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Coalition for HealthCARE and Conscience

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Ontario physicians oppose referrals for assisted suicide, seek judicial review of CPSO requirement

News Release

Coalition for HealthCARE and Conscience

TORONTO, ONT. (June 20, 2016) – The Coalition for HealthCARE and Conscience, representing more than 5,000 physicians and 100 healthcare facilities across Canada, is heartened that federal legislation for assisted suicide specifically states that no one should be compelled to participate in euthanasia.

However, the coalition is deeply troubled that this directive in Bill C-14 is already being ignored and that doctors who oppose assisted suicide over conscience concerns will be required to help take the lives of patients — at least in Ontario.

The College of Physicians and Surgeons of Ontario (CSPO) demands that doctors who conscientiously object to assisted suicide refer patients seeking to end their lives to other physicians who will provide the procedure.

No other foreign jurisdiction that has legalized assisted suicide requires doctors to perform or refer for this procedure. Other provinces have already implemented guidelines to protect doctors who object to providing or referring for assisted suicide.

“The current approach of the CPSO demands that doctors set aside their morals and go against their conscience to directly refer for assisted suicide,” said Larry Worthen, Coalition member and Executive Director of the Christian Medical and Dental Society of Canada. “In our view, effective referral and participating in assisted suicide are morally and ethically the same thing.”

To ensure that conscience rights are respected for Ontario doctors, three physician groups in the Coalition are seeking an expedited judicial review asking the court to determine whether the approach by the CPSO is unconstitutional.

Members of the Coalition fully support the right people clearly have to refuse or discontinue the use of life-sustaining treatment and to allow death to occur.  However, they also hold strong moral convictions that it is never justified for a physician to help take a patient’s life, under any circumstances.

“By requiring effective referral, the CPSO is forcing people of conscience and faith to act against their moral convictions. This threatens the very core of why they became physicians, which is to help to heal people. This is discrimination. It is unnecessary,” Worthen said.

The Coalition is calling on the College to make accommodations that would allow people who have conscientious objection to assisted suicide to continue to practice medicine.

Protecting conscience rights of health practitioners would require only minor accommodations, such as allowing patients direct access to an assessment or allowing complete transfer of care to another physician.

“There are ways to respect patients’ wishes while protecting conscience rights,” Worthen said. “Not to do so is discrimination against people for their morals and convictions, which are protected in the Canadian Charter of Rights and Freedoms.”

A strong majority of Canadians are on side with the coalition’s beliefs on conscience protection. A recent Nanos Research poll found that 75% of Canadians agreed that doctors “should be able to opt out of offering assisted dying,” compared with 21% who disagreed.

The coalition continues to urge Canadians with concerns about assisted suicide legislation to visit where they can communicate directly with their elected members of provincial or federal parliament.

The coalition represents several like-minded organizations committed to protecting conscience rights for health practitioners and institutions. Members of the coalition include the Catholic Archdiocese of Toronto, the Christian Medical and Dental Society of Canada, the Catholic Organization for Life and Family, the Canadian Federation of Catholic Physicians’ Societies, the Canadian Catholic Bioethics Institute, Canadian Physicians for Life, Evangelical Fellowship of Canada, Archdiocese of Vancouver, and the Catholic Health Alliance of Canada.

 About The Coalition for HealthCARE and Conscience:

The Coalition for HealthCARE and Conscience represents a group of like-minded organizations, including representing more than 110 healthcare facilities (with almost 18,000 care beds and 60,000 staff) and more than 5,000 physicians across Canada, that are committed to protecting conscience rights for faith-based health practitioners and facilities. We were brought together by a common mission to respect the sanctity of human life, to protect the vulnerable and to promote the ability of individuals and institutions to provide health care without having to compromise their moral convictions.

Submission to the College of Physicians and Surgeons of Ontario

Re: Professional Obligations and Human Rights

Evangelical Fellowship of Canada

The Evangelical Fellowship of Canada (EFC) welcomes this opportunity to participate in the dialogue about the College of Physician and Surgeons (CPSO) draft policy on “Professional Obligations and Human Rights.” The EFC is a national association of denominations, ministry organizations, post-secondary educational institutions including universities, seminaries and colleges, and local congregations. Some of our affiliates provide medical and health care in Canada and overseas, and many physicians are members of our affiliated denominations. The Christian Medical Dental Society (CMDS) is an affiliate of the EFC and we endorse the submission made by the CMDS and the Canadian Federation of Catholic Physician Societies (CFCPS) dated February 11, 2015.

The EFC is active in promoting the religious freedom of all persons. We agree that physicians ought to respect the rights and freedoms, and the diversity of all patients, and treat all with the same respect and dignity.

We also affirm the rights and freedoms of physicians and surgeons, including their freedom of conscience and religion. Our concern with the draft policy is that it requires doctors to provide an effective referral for services, and in some situations, undertake procedures that violate the conscience and/or religious beliefs of some doctors.

The freedoms of patients and of doctors are protected under the Charter of Rights and Freedoms (Charter).The CPSO is bound by the Charter and must not enforce policies that violate the rights or freedoms of either its members or their patients. It must make every effort to ensure that a system is in place to ensure that a physician is not compelled to participate in undertaking procedures or prescribing pharmaceuticals that violate their freedom of conscience and religion.

As noted in the brief of the CMDS and the CFCPS, there is no right for a patient to demand and receive a particular service from a specific physician. It is the health care system that is obligated, not the individual physician, and the system established for the delivery of services must respect the diversity and plurality of both those who access the system and those who provide the services. The onus is on the health care system, and in this case the CPSO, to devise policies that respect and accommodate the Charter rights and freedoms of both the patients and the physicians. We are concerned that under the proposed policy the burden is being placed on the individual physician when it is the CSPO which is bound by the Charter and has a duty to accommodate the Charter rights of both patients and the physicians. The CPSO policy must balance the rights of all involved and ensure the rights and freedoms of all are respected and accommodated.

The draft policy refers to the Ontario Human Rights Code (Code) which sets out the rights of Ontario residents to receive treatment without discrimination. However, the
Code does not compel a service provider to provide all services demanded by a client or customer. If a service is not offered, whether it be a particular food in a restaurant or a certain type of repair by a mechanic, there is no discrimination as long as all customers are treated the same. Human rights codes are intended to protect people seeking a service from being denied that service if it is otherwise offered to others. A physician refusing to undertake a certain procedure which violates his or her conscience or religious beliefs does not constitute discrimination toward the patient seeking a treatment the physician does not offer.

Further, providing an effective referral involves more than providing information about clinical options. Providing a referral means the doctor is convinced that in their judgment the best interest of the patient is served by a particular course of medical treatment or procedure. By providing the referral, the doctor is taking direct action and is, in effect, prescribing a course of action or treatment for a patient. Some doctors believe that providing an effective referral is morally the same as providing the course of action or treatment itself. To compel them to do so, then, is a violation of their rights and freedoms.

All doctors, including those with deep religious convictions, desire to serve their patients in an open and non-discriminatory manner. In a religiously, ethnically, culturally and morally plural society, the duty to accommodate extends to all, both to the patient and the physician.

One of the key values identified in the draft policy is trustworthiness. Compelling a physician to undertake a procedure or to refer a patient for a procedure that they do not believe is in the best interest of their patient, and which may harm their patient, undermines this value. Forcing a physician to violate their conscience undermines the moral integrity of the physician and the honest, respectful and open relationship that should exist between the patient and physician.

We urge the CPSO to revise the draft policy to ensure the Charter rights and freedoms
of all impacted by the policy are affirmed and respected.

‘Frightening’: Life and family leaders react to Ontario College of Physicians’ draft policy

LifeSite News

Pete Balinski

Numerous life-and-family groups have slammed a draft policy from Ontario’s College of Physicians and Surgeons that threatens to force doctors into providing abortions and contraceptives in some circumstances, calling it “inimical to living in a free society” and “frightening.”

“We can say goodbye to a slew of good doctors in Ontario [if the policy passes],” Andrea Mrozek, executive director of Institute of Marriage and Family Canada, told LifeSiteNews. “If I were one, with a young family, I’d leave. Who wants to live under the threat of constant legal action for doing what you believe is good care?”

The College Council approved the draft policy last week. The policy would force doctors who are “unwilling to provide certain elements of care due to their moral or religious beliefs” — such as abortion — to refer the patient “in good faith” to another doctor who would provide the service.

If there is nobody to whom the patient can be referred, then the doctor “must provide care that is urgent or otherwise necessary to prevent imminent harm, suffering, and/or deterioration, even where that care conflicts with their religious or moral beliefs.”

“Although physicians have [freedom of conscience and religion] under the Charter, the Supreme Court of Canada has determined that no rights are absolute,” the draft policy states, adding that the “right to freedom of conscience and religion can be limited.”

The College’s former president, Marc Gabel, has stated that doctors who fail to comply will face disciplinary action. . . [Full text]

Submission to the College of Physicians and Surgeons of Ontario

Evangelical Fellowship of Canada

Re: CPSO Policy #5-08: Physicians and the Human Rights Code

The Evangelical Fellowship of Canada (EFC) appreciates the ability to offer comments on this policy review. The EFC is a national association of denominations, ministry organizations, post-secondary educational institutions including seminaries, colleges and universities, and local churches. Some of our affiliates provide medical and health care in Canada and overseas, and many physicians are members of our affiliated denominations.

Having reviewed to policy, we note that while there is a strong emphasis on the duty not to discriminate in the provision of services, there is a lack of emphasis on the religious freedom and freedom of conscience guarantees and protections offered in Canadian law to individuals and, in this context, physicians.

We endorse the analysis and commentary in the written submission and covering letter of the Christian Medical Dental Society (CMDS) and the Canadian Federation of Catholic Physician Societies. The CMDS is an EFC affiliate, and we commend these documents to you.

Christianity has a long history of fostering and promoting medical care. It was and continues to be a distinctive of the Christian tradition, as documented by Gary Ferngren in his book Medicine and Health Care in Early Christianity (Johns Hopkins, 2009). Integrity of belief and practice is a core element of the Christian faith and respect for religious freedom is critical to the ability of individuals and groups to live out their faith in an integral way before God and in the service of others.

Evangelical Fellowship of Canada


Christians and civil disobedience

Evangelical Fellowship of Canada

Background Paper

John H. Redekop*


A basic requirement for the functioning of civil society, especially in a democracy, is that citizens, generally speaking, should obey the laws of the land.  Christians and most, if not all, other religious groups accept that principle as an over-arching reality.  The logic is compelling. If citizens, in substantial numbers, would take the law into their own hands and individually decide which laws to obey and which to disobey, then anarchy might result rather quickly.  The theory is clear and essentially true but the practical situation is sometimes more complicated.

What is to be done by responsible and highly moral citizens if certain laws are inherently evil?  What should citizens do if the government of the day pressures them to violate their conscience on a fundamental principle?  What should they do if their government suddenly denies them the most basic of freedoms?  We know from history as well as from the present global situation that Christians often encounter laws which are unjust and simply wrong.  The Christian response is clear. . . [Read on]

Pharmacy colleges quash conscientious objection


Greg J. Edwards

Pharmacists are critically thinking individuals who integrate their values into their work life-and they are not mere robots who are glorified order-takers for physicians. We should be promoting such thinking, not punishing it.–Nancy Metcalfe, pharmacist

Pharmacists are said to be the most trusted professionals in medicine; they’re conscientious; we rely on their discretion and their judgment; they have our confidence; we respect them; but do pharmacists respect themselves, let alone one another?

It’s a good question, because in Canada, pharmacists, unlike doctors, find that conscientious objection is a bitter pill for their professional licensing organizations to swallow.

The pharmacists’ governors pay lip service to a pharmacist’s right to refuse to dispense products, but, in fact, a customer’s convenience trumps a pharmacist’s freedoms of conscience and religion: pharmacists are free to object but in the end they must refer or otherwise help customers get the objectionable product. [Full text]