We Can’t Afford to Abandon Conscience Rights for Medical Professionals
On February 4, 2022, MP Kelly Block introduced the Protection of Freedom of Conscience Act. This private member’s bill will make it an offence to intimidate or dismiss from employment a medical professional who cannot in good conscience take part in providing medical assistance in dying.
Since Canada’s confederation, Canadian leaders have worked to promote tolerance of religion and conscience for all Canadians. They understood that Canadians have different moral perspectives and that making room for diversity is the best option for a unified country. By 1982, freedom of conscience was officially included in the Charter of Rights and Freedoms. In that light, it may seem that this bill would easily gain cross-party support.
However, that a bill like this is needed at all reflects the fact that we are seeing a worrying trend away from freedom of conscience in Canada. Conversations about conscience in healthcare often centre around whether we should prioritize the rights of doctors or prioritize patient wishes – and patient wishes often come out on top. But this question presents a false dilemma – freedom of conscience protects both doctors and patients and is critical for a good healthcare system.
The ongoing expansion of medical assistance in dying (MAiD) has meant some doctors are being forced out of the profession by policies that do not permit freedom of conscience. Doctors are being pressured to provide what a patient requests, whether or not they think it is in the patient’s best interest and with little room for other professional, moral, or ethical considerations.
Many doctors believe they cannot participate in intentionally ending a patient’s life. Insisting that they do so is damaging to their professional and emotional wellbeing.
One doctor, testifying to an Ontario Legislative committee, relates the story of how she was directed to make an effective referral for assisted suicide: “I ignored my conscience, opting instead to follow the college policy and convincing myself that I had no choice … this was destructive to my very core. I felt like a shell of myself. Months later, I often still do. I came very close to leaving palliative care at the time, and every day I continue to question my ability to stay in this field.”
Canada already has a shortage of healthcare workers. This problem will only get worse if principled healthcare professionals are increasingly forced to leave or discouraged from entering the field in the first place. If we do not prioritize freedom of conscience, access to medical care will be further reduced as medical professionals are removed, move to another jurisdiction, retire early, or change careers.
Many patients want doctors who will help and treat them from a shared moral perspective. Patients may want the security of knowing their doctor will never recommend MAiD. Others may desire a doctor with a moral code that allows for MAiD. And most would surely prefer a principled doctor who provides their honest, ethical opinion, whether or not they agree with that opinion.
A heavy-handed approach to controversial medical and ethical issues is not helpful for either doctors or patients. It can cause specific groups of people to feel isolated, marginalized, and suspicious of the system in which they work, or which is supposed to help them navigate difficult medical choices. Penalizing physicians with conscientious objections to MAiD reduces the opportunity for many patients to receive their preferred care through a diverse healthcare system.
Conscience claims may on occasion cause inconvenience or hurt feelings. Inevitably, one person’s conscientious beliefs will explicitly or implicitly conflict with the beliefs of another person, no matter what the topic is. But our Canadian forefathers were right to recognize the value of unity in diversity for a stronger Canada.
Both doctors and patients should have the freedom to live and work in line with their moral and ethical principles. No one should be coerced to do what they believe is wrong.
Federal and provincial governments must ensure that doctors can continue to make ethical decisions that are both in line with their conscience and in the best interests of their patients, rather than forcing them to be identical in their thoughts, beliefs, and practices. The Protection of Freedom of Conscience Act will be good for both doctors and patients.
