . . . [Full text]

 

Faith-based hospitals in Winnipeg ban medically assisted deaths

St. Boniface General Hospital and Concordia Hospital conscientiously object to legal practice

CBC News

Laura Glowacki

Two faith-based hospitals in Winnipeg say they will not be providing doctor-assisted deaths to their patients.

Both Concordia Hospital (Anabaptist-Mennonite) and St. Boniface Hospital (Catholic) say they will not offer the legal service to patients.

In June, the federal government amended the criminal code with Bill C-14 to allow doctors and nurse practitioners to help patients with “grievous and irremediable” illnesses to die. Manitoba introduced its own policy to implement medical assistance in dying, commonly called MAID, that same month. . . [Full text]

Christian doctors’ group calls referring patients for assisted death ‘morally the same’

Christian Medical and Dental Society prefers ‘total transfer of care’ to other doctors in such cases

CBC News

The head of the Christian doctors’ group that met recently with Manitoba’s health minister says doctors with religious or moral objections to physician-assisted dying should not be forced to issue referrals to patients but instead allow patients to switch doctors altogether.

The Christian Medical and Dental Society met with Health Minister Kelvin Goertzen on July 11 to lobby for conscience protection for doctors who object to physician-assisted death.

The group is also asking Ontario’s top court to reverse a provincial government policy requiring physicians to refer patients who want an assisted death to another doctor. . . [Full text]

A “uniquely Canadian approach” to freedom of conscience

Provincial-Territorial Experts recommend coercion to ensure delivery of euthanasia and assisted suicide

Recommendations designed to broaden and maximize impact of Supreme Court ruling

Sean Murphy*

Abstract

The Experts’ recommendations are intended to extend and maximize the impact of the Carter ruling. They will effectively require all institutions, facilities, associations, organizations and individuals providing either health care or residential living for elderly, handicapped or disabled persons to become enablers of euthanasia and assisted suicide. This will entail suppression or significant restriction of fundamental freedoms.

The broader the criteria for the provision of morally contested procedures, and the more people and groups captured in the Experts’ enablers’ net, the greater the likelihood of conflicts of conscience.  Relevant here are recommendations to make euthanasia/assisted suicide available to mentally ill and incompetent persons, and to children and adolescents, even without the knowledge of their parents.

The Experts’ distinction between “faith-based” and “non-faith-based” facilities is meaningless. They impose identical obligations on both. All will be forced to allow homicide and suicide on their premises, or compelled to arrange for euthanasia or assisted suicide elsewhere.
Likewise, they recommend that objecting physicians be forced to actively enable homicide or suicide by providing referrals, arranging direct transfers or enlisting or arranging the enlistment of patients in a euthanasia/assisted suicide delivery system.

The Supreme Court did not rule that people ought to be compelled to become parties to homicide and suicide, but that is what the Experts recommend. This is not a reasonable limitation of fundamental freedoms, but a reprehensible attack on them and a serious violation of human dignity.

Other countries make euthanasia and assisted suicide available without attacking fundamental freedoms. In this respect, the Experts’ claim to have produced “a uniquely Canadian approach to this important issue” is regrettably accurate. They fail to provide any evidence that the suppression of freedom of fundamental freedoms they propose can be demonstrably justified in a free and democratic society.


Table of Contents

I.    Background

I.1    Formation and work of the Advisory Group

II.    Overview of the Final Report

II.1    Moral/ethical unanimity
II.2    “Statement of Principles and Values”
II.3    Recommendations broadening the Carter criteria
II.4    Recommendations impacting freedom of conscience and religion

III.    The Experts’ “uniquely Canadian approach”

III.1     Expanded criteria and increasing likelihood of conflict

III.1.1    “Irremediable medical condition”.
III.1.3     Euthanasia approved for future suffering.
III.1.7     No waiting/reflection period.
III.1.10     Adolescents and children.
III.1.13     Euthanasia/assisted suicide by non-physicians.
III.1.15     Doctor shopping.
III.1.18     Physicians need not be present at suicides.
III.1.20     Euthanasia/assisted suicide wherever people live.
III.1.22     Families, caregivers may not be advised.

III.2    Institutions, associations, organizations

III.2.1     The meaning of institution.
III.2.3    All “institutions” must allow/arrange euthanasia/assisted suicide
III.2.6     All “institutions” must disclose policies.
III.2.8     “Institutions” may not manifest or enforce commitments

III.3    Objecting physicians: information, disclosure, non-discrimination

III.3.3    Objecting physicians must provide information.
III.3.8    Objecting physicians must disclose views and their implications.
III.3.11    Objecting physicians must not illicitly discriminate.

III.4    Objecting physicians must become critical enablers

III.4.4    Referral or direct transfer of care.
III.4.5    Referral to “system/third party.”
III.4.8    The Experts’ proposal and the CMA’s proposal.

IV.    Project response

IV.1    Expert recommendations broadening Carter criteria
IV.2    Expert recommendations and fundamental freedoms in general
IV.3    Expert recommendations and freedom of conscience

V.    Conclusion


Appendix “A”  Supreme Court of Canada, Carter v. Canada (Attorney General), 2015 SCC 5

A1.    Carter criteria for euthanasia and physician assisted suicide
A2.    Carter and the criminal law
A3.    Carter and freedom of conscience and religion

Appendix “B”  Expert recommendations re: broadening Carter criteria

B1.     Expanding the Carter criteria

B1.1    “Grievous and irremediable medical condition” includes mental illness
B1.2    Suffering not a prerequisite
B1.3    Competence not a prerequisite: euthanasia for dementia
B1.4    Euthanasia and assisted suicide for children and adolescents
B1.5    Assessment, euthanasia and assisted suicide by non-physicians

B2.    Increasing the impact of Carter

B2.3    Doctor shopping
B2.4    No “waiting/reflection” period
B2.5    Physicians need not be present at suicides
B2.6    Euthanasia & assisted suicide in hospitals, hospices, etc.
B2.7    Families and caregivers may not be advised

Appendix “C”    Expert recommendations re: freedom of conscience and religion

C1.    Institutions

C1.1    Meaning of “institution”
C1.2    “Institutions” must allow or arrange for euthanasia or assisted suicide
C1.3    All “institutions” must disclose position on euthanasia and assisted suicide
C1.4    “Institutions” must not require patients/residents to give up “the right to access,” interfere with employees providing eutanasia or assisted suicide elsewhere

C2.    Objecting physicians/health care providers

C2.1    Must provide information on “all options”
C2.2    Must disclose views on euthanasia and assisted suicide
C2.3    Must not discriminate
C2.4    Must act as critical enablers

C2.4.1  Three alternatives
C2.4.2  Referral
C2.4.3  Direct transfer of care
C2.4.4  Transfer to “a publicly-funded system” or “third party”
C2.4.5  The Experts’ “system/third party” and the CMA’s “central service”

Appendix “D”    Canadian Medical Association on euthanasia and assisted suicide

D1.    CMA policy: Euthanasia and Assisted Death (2014)
D2.    CMA Annual General Council, 2015

D2.1    Surveys on support for euthanasia/assisted suicide
D2.2    Physician freedom of conscience

D3.    CMA rejects “effective referral”

Appendix “E”    International comparisons

E1.    Netherlands
E2.    Luxembourg
E3.    Belgium
E4.    Oregon
E5.    Washington
E6.    Vermont
E7.    California

Appendix “F”    An Act to Safeguard Against Homicide and Suicide

 

Should doctors have the right to refuse to prescribe birth control because of their religious beliefs?

CBC Radio

Day 6

Last week Joan Chand’oiseau was outraged to learn that the physician at her Calgary walk-in clinic refused to prescribe birth control because of her religious beliefs. Chand’oiseau’s story broke just after Canada’s largest medical regulator – The College of Physicians and Surgeons of Ontario – announced it would be revisiting its policies on physicians and the Human Rights Code.  We check in with Joan Chand’oiseau, and invite  Margaret Somerville, Director of the McGill Centre for Medicine, Ethics and Law, and Arthur Schafer, director of the Centre for Professional and Applied Ethics at the University of Manitoba, to debate whether doctors should have the right to refuse to treat a patient on religious or moral grounds.

Listen

 

Project letter to the Edmonton Sun

Edmonton, Alberta, Canada
25 April, 2000

Sean Murphy, Administrator
Protection of Conscience Project

Mindelle Jacobs cites Arthur Schafer, director of the Centre for Professional and Applied Ethics at the University of Manitoba, to the effect that conscientious objectors should be driven out of the medical profession if they are unwilling to provide “perfectly legal services” to patients who want the services but can’t go elsewhere to get them. According to Jacobs, Alberta Pharmaceutical Association registrar Greg Eberhart has similar views (Pharmacists want right of refusal, Edmonton Sun, 16 April, 2000).

Well, perhaps they wouldn’t drive them out of the profession. Perhaps they’d just drive them out of the province, or out of the country. Freedom of conscience, if you insist, but not in my back yard.

Now, Jacobs is surely convinced of the truth of the moral vision she shares with Schafer and Eberhart, and of its fundamental importance. After all, she wants to impose that morality by denying conscientious objectors employment, or firing them, or forcing them to go elsewhere to make a living. One wouldn’t do such things unless the morality to be imposed was at least superior to the morality being suppressed, and unless one was also convinced of the necessity of forcing it upon others.

Unfortunately, Jacobs does not explain why her morality is superior to that of pharmacists like Maria Bizecki and Concerned Pharmacists for Conscience. Instead, she indulges in a bit of speculative scare-mongering. If “Bizecki and her pals”have their way, she wonders, “Where will it stop?”

One might also ask where it will stop if conscientious objection is suppressed. A recent bulletin from the College of Pharmacists of British Columbia (Vol. 25, No. 2. Ethics in Practice: Moral Conflicts in Pharmacy Practice) suggests the answer. Driven by the primary ‘ethical criteria’ of legality and consumer demand, the CPBC would require pharmacists to dispense drugs not only for abortion, but for euthanasia, assisted suicide and execution by lethal injection. Canada Safeway, apparently taking its ethical direction from such missives, entered the millennium by asserting that it has the right to ensure employees with religious scruples “promptly serve its customers” and not direct them to competitors for euthanasia drugs and abortion pills (Pharmacy Policies and Procedures, Section IV, Pharmacy Operations, Chapter 4, 1/1/2000, Page No. 16).

Alberta M.L.A. Julius Yankowsky has put forward a bill seeking limited legal protection of conscience for health care workers. The bill does not take any position on the morality or desirability of abortion, assisted suicide, euthanasia or other controversial medical procedures. It simply recognizes that such procedures are morally controversial. It permits discussion and reasoned argument, but not discrimination or coercion.

Sadly, the reaction of Mindelle Jacobs, Arthur Schafer and Greg Eberhart to Mr. Yankowsky’s modest proposal demonstrates the need for such legislation.