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 SubmissionSubmission 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 SubmissionSubmission 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 SubmissionLetter 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 LetterLettre 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. . .
LettreSubmission 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 SubmissionSoumission 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 SubmissionPresentación 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
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 LetterLettre 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. . .
LettreLettre 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 SubmissionSubmission 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 SubmissionSubmission 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 SubmissionPrésentation 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. . .
PrésentationSubmission 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
Submission2015
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 SubmissionSubmission 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
SubmissionSubmission 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 SubmissionSubmission 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 SubmissionSubmission 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
SubmissionSubmission 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 Refusalas 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 Refusalfails 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
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
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 | 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
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
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
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