Media Commentary Archive

Proposed policy could severely
limit freedom
of Ontario physicians

Doctors must always have
the right to follow conscience

by Lea Singh

While the College of Physicians and Surgeons of Ontario (CPSO) has been in the spotlight for its proposal to restrict doctors' freedom of conscience, the source of the CPSO's attacks on doctors has been revealed to be the Ontario Human Rights Commission. And this bodes badly not just for Ontario doctors, but for the future freedoms of all working Ontarians.

The commission appears convinced of the need to remove ethical discretion from Ontario doctors and to turn them into technicians who will blindly provide any services that are legal, regardless of their personal values. Not only that: its submissions to CPSO hint that it expects this kind of conduct from "all Ontarians."

The commission says doctors must "'check their personal views at the door' when providing their services." What does this mean? One example: "A physician's denial of services or refusal to provide a woman with information relating to contraception or abortion, for example, would be discriminatory."

Another result: the doctor has the duty to refer, even for abortion. The commission insists that where a family doctor is able to refer a patient for the requested procedure, even if not himself competent to provide the procedure, the doctor must accept the patient and make the referral.

At this point, all doctors should be asking whether they still have any meaningful freedom of conscience in Ontario. Regardless of what happens with the much-attacked CPSO policy, the opinions expressed by the commission will stand. The commission has slammed its royal flush on the table. Any doctor who finds himself before the new Human Rights Tribunal now has fair warning, that these are the rules by which he will be judged.

And here's the crux: doctors are only among the first in the firing line, but the commission has it in for all of us. It says: "all Ontarians must make distinctions between their personal beliefs and opinions, religious or otherwise, and their obligation to act in a non-discriminatory manner."

What this means is that the Ontario Human Rights Commission expects everyone, other than "religious officials" such as clergy, to put their ethics aside in their daily workplace. They explain: "While the expression of their religious beliefs is essential for religious officials in the performance of their duties, secular service providers cannot claim that the performance of their job functions is an expression of their deeply held religious beliefs."

Of course, almost everything can be viewed as a "secular service," meaning that it is done by lay people and not officially connected to a church. Medicine, law, education, you name it -- it all falls under this term.

As does the Ontario public service. This is why the commission wrote a letter to the attorney general in 2004, recommending that marriage commissioners must be forced to perform same-sex marriages, and again noting that they must "check their personal views at the door."

In their submission to the CPSO, the commission further illustrates what it means by checking one's personal views at the door. They give the example of Hall v. Powers, the recent case where "a Catholic school board was required to allow a male student to attend the prom with his boyfriend." The commission applauds this result "because, although the board was entitled to hold beliefs against homosexuality, it was not permitted to act on these beliefs in a discriminatory manner."

There is a clear conflict here, and it threatens to explode not long from now. The commission's views could not be more opposed to the teachings of many religions about integrating one's faith into one's daily working life. To be one person in public, and another in private, would mean a fundamental betrayal of these faiths.

Those who follow such religions can expect rough weather ahead. The new prime directive in Ontario is that you'd better not let your ethics get in the way of your work.

Lea Singh graduated from Harvard Law School in 2003, and works for a nonprofit organization in Ottawa.

Shoving abortion down doctors' throats
National Post, 17 September, 2008
Reproduced with permission

Related Links
Physicians and the
Ontario Human Rights Code

Proposed policy could severely
limit freedom
of Ontario physicians

Doctors must always have
the right to follow conscience

by Barbara Kay

Time was, even as abortion became widely available, one's beliefs around the morality of the practice were one's own business.

Today, unconditional support for unfettered access to abortion seems to be the litmus test of an individual's or an institution's moral standing within the community.

Resistance can result in a form of politically correct "shunning" reminiscent of totalitarian regimes. We saw it last week in Bloc Quebecois leader Gilles Duceppe's reflexive call for the civic ex-communication of a Conservative party candidate on the basis of her affiliation with a pro-life prelature of the Catholic Church.

But the push for moral clarity around publicly funded abortion stubbornly persists: a Dr. Seuss-like cat in our cultural house that keeps coming back.

This time, it padded back in with Republican vice-presidential candidate Sarah Palin's serene acceptance of her Down syndrome fifth child, Trig, as a "gift."

The image of a politically ascendant woman drawing strength from two allegedly incompatible female traits -- soaring personal ambition and reproductive selflessness -- challenges the self-righteous certainties of politically correct ideologues, fuming at the marketing implications of Ms. Palin's story.

This was evident last week in a declaration from the notionally disinterested Society of Obstetricians and Gynecologists of Canada. Their executive vice-president, Dr. Andre Lalonde, worried aloud, with thinly veiled contempt for Ms. Palin, that "[Her decision to carry Trig to term] will have an implication for abortion issues in Canada."

His subsequent disclaimer that, "We offer the woman the choice … We're coming down to a moral decision and we all know moral decisions are personal decisions," rings hollow.

For if Dr. Lalonde himself really believes "moral decisions are personal decisions," Ms. Palin would not have been held up for public chastisement.

More consequential hypocrisy was evident in a draft document by the College of Physicians and Surgeons Ontario (CPSO) on physicians' conscientious objection to performing, or even referring for, abortions. The document's thrust -- to be voted on this week--is to threaten conscientious objectors with aggressive Human Rights Commission retaliation for failure to co-operate with abortion provision.

This is unconscionable, and the Ontario Medical Association, on behalf of its 25,000 members, quite rightly insists the initiative runs counter to the Charter's protection of freedom of religion.

The CPSO document is riddled with logical inconsistencies, as is usually the case with foregone conclusions arrived at through ideology rather than reason. To wit:

-We have no abortion law; yet, as liberals often boast, virtually no doctor in Ontario will abort a fetus after 22 weeks' gestation. Why, then, should doctors who are rendered squeamish by late pregnancy be spared a moral ordeal, but not those tortured by extinguishing life from conception forward?

-The CPSO says refusing abortion violates a patient's right to "treatment." Pregnancy is not a medical illness; it is a natural condition. Doctors in other disciplines routinely refuse to give treatment or write prescriptions they judge unnecessary for healthy patients, or to refer them to other doctors who might. Why the double standard for abortion?

-The CPSO states doctors must set aside personal beliefs to ensure patients get the "medical services they require." Medically speaking, most pregnant women do not "require" abortion. They want an abortion. The word "require" is an ideological construct, not a physiological observation.

The greatest irony is the CPSO statement that, "physicians [must] provide information to patients about all facets of their health care." If that were truly the case, abortion providers would inform their "clients" (what most are in fact) that abortion is linked to elevated risks of pre-term delivery -- and multiple abortions to Cerebral Palsy -- in future pregnancies, not to mention an elevated risk for future mental dysfunction, including suicide.

But they don't. Again, their ideological commitment to abortion's political symbolism outweighs their professional ethical obligation to ensure "informed consent."

In the end, the almost cultish aura that has been whipped up around the sanctity of abortion by politicians and medical bodies comes down to the morally irrelevant cause of satisfying consumer demand for a service of convenience. Hardly worth the sacrifice of individual freedom of conscience, the litmus test of a true democracy.

Hear that scratching at the door? It's that cat coming back.

bkay@videotron.ca

A Handmaid's Tale
Will Ontario doctors be forced to ignore personal beliefs just to please a pompous human rights commission?
National Post, 2 September, 2008
Reproduced with permission

Related Links
Physicians and the
Ontario Human Rights Code

Proposed policy could severely
limit freedom
of Ontario physicians

Check your Ethics

Doctors must always have
the right to follow conscience

by Lorne Gunter

The sheer arrogance of human rights commissions will be their downfall: their conviction that they have a superior understanding of rights compared to anyone else and that once they have pronounced how rights shall be interpreted, the rest of us should fall in lockstep with smiles on our faces and cheery tunes on our tongues, content that our intellectual betters have shown us the error of our ways and revealed the path to true enlightenment.

Consider the Ontario Human Rights Commission's submission to the College of Physicians and Surgeons of Ontario (CPSO) on doctors' ability to practise medicine according to their consciences. It drips and oozes with the kind of sanctimonious condescension to differing views that has become a hallmark of such commissions.

The OHRC's conclusion, though couched as mere friendly advice, states barefaced that "doctors, as providers of services that are not religious in nature, must essentially 'check their personal views at the door' in providing medical care."

The gall of such a statement is stunning. Abortion? Contraception? Fertility counselling for same-sex couples? How are those not services that are "religious in nature"? Every one of the world's major religions has had views on these actions for hundreds of years.

They could only be considered non-religious in nature if you were a detached, disconnected, pompous human rights twit who was convinced you had the power to provide written-in-stone, immutable definitions that were binding on all concerned.

The Roman Catholic church, for instance has been opposed to contraception for centuries. Is the OHRC now saying it has the power to declare definitively that view null and void?

It would be impossible for a doctor to be a devout Catholic and perform abortions. So the OHRC is saying only some people can be doctors in Ontario -- i. e., those with no religious convictions in conflict with the province's human rights code. No orthodox Jews nor Evangelical Christians nor pious Muslims need apply. That sounds like the true discrimination to me.

The OHRC's response to such a charge would be that religious people are free to believe what they wish in private, but they have no right to act on those beliefs in public if the beliefs conflict with the current fashion in human rights thinking. Indeed, in their submission to CPSO on doctors' conscience, the commission states flatly "a physician's refusal to provide a service or accept a patient on the basis of a prohibited ground, such as sex or sexual orientation, is prima facie discrimination, even if the refusal is based on the physician's moral or religious belief."

The commission truly believes that "the freedom to hold beliefs is broader than the freedom to act on them," especially when religious beliefs come in conflict with causes for which the commission sees itself as chief cheerleader, such as gay rights and reproductive choice. On today's trendy ladder of rights, freedom of religion is on the bottom rung. It is the first to get stepped on by ambitious rights climbers.

The commission's submission is full of talk about the need to accommodate -- everyone should try to accommodate everyone else's beliefs. But the commission doesn't believe its own bumph. Over and over again it states (rather than merely advising) that the obligation to accommodate falls only on religious-minded doctors in this case. The commission has never sought to balance the beliefs of the faithful with the demands of advocates for causes it itself champions.

Nearly a decade ago, the OHRC showed its true colours in the Scott Brockie case. Mr. Brockie was a Christian and a printer. A gay rights organization sought to prove a point by seeking out Mr. Brockie and demanding he print their stationery. Even though there were many printers closer to the gay organization's offices --and therefore both their printing needs and Mr. Brockie's beliefs could have been easily accommodated if the group had obtained printing services conveniently elsewhere --the OHRC said religious rights could be exercised only in the private sphere. When they entered the public realm, they were secondary to gay rights.

It will be the same for Ontario doctors if their own college decides to become a handmaid to the pompous, dictatorial operatives at the OHRC. Doctors with strong moral or religious views on abortion and same-sex reproduction will be sought out by gay and feminist activists and, under the truncheon of the OHRC, forced to perform procedures they find morally repugnant, because the goal of human rights adjudicators and their ideological compatriots in the rights industry is not freedom for all but conformity by everyone to the prevailing rights thinking.

It is not enough that Ontario doctors who wish to may perform morally and religiously charged procedures without fear of prosecution. Today, all doctors must be forced to check their personal convictions at the door in the name of rights for the chosen few.

Some people must be made subservient to the biased views of the state's rights police so that those people favoured by the police may do as they wish always and anywhere.

Such is the sad state of human rights thinking and freedom of thought in Canada in the 21st century.

lgunter@shaw.ca

Doctors must always have right to follow conscience
Calgary Herald, 22 August, 2008
Reproduced with permission

Related Links
Physicians and the
Ontario Human Rights Code

Proposed policy could severely
limit freedom
of Ontario physicians

A Handmaid's Tale

Check your Ethics

by Susan Martinuk

Some 2,500 years ago, doctors were both healers and killers. Abortion and euthanasia were commonplace, and the type of medical service rendered depended on who was paying the bill or how the 'payee' asked the 'doctor' to take care of the patient. That ended in 400 BC, when a Greek physician named Hippocrates decided that patients deserved better and wrote an oath to affirm the sanctity of life and the doctor's duty to protect it.

Doctors who took the Hippocratic oath could then offer patients an element of trust and care that was previously non-existent and, for obvious reasons, Hippocratic physicians became the physicians of choice.

Well-known anthropologist Margaret Mead commented on this marked shift in the physician's role by saying, "For the first time in our tradition there was a complete separation between killing and curing. Throughout the primitive world, the doctor and sorcerer tended to be the same person. He with the power to kill had power to cure . . . (but now) One profession . . . (would) be dedicated completely to life under all circumstances . . .

"This is a priceless possession which we cannot afford to tarnish, but society is always attempting to make the physician into a killer -- to kill the defective child at birth, to leave the sleeping pills beside the bed of the cancer patient . . . it is the duty of society to protect the physician from such requests."

This oath became an important symbol of a doctor's integrity and commitment to protect life at all stages. But as with most traditions, it has increasingly fallen out of favour with medical schools. So, too, society seems to have come full circle in terms of its expectations of physicians -- the sanctity of life is no longer as important as our own convenience and demands.

The proof of this is in a draft proposal put forth by the College of Physicians and Surgeons of Ontario that will severely compromise the ethical integrity of physicians by limiting their ability to practice according to their own freedom of conscience and moral/religious beliefs. It would force physicians to set aside their moral consciences to fulfil all demands by all patients -- including providing or assisting patients in obtaining morally controversial services such as abortion, birth control and reproductive technologies for same-sex couples.

If physicians ignore the guidelines, they would be considered to have contravened the human rights code and their licences could be suspended; not because of incompetence or inappropriate activities -- but because of their religious beliefs.

Such tolerance is coming to Ontario physicians, courtesy of their government and its plan to expand the scope of the Ontario Human Rights Commission and increase the number of cases it hears from 150 to 3,000 per year. Sadly, this has motivated the commission to insert its misguided, Orwellian human rights policies into the realm of the physician-patient relationship.

Of course, a 2,000 per cent increase in cases doesn't equal a 2,000 per cent increase in human rights. Rights remain a very circular concept in that there are only so many to go around. Giving more rights to one group inevitably means taking rights from another. That means the commission will be taking away a whole bunch of rights from unsuspecting Ontarians. In this case, it's the physicians who lose.

All of this is disturbing on many levels. The college knew this would be controversial. A 2006 guest editorial in the Canadian Medical Association Journal that called for all physicians to be forced to make referrals for abortion generated such a firestorm that the CMA's director of ethics had to publish a statement saying CMA policy would not require this, since it would violate the conscientious or religious beliefs of many physicians.

Yet, in an indication of how much tolerance and freedom this new era of rights will bring, the college developed this proposal behind closed doors. There were no press releases and, despite placing an Aug. 15 deadline on consultations with physicians, no attempt was made to inform physician groups that will be most affected by/and want to comment on the policy. Since this proposal only came to light on Aug. 14, the college has now graciously responded to outraged demands by extending the consultation deadline to Sept. 12.

Section 2 of the Charter of Rights and Freedoms guarantees freedom of conscience to all Canadians. Yet, for some reason, the college (that should be defending the rights of its members) is eager to prematurely cede these rights at the mere suggestion of a human rights complaint. This willingness to give up suggests that college leaders may be moonlighting as motivational speakers for the Toronto Maple Leafs.

The fact is that every physician operates on some sort of moral framework, whether it be religious or secular or adamantly anti-religious. Just as one physician might encourage a patient to consider other options than abortion, another physician may withhold such information and suggest abortion is the only option. If we discriminate against one doctor's framework for practising medicine, we will inevitably discriminate against others. No doctor will be safe to practise or offer any human interpretation of, or context to, the medical facts.

We have an obligation to not let that happen.

Forcing our doctors' hands
National Post, 18 August, 2008
Reproduced with permission

Related Links
Physicians and the
Ontario Human Rights Code

Proposed policy could severely
limit freedom
of Ontario physicians

Doctors must always have
the right to follow conscience

A Handmaid's Tale

Check your Ethics

by Lorne Gunter

One of the best-known aid organizations in the world is Medecins Sans Frontieres -- Doctors Without Borders. It may soon be joined by a similar group operating within Canada's largest province -- Medecins Sans Conscience -- Doctors Without Consciences.

If the College of Physicians and Surgeons of Ontario (CPSO) gets its way, Ontario's doctors will soon be stripped of their right to follow their moral convictions or religious beliefs when treating patients. In other words, doctors will risk losing their licenses if they run afoul of Ontario's human rights police.

If, out of moral conviction, they refuse to perform abortions, refer patients for abortions or prescribe morning-after and birth control pills, or if they refuse to help same-sex couples conceive children, their own governing body will take away their right to practice medicine.
Should euthanasia become legal at some point, physicians would be expected to help patients die, too, even if doing so violated their every moral fibre. I may not agree with social conservatives that assisted suicide or abortion should be illegal, yet I am repulsed by the idea of coercing doctors into participating in procedures that contravene their morality. It is nothing short of politically correct extortion to threaten doctors with their livelihood if they don't buckle under and practice medicine the way Ontario's human rights junta thinks it should be practiced.

The key passage in the CPSO's seven-page proposal states that a "physician's responsibility is to place the needs of the patient first, [so] there will be times when it may be necessary for physicians to set aside their personal beliefs in order to ensure that patients or potential patients are provided with the medical services they require."

But a lot of the services the CPSO proposes forcing physicians to perform are hardly "necessary."

A particular woman may want an abortion for any number of reasons, but unless her own life is in danger from her pregnancy, it cannot truly be said that an abortion is necessary. Similarly with the desire of same-sex couples to have children; it may be a strong desire, but it is hardly a necessity.

So long as there are no prohibitions against doctors performing these services, the rights of women and gays and lesbians are not violated. They may get what they want without trampling on the rights of conscientious-objector doctors.

There may be some inconvenience involved. Patients seeking abortions or same-sex conception may have to travel to another Ontario town or city to fulfill their rights, but inconvenience is not the same as discrimination.

Freedom often isn't easy. Yet we have developed a very juvenile notion that unless our freedoms come with no obligations or consequences, we aren't really free, which is nonsense.

What the CPSO is proposing, in effect, is to set itself up as an enforcer for the new Human Rights Tribunal of Ontario (HRTO) by incorporating the Tribunal's concept of rights into the physicians' code of professional conduct. This would enable the college to discipline a doctor for political rather than medical conduct. Any Ontario doctor refusing to abide by the twisted definition of rights contained in the province's human rights code -- in which some groups are more equal than others -- could be deemed a bad doctor and decertified.

This is yet another example of the tyranny of human rights commissions over our daily lives. Should these new rules be adopted next month, an Ontario doctor could be barred from practicing medicine not because he or she is unethical or incompetent, but merely because he or she fails to share the same political view of rights and morality as the HRTO (and the brass of the CPSO).

If this were really about maximizing human rights, the college would be proposing to protect from professional discipline any doctor assisting in abortions, same-sex conception or other morally charged procedures. Instead, by insisting that all doctors must participate in such procedures, regardless of their personal beliefs, the college is taking sides. Like human rights tribunals and commissions, it is placing the rights of women and gays ahead of those of doctors and people of faith, whether they are Jews, Muslims, Christians or others.

The college is not seeking justice, it is demanding conformity. It is not striving for "choice" for patients and doctors, it is attempting to force acceptance of one political and moral view on everyone.

If there is anything unethical in the debate over physicians' consciences, the one-philosophy-trumps-all attitude of the CPSO is it.

lgunter@shaw.ca

Letter to the Editor, National Post
16 August, 2008 (Not published)
Reproduced with permission

Related Links
Physicians and the
Ontario Human Rights Code

Proposed policy could severely
limit freedom
of Ontario physicians