Doctors who object to treatment on moral grounds must give referral: court

Some observers said the court didn’t go far enough to safeguard patients’ rights to receive care

Ontario doctors who have a moral or religious objection to treatments such as assisted dying, contraception or abortions must refer patients to another doctor who can provide the service, after a court found it is necessary to guarantee that vulnerable patients can access the care they need.

A group of five doctors and three professional organizations had launched a legal challenge against a policy issued by the province’s medical regulator, arguing it infringed on their right to freedom of religion and conscience under the Charter of Rights and Freedoms.

The group — which includes the Christian Medical and Dental Society of Canada, the Canadian Federation of Catholic Physicians’ Societies and Canadian Physicians for Life — said the requirement for a referral amounted to being forced to take part in the treatment.

The College of Physicians and Surgeons of Ontario, meanwhile, said its policy aims to balance the moral beliefs of individual physicians while nonetheless ensuring access to care, particularly for vulnerable patients.

In a ruling released Wednesday, the divisional court said that though the policy does limit doctors’ religious freedom, the breach is justified. The benefits to the public outweigh the cost to doctors, who can choose to practise a specialty where such moral dilemmas will not arise, the court said.

“The goal of ensuring access to health care, in particular equitable access to health care, is pressing and substantial. The effective referral requirements of the policies are rationally connected to the goal,” Justice Herman J. Wilton-Siegel wrote on behalf of a three-member panel.

“The requirements impair the individual applicants’ right of religious freedom as little as reasonably possible in order to achieve the goal.”

What’s more, the court found, “the applicants do not have a common law right or a property right to practise medicine, much less a constitutionally protected right.”

“Those who enjoy the benefits of a licence to practise a regulated profession must expect to be subject to regulatory requirements that focus on the public interest, rather than the interests of the professionals themselves,” Wilton-Siegel wrote.

The groups said they were disappointed with the ruling and would review their options in regards to an appeal.

“We heard from our members and other doctors with conscientious objections over and over again that they felt referral made them complicit and that they wouldn’t be able to live with themselves or stay in the profession if effective referral is still required,” Larry Worthen, executive director of the Christian Medical and Dental Society of Canada, said in a statement.

The college and its supporters welcomed the decision, calling it a victory for patients.

“We believe the effective referral policy strikes a fair, sensible balance between a physician’s right to conscience or moral objection and a patient’s right to care. We are grateful that the judges’ decision puts patients first,” said Shanaaz Gokool, CEO of the advocacy group Dying With Dignity, which was an intervener in the case.

But some observers said the court didn’t go far enough to safeguard patients’ rights to receive care.

Udo Schuklenk, a bioethicist at Queen’s University in Kingston, Ont., called the ruling a “classic Canadian compromise” and said it failed to consider whether the accommodation was warranted.

Protections for conscientious objectors are valuable in situations such as military conscription, but have no place in a profession such as medicine, in which people participate voluntarily, he said. Some countries, such as Sweden and Finland, make no allowances for moral objections in medicine, he said.

If physicians are allowed to bypass treatments such as abortions or contraception — which patients have a legal right to obtain — by simply giving a referral, it paves the way for them to bow out of other services down the line, he said.

“With future developments in medicine, we will never be able to predict what the latest thing is that somebody will object to do,” he said.

The referral system can also put great strain on the health-care system, he said. If, for example, a patient seeks medically assisted death in a remote community and no one there will provide it, it falls on taxpayers to pay for another physician to travel there, he said.

The college’s policy was established in 2015 under the guidance of a working group and was subjected to external consultations. It said the referral doesn’t have to be in writing and can de delegated to office staff.

Paola Loriggio, The Canadian Press

Like us on Facebook and follow us on Twitter.

Just Posted

Volunteers step up to the grill to help the Ksan Society

A group of volunteers from the Northwest Community College are flipping burgers, walking to help after this year’s Coldest Night of the Year fundraiser was cancelled.

Delays due to avalanche control on Highway 16

After another storm transportation crews are busy clearing snow between Prince Rupert and Terrace

Greyhound cleared to end routes in northern B.C., Vancouver Island

Company says nine routes have dropped 30% in ridership in last five years

UPDATE: Air quality advisory ended for Terrace

People with chronic underlying medical conditions should postpone strenuous exercise until the advisory is lifted.

Mills Memorial Hospital financing formula released

Regional taxpayers to pay $113.7 million for new facility.

President praises nearly 1,800 volunteers at B.C. Games

Ashley Wadhwani sits down with the Kamloops 2018 B.C. Winter Games President Niki Remesz

How to keep local news visible in your Facebook feed

Facebook has changed the news feed to emphasize personal connections. You might see less news.

The way government learn someone has died is getting a digital overhaul

Governments in Canada turned to private consultants 2 years ago to offer blueprint

Bobsleigh team misses Olympic medal finish

Canadian team finishes four-man event 0.84 seconds behind first place, 0.31 seconds from podium

B.C. Games: Athletes talk Team Canada at PyeongChang 2018

From Andi Naudie to Evan McEachran there’s an Olympian for every athlete to look up to

Snowboarders sliding into fresh territory at B.C. Games

Athletes hit the slopes for first appearance as an event at the B.C. Winter Games in Kamloops

Cariboo woman raises funds for Seizure Investigation Unit beds at VGH

VGH Foundation gets VCH approval to begin fundraising for SIU beds; local efforts are paying off

Looking back at the 1979 B.C. Games: Good memories, even better jackets

39 years later, Kamloops is hosting the Winter Games again, with some volunteers returning

OLYMPICS 101: Oldest and youngest Canadians to reach the podium

This year, Canada sent its most athletes in Winter Games history, here’s a look at record breakers

Most Read