Protection of Conscience Project
Protection of Conscience Project
www.consciencelaws.org
Service, not Servitude

Service, not Servitude

Project Submissions

2024

Submission to the College of Physicians and Surgeons of Alberta Re: Draft Standard of Practice: Conscientious Objection
Parts of the draft standard Conscientious Objection relevant to Project advocacy are the preamble, two sections that mention “effective referral” and an overbroad prohibition of practitioners’ expression. . . Project Submission

2023

Submission to Canadian Regulatory Authorities and Ministers of Health
Re: Health Canada's Model Practice Standard for Medical Assistance in Dying (MAID) (March, 2023)
The Canadian federal department of health has issued a Model Practice Standard for euthanasia and assisted suicide (EAS) (commonly referred to in Canada as "Medical Assistance in Dying" or "MAID"). From March, 2024 it will apply to the provision of EAS for mental disorders alone. For constitutional reasons, the Standard has no legal effect except to the extent that provincial professional regulators adopt its provisions. However, it articulates state expectations in relation to lawfully killing people that are intended to override the moral/ethical convictions of individuals. . . . Project Submission

 

2022

Submission to the College of Physicians and Surgeons of Ontario
Re: Human Rights in the Provision of Health Services (2022)
The College of Physicians and Surgeons of Ontario (CPSO) has invited comment on a draft policy and related document, Human Rights in the Provision of Health Services (Human Rights 2022) and Advice to the Profession: Human rights in the Provision of Health Services (Human Rights-Advice 2022). The draft revision updates the current policy through which the CPSO imposed a requirement for “effective referral” for morally contested services. Ontario physicians unwilling to provide a procedure they consider unethical/immoral/harmful are required by the CPSO to make an “effective referral” — to connect a patient with a practitioner willing to do what they refuse to do. The policy survived a constitutional legal challenge. It appears that judicial approbation has become a license to make increasingly oppressive demands on objecting physicians. . . . Project Submission
Submission to the College of Physicians and Surgeons of Ontario
Re: Medical Assistance in Dying (2022)
The College of Physicians and Surgeons of Ontario (CPSO) has invited comment on a draft revision of its euthanasia/assisted suicide policy, Medical Assistance in Dying (CPSO MAID 2022). The focus of this submission is on issues related to the exercise of freedom of conscience by practitioners who refuse to do what they believe to be unethical or immoral in relation to euthanasia and assisted suicide (EAS, “medical assistance in dying”, MAID). . . Project Submission

 

2021

Submission to the College of Physicians and Surgeons of Ontario
Re: Medical Assistance in Dying (December, 2018 update)
The focus of this submission is confined to the exercise of freedom of conscience by practitioners who refuse to do what they believe to be unethical or immoral in relation to euthanasia and assisted suicide ("medical assistance in dying": EAS, MAiD). . . Project Submission
Submission to the College of Physicians and Surgeons of Ontario
Re: Professional Obligations and Human Rights
This submission . . . is primarily concerned with provisions of Professional Obligations and Human Rights (POHR) and Advice to the Profession (Advice: POHR) demanding "effective referral." This policy of compulsory collaboration in perceived wrongdoing requires physicians unwilling to provide a procedure they consider unethical/immoral/harmful  —  including killing their patients  —  to arrange for it to be provided by someone else. . . Project Submission
Letter to the Standing Senate Committee on Legal and Constitutional Affairs
Re: Bill C-7 (medical assistance in dying)
I am writing on behalf of the Protection of Conscience Project in support of the letter from Dr. Samantha Hill, President of the Ontario Medical Association, urging that Bill C-7 be amended to protect freedom of conscience for health care practitioners. . .Project Letter
Lettre au Comite permanent affaires juridiques et constitutionnelles Sénat du Canada
Sujet: Projet de loi C-7 (Aide médicale à mourir)
J'écris au nom du Projet de Protection de la Conscience pour appuyer la lettre de Dr Samantha Hill, présidente de l'Ontario Medical Association, demandant que le projet de loi C-7 soit amendé pour protéger la liberté de conscience des praticiens de la santé. . . Lettre
Submission to the World Medical Association
Re: WMA International Code of Medical Ethics
This submission responds to the World Medical Association (WMA) request for public feedback about a proposed revision to the International Code of Medical Ethics (ICME). Amendments to Paragraphs 14 (Patient-centred practice) and 27 ("Conscientious objection") are the principal concern. . . Project Submission
Soumission à l'Association Médicale Mondiale
Re: Révision du Code International d’Éthique Médicale
Cette soumission répond à la demande de commentaires publics de l’Association Médicale Mondiale (AMM ou WMA) sur une proposition de révision du Code international d’éthique médicale (International Code of Medical Ethics ou ICME). Les amendements aux paragraphes 14 (pratique centrée sur le patient) et 27 (« Objection de conscience ») en constituent le principal sujet. . . Project Submission
Presentación a la Asociación Médica Mundial
Re: Código Internacional de Ética Médica revisión
Esta presentación responde a la solicitud de la Asociación Médica Mundial (AMM) de recibir opiniones de los ciudadanos acerca de un proyecto de revisión al Código Internacional de Ética Médica ("ICME", por sus siglas en inglés).  Las enmiendas a los apartados 14 (Práctica centrada en el paciente) y 27 ("Objeción de conciencia") son la principal inquietud. . . Project Submission

2020

Submission to the Standing Committee on Justice and Human Rights, Parliament of Canada
Re: Amendment to Bill C-7: An Act to amend the Criminal Code (medical assistance in dying)
The Protection of Conscience Project does not take a position on the acceptability of euthanasia or physician assisted suicide. The Project supports legislation that ensures that health care workers who object to providing or participating in homicide and suicide for reasons of conscience or religion are not compelled to do so or punished or disadvantaged for refusal. . . Project Submission
Mémoire présenté au Comité permanent de la justice et des droits de la personne, Parlement du Canada
La modification proposée Projet de Loi C-7 Loi modifiant le Code criminel (aide médicale à mourir)
Le Protection of Conscience Project ne se prononce pas sur l'acceptation de l'euthanasie ou de le suicide médicalement assisté. Le projet soutient la législation qui garantit que les travailleurs de la santé qui s'opposent à pratiquer des homicides et des suicides ou à y participer pour des raisons de conscience ou de religion ne sont pas obligés de le faire, ni punis ou désavantagés en cas de refus. . . Mémoire du projet

2018

Submission to the Canadian Medical Association
Re: 2018 Revision of the CMA Code of Ethics (2 April, 2018)
The CMA Code of Ethics Revision Task Force has proposed a substantial revision to the Association's Code of Ethics. The Project applauds the emphasis placed by the Task Force on the moral agency of both patients and physicians, on human dignity, and on the importance of integrity and freedom of conscience in medical practice.

However, the 2018 Revision adds a requirement quite inconsistent with that emphasis: that physicians provide a formal referral or initiate a transfer of care to facilitate procedures to which they object for reasons of conscience. This reverses the CMA's longstanding position against mandatory referral. . . .Project Submission

2016

Submission to the Parliamentary Inquiry into Freedom of Conscience in Abortion Provision, United Kingdom (11 July, 2016)
. . . Abortion has developed technologically and now includes medical and surgical methods, but, generally speaking, remains the deliberate killing of a developing human individual at some point between implantation in the uterus and birth, either directly or by premature delivery intended to cause death. The moral arguments against abortion have been refined and somewhat expanded since 1967, but their focus is substantially unchanged. . .Project Submission
Letter to Members of Parliament and Senators, Parliament of Canada Re: Bill C-14 - An Act to amend the Criminal Code (medical assistance in dying)
. . . Enclosed is the amendment to Bill C-14 proposed by the Project. Ironically, perhaps, what the Protection of Conscience proposes is not a protection of conscience amendment. . . .The proposed amendment would establish that, as a matter of law and national public policy, no one can be compelled to become a party to homicide or suicide, or punished or disadvantaged for refusing to do so. . .Project Letter
Lettre aux Députés et Sénateurs, Parlement du Canada
Re: Loi C-14 (aide médicale à mourir)
. . .Ci-joint l'amendement au projet de loi C-14 proposé par notre organisation. Ironiquement, nous ne proposons pas un amendement pour la protection de conscience . . .La modification proposée établirait que, en matière de droit et de la politique publique nationale, personne ne peut être obliger de devenir partie à l'homicide ou de suicide, ou puni ou défavorisé pour avoir refusé de le faire. . .Lettre
Lettre aux Députés et Sénateurs, Parlement du Canada
Submission to the Standing Committee on Justice and Human Rights(Parliament of Canada)
Re: Bill C-14 - An Act to amend the Criminal Code (medical assistance in dying)
The Protection of Conscience Project does not take a position on the acceptability of euthanasia or physician assisted suicide or the merits of legalization of the procedures. The Project's concern is to ensure that health care workers who object to providing or participating in homicide and suicide for reasons of conscience or religion are not compelled to do so or punished or disadvantaged for refusal. . . Project Submission
Submission to the College of Physicians and Surgeons of Nova Scotia
Re:
Standard of Practice: Physician Assisted Death
The Project considers the proposed standard of practice satisfactory with respect to the accommodation of physician freedom of conscience and respect for the moral integrity of physicians. Neither direct nor indirect participation in euthanasia and assisted suicide is required. . . While the standard is satisfactory with respect to freedom of conscience, the fundamental freedoms of physicians in Nova Scotia will remain at risk as long as the College Registrar and others persist in the attitude and intentions demonstrated in his presentation to the Special Joint Committee on Physician Assisted Dying. . .Project Submission
Submission to the Standing Committee on Justice and Human Rights (Parliament of Canada)
Re: Bill C-14 - An Act to amend the Criminal Code (medical assistance in dying) 2 May, 2016
Carter should not be understood to mean that a learned or privileged class, a profession or state institutions can legitimately compel people to be parties to homicide or suicide - and punish them if they refuse.  This is not a reasonable limitation of fundamental freedoms, but a reprehensible attack on them and a serious violation of human dignity.  From an ethical perspective, it is incoherent.  From a legal and civil liberties perspective, it is profoundly dangerous. . . Project Submission
Submission to the Special Joint Committee on Physician Assisted Dying (Parliament of Canada)
31 January, 2016
The Protection of Conscience Project does not take a position on the acceptability of euthanasia or physician assisted suicide or the merits of legalization of the procedures. The Project's concern is to ensure that health care workers who object to providing or participating in homicide and suicide for reasons of conscience or religion are not compelled to do so or punished or disadvantaged for refusal. . . Project Submission
Présentation au Comité mixte spécial sur l'aide médicale à mourir (Parlement du Canada)
(31 janvier 2016)
Le Protection of Conscience Project ne se prononce pas sur l'acceptation de l'euthanasie ou de le suicide médicalement assisté, ni sur le bien-fondé de la légalisation de ces procédures. L'objectif du Protection of Conscience Project est de s'assurer que les travailleurs de la santé qui s'opposent à pratiquer des homicides et des suicides ou à y participer pour des raisons de conscience ou de religion ne sont pas obligés de le faire, ni punis ou désavantagés en cas de refus. . .Présentation
Submission to the College of Physicians and Surgeons of Ontario
Re: Interim Guidance on Physician Assisted Death (10 January, 2016)
Virtually all of what is proposed in Interim Guidance on Physician-Assisted Death (IGPAD) is satisfactory, requiring only clarifications to avoid misunderstanding and appropriate warnings concerning the continuing effects of criminal law. . .The College has no basis to proceed against physicians who refuse to do anything that would entail complicity in homicide or suicide, including "effective referral" because they believe that a patient does not fit the criteria specified by Carter. College policies and expectations are of no force and effect to the extent that they are inconsistent with criminal prohibitions. . .Project Submission

2015

Submission to the College of Physicians and Surgeons of Manitoba
Re:  Draft Statement on Physician Assisted Dying (15 October, 2015)
The Project finds the proposed policy concerning the exercise of physician freedom of conscience generally satisfactory.  Unfortunately, in its current form, the proposed policy could be understood to mean that objecting physicians cannot or should not discuss euthanasia and assisted suicide with patients.  This is inconsistent with recent advice from the College of Family Physicians, and it inadvertently introduces bias against objecting physicians.  However, this can easily be corrected by rewording the draft to bring it more closely into line with existing College policy on moral or religious beliefs. . .Project Submission
Submission to the College of Physicians and Surgeons of Alberta
Re:  Informed Consent (Draft)  (28 October, 2015)
The Project finds the proposed policy on conscientious objection generally satisfactory. Pursuant to Moral or Religious Beliefs Affecting Medical Care, it distinguishes between providing information (required) and facilitating access to morally contested procedure (not required). This preserves physician freedom of conscience and religion without interfering with patient access to services. The wisdom of this approach has become particularly obvious since the Carter ruling. . . Project Submission
Submission to the (Federal) External Panel
On Options for a Legislative Response to Carter v. Canada (26 October, 2015)
I will first discuss terminology, the language I will be using, so as not to shock people. I will then explain the concept of freedom of conscience that informs the work of the Project. Next I will discuss the obligation to kill, which is related to failed euthanasia attempts and urgent requests for euthanasia or assisted suicide. I will then discuss eligibility criteria and key terms, which are issues that concern the panel. Much of my time will be spent on referral, and I will be relating referral to the risks to society, another of the panel's concerns, and to safeguards. I will offer examples of model policies. . . Project Submission
Submission to the College of Physicians and Surgeons of Saskatchewan
Re:  Physician-Assisted Dying Draft Guidance Document (20 October, 2015)
The Project makes some cautionary observations concerning the provision of information (Part III), specific recommendations concerning informed decision-making (Part IV) and one of the proposed standards (Part V), and offers a policy to ensure protection of physician freedom of conscience that can be applied to euthanasia and assisted suicide as well as other morally contested procedures (Part VI). . . Project Submission
Submission to the Canadian Provincial/Territorial Expert Advisory Group on Physician-Assisted Dying
Re:  Implementation of Supreme Court of Canada ruling in Carter v. Canada (23 September, 2015)
The Protection of Conscience Project is a non-profit, non-denominational initiative that advocates for freedom of conscience among health care workers. It does not take a position on the acceptability of morally contested procedures. For this reason, almost half of the questions in the Written Stakeholder Submission Form are outside the scope of the Project’s interests. . . Project Submission
Submission to the College of Physicians and Surgeons of Saskatchewan
Re:  Conscientious Objection (7 August, 2015)
Abstract: Conscientious Objection is unacceptable because it attacks the character and competence of objecting physicians, and it nullifies their freedom of conscience by compelling them to arrange for patients to obtain services to which they object. Council has been given no evidence that anyone in Saskatchewan has ever been unable to access medical services or that the health of anyone in Saskatchewan has ever been adversely affected because a physician has declined to provide or refer for a procedure for reasons of conscience. In the absence of such evidence, the limits proposed in Conscientious Objection are neither reasonable nor demonstrably justified. . . Project Submission
Submission to the College of Physicians and Surgeons of Saskatchewan
Re:  Conscientious Objection (5 June, 2015)
Abstract: Council has been given no evidence that anyone in Saskatchewan has ever been unable to access medical services or that the health of anyone in Saskatchewan has ever been adversely affected because a physician has declined to provide or refer for a procedure for reasons of conscience. 

The conclusion that objecting physicians "should not be obligated to provide a referral to a physician who will ultimately potentially provide the service" is entirely satisfactory. It is a tacit admission that such a policy would be an unacceptable assault on freedom of conscience.

Conscientious Refusal
as revised attempts to nullify the alleged 'bias' of physicians who object to a procedure for reasons of conscience by requiring them to refer patients to a non-objecting colleague. This proposal is not sound . . . Project Submission
Submission to the College of Physicians and Surgeons of Saskatchewan
Re:  Conscientious Refusal (5 March, 2015)
Abstract: The policy Conscientious Refusal requires all physicians who object to a procedure for reasons of conscience to facilitate the procedure by referring patients to a colleague who will provide it, even if it is homicide or suicide.  No evidence was provided to justify the policy.  None of the arguments provided to Council justify the policy, nor do the principles included in the text.

Conscientious Refusal
fails to recognize that the practice of medicine is a moral enterprise, that morality is a human enterprise, and that physicians, no less than patients, are moral agents. . . Project Submission
Submission to the College of Physicians and Surgeons of Ontario
Re: Professional Obligations and Human Rights (20 February, 2015)
Abstract: The focus of this submission about Professional Obligations and Human Rights (POHR) is its demand for "effective referral" - the demand that physicians do what they believe to be wrong - even gravely wrong - even arranging homicide or suicide - and the implied threat that they will be punished if they refuse.

This is a dangerous and extraordinarily authoritarian policy, completely at odds with liberal democratic aspirations and our national traditions. The burden of proof is on the working group to prove beyond doubt that it is justified and that no reasonable alternatives are available. The working group has not done so. . . Project Submission

2014

Submission to the College of Physicians and Surgeons of Ontario
Re: Physicians and the Ontario Human Rights Code (3 August, 2014)
Background | The Ontario Human Rights Commission made a serious error in 2008 when it attempted to suppress freedom of conscience and religion in the medical profession on the grounds that physicians are "providers of secular public services." In its public perpetuation of this error, the Commission has contributed significantly to anti-religious sentiments and a climate of religious intolerance in Ontario. Both were on display earlier this year when it became front page news and a public scandal that three physicians had told their patients that they would not recommend, facilitate or do what they believed to be immoral, unethical, or harmful. . . Project Submission

2012

Submission to the General Medical Council of the United Kingdom
Re: Personal beliefs and medical practice: A draft for consultation  (3 June, 2012)
Background | The General Medical Council is the state agency that regulates the medical profession in Britain.  A draft guideline on personal beliefs and medical practice generated concern that, if adopted, it would produce an "atmosphere of fear" among physicians who are religious believers. . . Project Submission

2010

Submission to the Parliamentary Assembly of the Council of Europe
Re: Women's access to lawful medical care: the problem of unregulated use of conscientious objection. (6 October, 2010)
Background | On 7 October, 2010, the Parliamentary Assembly of the Council of Europe (PACE) considered a report recommending that freedom of conscience be denied to denominational health care facilities and, in large part, to medical practitioners. . . Project Submission

2009

Submission to the Alberta College of Pharmacists
Re: Draft Code of Ethics (27 February, 2009)
Background | The Alberta College of Pharmacists is the statutory regulator of the profession.  The draft a revised code of ethics eliminated references to accommodation of freedom of conscience, suggesting that the revision was intendeded to force objecting pharmacists to enhance access to euthanasia, assisted suicide, post-coital interception, etc., and to compel them to assist the patient to obtain such services in a timeframe acceptable to the patient. . . Project Submission

2008

Submission to Department of Health and Human Services (USA)
Re: Draft Regulation: Ensuring that Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices In Violation of Federal Law. (24 September, 2008)
Background | On 21 August, 2008, the U.S. Department of Health and Human Services issued a final version of the draft regulation, Ensuring that Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices In Violation of Federal Law ,with a deadline of 25 September, 2008 for public comments.  The regulation made no judgement about the desirability of abortion or other controversial procedures, nor did it restrict or prohibit provision of such services by any private or government entity. . .Project Submission
Submission to the College of Physicians and Surgeons of Alberta
Re: CPSA Draft Standards of Practice (8 October, 2008)
Background | The College of Physicians and Surgeons of Alberta is the statutory regulator of the medical profession.  Draft revisions to standards of practice were made available for public comment.  Some of the revisions appeared to suggest that objecting physicians might be expected to refer patients for morally contested procedures. . .Project Submission
Submission to the College of Physicians and Surgeons of Ontario
Re: Physicians and the Ontario Human Rights Code(11 September, 2008)
Background | The College of Physicians and Surgeons of Ontario is the regulatory and licensing authority for physicians and surgeons practising in Ontario. The Ontario Human Rights Commission responded to a draft policy of the College by recommending that the exercise of freedom of conscience by physicians be restricted.  The College, in response, released a draft policy Physicians and the Ontario Human Rights Code, indicating that Ontario physicians would be expected to sacrifice their freedom of conscience to meet the demands of their patients and avoid prosecution by Ontario's human rights apparatus. . . Project Submission

2002

Submission to the Select Special Freedom of Information and Protection of Privacy Act Review Committee (Alberta)
(11 April, 2002)
Background | During 2000, a controversy arose because some pharmacists objected, for reasons of conscience, to involvement in dispensing potentially abortifacient drugs. Pharmacy regulatory authorities made statements and proposed policies that exerted a significant influence on the attitudes of pharmacists, employers, media, the public and government. As a result, the Protection of Conscience Project wrote to Canadian pharmacy regulators seeking information about the basis for their policies and statements.  The Alberta Pharmaceutical Association ignored requests from the Project, from some of its own members and from a member of the public.  The conduct of the College suggested the need to make self-governing professions subject to Alberta's Freedom of Information and Protection of Privacy Act. . .Project Submission

2001

Submission to the Minister of Health (Canada)
Re: Assisted Human Reproduction Act (10 December, 2001)
Background | The Canadian federal government proposed draft legislation to control artifical reproductive technology and invited public comment.  The draft failed to include any reference to protection for health care workers and others who, for reasons of conscience, might object to participation in the defined controlled activities. . . Project Submission

2000

Submission to the National Association of Pharmacy Regulatory Authorities (NAPRA) (Canada)
Re: A Model Code of Ethics for Canadian Pharmacists (September, 2000)
Background | The National Association of Pharmacy Regulatory Authorities (NAPRA) is a national organization consisting of representatives from provincial pharmacy regulators.  It has no regulatory authority, but co-ordinates policy-making among Canadian pharmacy regulators.  In 2000, NAPRA proposed a Model Code of Ethics for Canadian Pharmacists and solicited comment. . . Project Submission
Submission to the Executive Council of the British Columbia Civil Liberties Association
(19 September, 2000)
Background | Prompted by the hostility toward freedom of conscience demonstrated by the British Columbia College of Pharmacists, the Project made a submission on the subject of freedom of conscience in health care to the BC Civil Liberties Association. . .Project Submission
Submission to the All-Party Oireachtas Committee on the Constitution (Ireland)
Re: Abortion(19 June, 2000)
Background | In 2000, a parliamentary committee in Ireland held hearings into the possibilty of legalizing abortion in the country.  One of the physicians who testified stated that most obstetricians-gynaecologists would refuse to participate in the procedure. . . Project Submission