ARPA Submits Recommendations for Freedom of Conscience for Ontario Physicians
Freedom of conscience is an issue that is increasingly at stake in our society. While freedom of conscience has a role in many areas of life, one specific area is in the medical field. In light of legalized and recently expanded access to euthanasia, doctors are at risk of being forced to participate in providing euthanasia to patients, whether directly or indirectly, even if their consciences do not permit it.
The College of Physicians and Surgeons of Ontario (CPSO) is requesting feedback on their policy and guidelines for Ontario physicians regarding Medical Assistance in Dying (MAiD). ARPA Canada submitted concerns and recommendations to the CPSO, and we encourage you to read the submission here.
The deadline for the consultation has been extended to April 30. More information regarding the consultation and how to submit your own thoughts can be found here.
Our main concern with the CPSO’s MAiD policy is the lack of accommodation for healthcare professionals who are conscientious objectors (for professional, moral, or other reasons) to providing or participating in MAiD. While the CPSO recognizes the right of physicians to abstain from providing health services that violate their conscience or religion, the policy still requires physicians to provide an effective referral for MAiD. The lack of protection for freedom of conscience causes a problem for both physicians and patients within Ontario’s health care system. In our submission, we lay out the reasons for this concern and offer means for improving the policy.
Freedom of conscience and religion are protected under section 2(a) of the Charter of Rights and Freedoms. Conscientious beliefs are fundamental to human beings and are a significant part of the worldview that shapes our actions. When a person is forced to act contrary to their conscience, their morality and integrity are being violated. The CPSO should remove the requirement for doctors to provide an effective referral for MAiD. Medical and ethical decisions should never be separated because doctors seek to provide the best medical opinion based on both professional and moral factors. In many medical cases, physicians are permitted to have a dialogue with their patients regarding the best options for care, but in the case of MAiD, that dialogue is stifled because a physician is required to simply abide by the wishes of the patient, without asking questions. Doctors who object to MAiD may not refuse the request and must provide an effective referral.
A requirement for effective referral results in doctors leaving the medical field or being forced to change their specialization. Conscientious doctors are not only left with fewer opportunities in medicine, but patients also have reduced access to care due to fewer doctors and underrepresentation of various religious backgrounds in the field. Ontario’s medical system should be one where ideas are challenged and improved. Doctors should be permitted to provide honest advice to their patients, and the patient can choose to accept that perspective or receive a second opinion from another doctor. There should be a dialogue about what treatments are best for patients, rather than a demand for immediate approval.
Finally, the CPSO policy should clarify that doctors are not permitted to recommend or suggest MAiD to a patient. Many patients are vulnerable, and doctors who suggest MAiD may cause the patient to think that their life is no longer worth living. If a patient requests MAiD, there should be an open discussion about options for end-of-life care, including palliative care.
We are pleased to participate in the CPSO’s consultation, and we pray that this submission will positively impact the protection of conscience for medical professionals in Ontario.