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

News Release

For immediate release

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)

Dr. Coelho’s ‘crazy’ battle for conscience rights

The Catholic Register

Michael Swan

It’s not surprising patients fall in love with Dr. Ramona Coelho. Not just because she’s a young, pretty doctor who smiles easily, laughs frequently and focuses her attention completely on whoever is talking to her.

Her patients in London, Ont., know that she’s a doctor who is in it for something more than the status, money or security attached to most medical practices.

“I love my work,” Coelho confesses. “I love being a doctor. I love helping people and being with them — trying to find solutions for them.”

Her practice is heavily slanted to marginalized patients. Her waiting room is full of refugees, ex-cons, the poor. Many of her patients are on permanent disability.

All that is at risk as the College of Physicians and Surgeons of Ontario mounts an ever more prickly defense of its “Professional Obligations and Human Rights Policy.” The policy is currently before the courts. It would force Ontario doctors to refer for abortions and for assisted suicide.  . . [Full text]

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Catholic health workers face crisis of conscience

The Catholic Register

Michael Swan

TORONTO – Dr. Luigi Castagna doesn’t think of practicing medicine as a protest movement. But a stalemate over conscience rights for doctors who object to physician-assisted dying may change that.

“We may have to resort to civil disobedience,” Castagna told The Catholic Register.

Castagna is a member and former president of the St. Joseph Moscati Toronto Catholic Doctors’ Guild. He doesn’t think helping a patient commit suicide is good medicine and he doesn’t think he should refer suicidal patients to doctors who believe it their duty to accommodate requests for death.

“You do, on occasion, encounter suicidal patients,” said Castagna. “That’s how we saw them before the (Supreme Court) decision. They were suicidal. It’s a psychological condition and you find out the reason. You do what you do with any patient. You do a history, a physical examination. You establish a diagnosis and you treat them. Successful treatment means that they now wish to live again.”

Given the College of Physicians and Surgeons of Ontario policy that forces doctors to provide an “effective referral” for any recognized, legal medical procedure or treatment, even in those cases where the doctor objects on moral or religious grounds, there is great fear among members of the Doctors’ Guild they will be forced to refer for assisted suicide. . . [Full text]

Further clarity on cooperation and morality

journal-medical-ethicsAbstract:  I explore the increasingly important issue of cooperation in immoral actions, particularly in connection with healthcare. Conscientious objection, especially as pertains to religious freedom in healthcare, has become a pressing issue in the light of the US Supreme Court judgement in Hobby Lobby. Section ‘Moral evaluation using the basic principles of cooperation’ outlines a theory of cooperation inspired by Catholic moral theologians such as those cited by the court. The theory has independent plausibility and is at least worthy of serious consideration—in part because it is an instance of double-effect reasoning, which is also independently plausible despite its association with moral theology. Section ‘Case study: Burwell v. Hobby Lobby’ examines Hobby Lobby in detail. Even if the judgement was correct in that case the reasoning was not, as it involved applying a ‘mere sincerity’ test to the cooperation question. The mere sincerity test leads to absurd consequences, whereas a reasonableness test applied using the theory of cooperation defended here would avoid absurdity. Section ‘A question of remoteness: “accommodations” and opt-outs’ explores the post-Hobby Lobby problem further, examining opt-outs and accommodations: the Little Sisters of the Poor case shows how opt-outs are misunderstood on a mere sincerity test, which the court rightly rejected. Section ‘Application to the medical field: Doogan and Wood’ discusses the UK case of Doogan and Wood, concerning participation in abortion. Again, a judicially recognised ethic of cooperation, if it were part of the fabric of legal reasoning in such cases, would have enabled the conscientious objectors in this and similar situations to have their freedom of conscience and religion respected in a way that it currently is not.

Oderberg DS, Further clarity on cooperation and morality.  J Med Ethics doi:10.1136/medethics-2016-103476

Conscientious objection in healthcare, referral and the military analogy

journal-medical-ethicsAbstract:  An analogy is sometimes drawn between the proper treatment of conscientious objectors in healthcare and in military contexts. In this paper, I consider an aspect of this analogy that has not, to my knowledge, been considered in debates about conscientious objection in healthcare. In the USA and elsewhere, tribunals have been tasked with the responsibility of recommending particular forms of alternative service for conscientious objectors. Military conscripts who have a conscientious objection to active military service, and whose objections are deemed acceptable, are required either to serve the military in a non-combat role, or assigned some form of community service that does not contribute to the effectiveness of the military. I argue that consideration of the role that military tribunals have played in determining the appropriate form of alternative service for conscripts who are conscientious objectors can help us to understand how conscientious objectors in healthcare ought to be treated. Additionally, I show that it helps us to address the vexed issue of whether or not conscientious objectors who refuse to provide a service requested by a patient should be required to refer that patient to another healthcare professional.

Clarke S.  Conscientious objection in healthcare, referral and the military analogy. J Med Ethics 2016;0:1–4. doi:10.1136/medethics-2016-103777

Ban conscientious objection by Canadian doctors, urge ethicists in volatile commentary

National Post

Tom Blackwell

Authorities should bar doctors from refusing to provide such services as abortion and assisted death on moral grounds, and screen out potential medical students who might impose their values on patients, leading Canadian and British bioethicists argue in a provocative new commentary.

The paper by professors at Queen’s and Oxford universities, who are also editors of two major bioethics journals, throws rocket fuel onto a debate already inflamed by the new law allowing assisted death.

They argue that physicians have no right to opt out of lawful medical services — from abortion to prescribing contraceptives — that are requested by a patient and in the person’s interest.

Those who let conscientious objection affect patient care are clearly unprofessional, say Udo Schuklenk and Julian Savulescu.

“Doctors must put patients’ interests ahead of their own integrity,” they write in the journal Bioethics. . . [Full text]

    

Vancouver bishop speaks out on conscience rights, end-of-life care

LifeSite News

Lianne Laurence

VANCOUVER, August 22, 2016 (LifeSiteNews) — Archbishop Michael Miller has reaffirmed that health care practitioners cannot be “pressured or coerced” into providing assisted suicide or euthanasia, which are now legal in Canada under Bill C-14, passed June 17.

In an August 11 letter to all hospitals and Catholic health care institutions in his diocese of approximately 430,000 Catholics, Miller stated that the “conscience of caregivers, physicians, nurses, and support staff must always be respected” and health care professionals should not be discriminated against for refusing to kill their patients by medical means or refusing to provide a “direct effective referral.”

“We maintain as a fundamental principle that any action or omission which of itself or by intention causes or hastens death is a grave violation of the commandment: ‘You shall not kill’,” he wrote. . . [Full text]

Referrals for Services Prohibited In Catholic Health Care Facilities

persp-sex-repro-healthAbstract:

  • Context | Catholic hospitals control a growing share of health care in the United States and prohibit many common reproductive services, including ones related to sterilization, contraception, abortion and fertility. Professional ethics guidelines recommend that clinicians who deny patients reproductive services for moral or religious reasons provide a timely referral to prevent patient harm. Referral practices in Catholic hospitals, however, have not been explored.
  • Methods | Twenty-seven obstetrician-gynecologists who were currently working or had worked in Catholic facilities participated in semistructured interviews in 2011–2012. Interviews explored their experiences with and perspectives on referral practices at Catholic hospitals. The sample was religiously and geographically diverse. Referral-related themes were identified in interview transcripts using qualitative analysis.
  •  Results | Obstetrician-gynecologists reported a range of practices and attitudes in regard to referrals for prohibited services. In some Catholic hospitals, physicians reported that administrators and ethicists encouraged or tolerated the provision of referrals. In others, hospital authorities actively discouraged referrals, or physicians kept referrals hidden. Patients in need of referrals for abortion were given less support than those seeking referrals for other prohibited services. Physicians received mixed messages when hospital leaders wished to retain services for financial reasons, rather than have staff refer patients elsewhere. Respondents felt referrals were not always sufficient to meet the needs of low-income patients or those with urgent medical conditions.
  •  Conclusions | Some Catholic hospitals make it difficult for obstetrician-gynecologists to provide referrals for comprehensive reproductive services.

Stulberg DB, Jackson  RA, Freedman LR.  Referrals for Services Prohibited In Catholic Health Care Facilities. Perspect Sex Repro H, 48:111–117. doi:10.1363/48e10216