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

News Release

For immediate release

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. 

 

 

Canadian court tells doctors they must refer for euthanasia

Will they be hounded out of their profession?

MercatornNet

Michael Cook

For years bioethicists of a utilitarian cast have argued that conscientious objection has no place in medicine. Now Canadian courts are beginning to put their stamp of approval on the extinction of doctors’ right to refuse to kill their patients.

The Superior Court of Justice Division Court of Ontario ruled this week that if doctors are unwilling to perform legal actions, they should find another job.

A group of five doctors and three professional organizations were contesting a policy issued by Ontario’s medical regulator, the College of Physicians and Surgeons of Ontario (CPSO), arguing it infringed their right to freedom of religion and conscience under Canada’s Charter of Rights and Freedoms.

However, Justice Herman J. Wilton-Siegel wrote on behalf of a three-member panel:

“the applicants do not have a common law right or a property right to practise medicine, much less a constitutionally protected right.

“Those who enjoy the benefits of a licence to practise a regulated profession must expect to be subject to regulatory requirements that focus on the public interest, rather than the interests of the professionals themselves.”

At issue is the policy of “effective referral”. A doctor who objects to participating in euthanasia cannot be forced to do it. But he is expected to pass the patient to another doctor who will. The CPSO argues that effective referral is necessary “to protect the public, prevent harm to patients and facilitate access to care for patients in our multicultural, multifaith society, by guiding all physicians on how to uphold their professional and ethical obligations of non-abandonment and of patient-centred care within the context of Ontario’s public health-care system.”

Without the policy of effective referral, equitable access would be “compromised or sacrificed, in a variety of circumstances, more often than not involving vulnerable members of our society at the time of requesting services,” Justice Herman Wilton-Siegel wrote. People in remote communities might request euthanasia. If their doctor refused, they might suffer needlessly and taxpayers would have to foot the bill to subsidise the refusnik’s conscience.

It is remarkable how closely Justice Wilton-Siegel’s text hews to the arguments of bioethicists who have been chipping away at the right to conscientious objection for years.

In 2005 American legal scholar Alta Charo described conscientious objection as “an unfettered  right to personal autonomy while holding monopolistic control over a public good … an abuse of the public trust—all  the worse if it is not in fact a personal act of conscience but, rather, an attempt at cultural conquest’.

In 2006 Oxford’s Julian Savulescu argued in the BMJ that “when conscientious objection compromises the quality, efficiency, or equitable delivery of a service, it should not be tolerated”.

More recently, Canadian bioethicist Udo Schuklenk and a colleague contended in the BMJ that

“If at any given time a doctor is unable to continue practicing due to their—ultimately arbitrary—conscience views, nothing would stop them from leaving the profession and taking up a different vocation. This happens across industries and professions very frequently. Professionals can be expected to take responsibility for the voluntary choices they make.”

Responding to the ruling, Larry Worthen, executive director of the Christian Medical and Dental Society of Canada, said: “We heard from our members and other doctors with conscientious objections over and over again that they felt referral made them complicit and that they wouldn’t be able to live with themselves or stay in the profession if effective referral is still required.”

The case is sure to be appealed, but if the doctors championing conscientious objection fail, the consequences will be dire.

Throughout Canada, doctors would be required to refer for euthanasia. If they refuse, they will be hounded out of their profession, or, at best, shunted into specialties where the question will not arise, like pathology or dermatology.

This ruling shows how quickly tolerance vanishes after euthanasia has been legalised. In the Carter decision which legalised it, Canada’s Supreme Court explicitly stated that legalizing euthanasia did not entail a duty on the part of physicians to provide it. Now, however, 18 months and more than a thousand death after legalisation, conscientious objection is at risk.

It also shows how vulnerable religious-based arguments can be. The plaintiffs contended that referring patients violated their right to religious freedom. While this is true, is this the main ground for conscientious objection? As several doctors pointed out in the Canadian Medical Association Journal last year, “Insofar as all refusals of therapy are ultimately justified by the ethical belief that the goal of therapy is to provide benefit and avoid harm, all treatment refusals are matters of conscience.”


This article is published by Michael Cook and MercatorNet under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to MercatorNet. Commercial media must contact MercatorNet for permission and fees.

Ontario court ruling “a significant loss for the entire health care system”

News Release

FOR IMMEDIATE RELEASE

CMDS, CFCPS, CPFL

Toronto, Ontario – From June 13-15, 2017, the legal application of three physicians’ organizations – the Christian Medical and Dental Society of Canada (“CMDS Canada”), the Canadian Federation of Catholic Physicians’ Societies (“CFCPS”) and the Canadian Physicians for Life – and five physicians – was heard in the Ontario Divisional Court. The respondent in the case is the College of Physicians and Surgeons of Ontario (CPSO).

An application was filed asking the Court to declare that portions of the CPSO’s Professional Obligations and Human Rights policy violate the Canadian Charter of Rights and Freedoms. An application for judicial review was simultaneously filed asking the Court to declare the same of the CPSO’s Medical Assistance in Dying policy.

Today, January 31, 2018, the Court declared that these CPSO policies violate freedom of religion by requiring physicians and surgeons to make referrals when their consciences will not allow them to perform a procedure or treatment. The Court stated, (at para. 87): “I am of the opinion that the Policies infringe the rights of religious freedom of the Individual Applicants as guaranteed under the Charter …”

However, the Court found that the violations were justified because of the importance of providing access to these services.

“The Court held that other jurisdictions had chosen less restrictive means of ensuring access. The Court also held that there was no evidence that conscientious objection ever results in a failure of access. The Court also held that the implications for physicians were serious and more than trivial or insubstantial. We are left wondering why an effective referral is necessary,” Larry Worthen, Executive Director of the Christian Medical and Dental Society of Canada said.

“Canada represents itself on the world stage as being a cultural mosaic. This is evidence that we are losing sight of that reality. To say we respect all cultures and beliefs, we need to respect their strongly held moral convictions. We heard from our members and other doctors with conscientious objections over and over again that they felt referral made them complicit and that they wouldn’t be able to live with themselves or stay in the profession if effective referral is still required. We are currently reviewing our options regarding an appeal.”

“This is a disappointing decision and puts our doctors – doctors who entered the field of medicine to provide quality, compassionate, and patient-centered care – in an impossible position,” states Dr. Ryan Wilson, President of Canadian Physicians for Life. “They don’t believe ending a patient’s life is medicine, and they don’t believe they can offer hope and healing in one room while assisting in killing a patient in another. Ultimately it is patient care that suffers, as our doctors will retire early, relocate, or change fields. For many, their religious and conscience rights are being violated and they won’t be able to practice medicine in Ontario. This is a significant loss for the entire health care system in the province and will have a direct impact on patient care.”

The CFCPS is very disappointed with this decision from this Ontario Court that denies conscience rights to many Ontario physicians. “The Canadian Charter of Rights and Freedoms guarantees freedom of religion for all Canadians,” stated Dr. Jim Lane, President of the CFCPS. “This decision forces many Ontario doctors to be unable to care for their patients. This decision also raises alarm bells to all health care workers and Ontario residents that their freedom of religion and conscience could also be jeopardized.”

CMDS Canada is a national association of Christian doctors and dentists who strive to integrate their Christian faith with medical or dental practice. CMDS Canada represents approximately 1600 medical doctors, dentists and medical and dental students, over 500 of which are located in Ontario.

The CFCPS is a national association of Catholic physicians’ guilds, associations and societies from eleven cities across Canada, four of which are in Ontario.

The physicians represented by CMDS Canada and CFCPS hold sincere religious and moral beliefs that form the basis of their moral or religious objection to physician-assisted death.

The Canadian Physicians for Life (“CPL”) is a national association of pro-life physicians, retired physicians, medical residents and students. CPL’s members are dedicated to building a culture of care, compassion and life. CPL was founded in 1975 and is a non-religious charitable organization. CPL’s members believe that every human life, regardless of age or infirmity, is valuable and worth protecting.

For more information and media requests contact:

Larry Worthen, Executive Director
Christian Medical and Dental Society of Canada
902-880-2495 (cell)
office@cmdscanada.org

Washington State mother sues employer for denying insurance coverage to transgender son

Lawsuit claims Catholic health care organization is breaking law by denying coverage for all transgender services

Metro Weekly

John Riley

The ACLU of Washington has filed a civil rights lawsuit against a Catholic health care organization for refusing to cover the medically necessary surgery required by a transgender son of one of their employees.

The ACLU is suing on behalf of Cheryl Enstad, a medical social worker at PeaceHealth St. Joseph Medical Center in Bellingham, Wash. Enstad decided to file a lawsuit after PeaceHealth refused to cover the medical expenses of her transgender son, Pax, even though the treatments that were denied were recommended to treat his gender dysphoria.

Because PeaceHealth is a Catholic health care organization, it tries to abide by the teachings of the Catholic Church when it comes to issues surrounding sexual orientation or gender identity. It used that as justification for refusing to provide coverage for a recommended chest reconstruction surgery and other treatments for gender dysphoria under its medical benefits plan. . . [Full text]

 

In US Supreme Court Brief, Christian Doctors Cite Conscience Conflicts Similar to Creative Artists

News Release

Christian Medical Association

WASHINGTON, Sept. 11, 2017 – The nation’s largest faith-based professional association of health professionals, the Christian Medical Association (CMA, www.cmda.org), contends in a legal brief filed with the Supreme Court that its members’ conscience battles parallel those of creative artists sued for declining to participate in proceedings inconsistent with their conscience and convictions.

CMA has filed a brief with the Court in the case (Masterpiece Bakeshops v. Colorado Civil Rights Commission) of Jack Phillips, a cake artist sued for declining to participate in a same-sex wedding, an event that contradicts his moral persuasions. CMA contends in its brief that health professionals face similar challenges to their First Amendment freedoms in situations involving abortion and other matters involving ethical choices and professional medical judgment.

The brief contends, “To force Mr. Phillips to make this cake would threaten a core liberty that is of the greatest possible importance to medical professionals – protection against compelled speech contrary to conscience, including purely symbolic expression. [T]he implications for the rights of medical professionals in the practice of their professions are clear, and disturbing.”

CMA CEO Dr. David Stevens commented, “This case reminds us that a threat to the First Amendment freedoms of one group is a threat to the First Amendment freedoms of everyone. Regardless of where one stands on controversial issues, as Americans we can all agree that the government cannot be allowed to compel any one of us to express ourselves in a way that violates our deepest held beliefs.

“Preserving freedom of medical judgment for doctors is an essential protection for patients. Imagine if the government were to dictate every medical decision and decide every medical prescription and procedure apart from the medical judgment of the doctors who know and care for their patients best.”

Contact:

Margie Shealy, Christian Medical Association, 423-341-4254

California Hospital Sued for Refusing to Assist in Suicide

National Review

Wesley J. Smith

This lawsuit is a little before its time.

Should assisted suicide become widely accepted in this country, activists will try to force all doctors to participate–either by doing the deed or referring to a doctor known to be willing to lethally prescribe.

But it isn’t yet, and so the pretense of the movement that they only want an itsy-bitsy, teensy-weensy change in mores and law continues as SOP.

But sometimes they show their true intentions. Thus, when UCSF oncologists refused to assist a cancer patient’s suicide, the woman died of her disease. Now, her family is suing–using the same attorney (Kathryn Tucker) who tried (unsuccessfully) to obtain an assisted suicide Roe v Wade in 1997 and has brought other pro-assisted sucide cases around the country. . . [Full text]

California’s assisted-dying loophole: Some doctors won’t help patients die

San Francisco Chronicle

Bob Egelko

Judy Dale died of cancer in her San Francisco home in September, in agony, after being denied the pain-relieving medication she might have received under the state’s aid-in-dying law that had taken effect three months earlier.

A lawsuit by her children will determine whether UCSF Medical Center, where Dale first went for treatment, was responsible for her suffering by allegedly concealing its oncologists’ decision not to provide life-ending drugs to patients who ask for them. More broadly, their suit illuminates the inner workings of a law that confers new rights on terminally ill patients, but few obligations on their health care providers.

The law allows a medically competent adult who has six months or less to live to ask a doctor to prescribe lethal medication. The patient, not the doctor, must be the one to administer the drug. Two doctors must agree on the terminal diagnosis, and the patient must make two requests, at least 15 days apart, before receiving the medication.

But doctors and hospitals are not required to take part in the process or to refer the patient to someone who will grant the request. Hospitals can prohibit their physicians from prescribing life-ending medication, something that medical centers affiliated with the Catholic Church and some secular hospitals have done. And a doctor who has decided not to prescribe the drugs is not required to disclose that fact until the patient asks for them. . . [Full text]

 

llinois Judge Suspends Abortion Notification Law

Measure forces pregnancy centers to promote abortion

Church Militant

Stephen Wynne

ROCKFORD, Ill. (ChurchMilitant.com) – In a setback for mandatory abortion referral laws, a federal judge is halting implementation of an Illinois notification measure.

U.S. District Court Judge Frederick Kapala has temporarily suspended enforcement of SB1564, a measure that compels pro-life pregnancy care centers and doctors to publicize abortion to their clients. In his ruling, Kapala warned that SB1564, an amendment to the Illinois Healthcare Right of Conscience Act, may threaten religious liberty and free speech rights.

SB1564 went into effect January 1. In response, the National Institute of Family and Life Advocates joined with 18 Illinois pregnancy care centers to challenge it in court. . . [Full text]

 

Ontario doctors fight law forcing them to help kill their patients

The Interim

Five doctors and three doctors’ groups were in an Ontario court June 13-15 arguing a policy from the College of Physicians and Surgeons of Ontario (CPSO) violates their Charter rights to freedom of conscience and religion. The CPSO forces doctors to refer patients for euthanasia and abortion, even when it violates their conscience or religion. Kathleen Wynne’s Liberal government intervened on behalf of the college.

The 2015 CPSO policy requires that doctors who object on religious or conscience grounds to providing certain procedures such as abortion and euthanasia must give patients seeking these practices an effective referral. This means directly handing over a patient to another colleague who will follow through with an abortion or euthanasia request. The doctors argue this implicates them in the immoral practices to which they object. . . . [Full text]

 

UCSF sued for refusing to help woman die

Daughters: Mother died “excruciating” death she didn’t want

The Mercury News

Tracy Seipel

In what may be the first-of-its-kind lawsuit related to California’s End of Life Option Act, the family of a San Francisco terminally ill cancer patient is suing the UC San Francisco Medical Center alleging that her physician and the system misrepresented that they would help the dying woman use California’s right-to-die law when her time came.

Instead, according to the July 7 civil lawsuit filed in San Francisco Superior Court, Judy Dale’s wish for a peaceful death was denied to her by the defendants’ “conscious choice to suppress and conceal” their decision that they would not participate in the law, despite Dale’s repeated indications to doctors and social workers that she intended to use its provisions. The suit also names the university’s Helen Diller Family Comprehensive Cancer Center, UCSF Health, a UCSF oncologist and the UC Board of Regents. . . [Full text]