Should doctors be forced to abandon their faith?

Western Standard Magazine, 2004
Reproduced with permission

During the 2000 election campaign, former prime minister Jean Chretien attacked his rival Stockwell Day, leader of the Canadian Alliance, over his proposal for a referendum on regulating abortion, claiming “we have social peace with that at this moment.”

 Critics were quick to point out that Chretien’s so-called “social peace” was in fact a government enforced pro-choice ideology, and that the absence of laws regulating abortion were as much a form of public policy as any legislation. Some say the case of a medical student at the University of Manitoba is evidence of what happens to those who buck official policy. The male Christian student received a failing  grade after completing his hospital rotation in obstetrics and gynecology because of differences with his teachers on abortion and related issues, says Sean Murphy, administrator of the Protection of Conscience Project based in Powell River, B.C. Murphy is a friend of  the would-be doctor,¹ who doesn’t want to be identified and is not talking to reporters. After receiving the failing mark last summer, the student appealed the grade three times. In February, he lost his final appeal and cannot graduate from medical school.

 The unofficial story, reported by local media in Winnipeg, was that Bryan Magwood, the university’s associate dean at the faculty of  medicine had suggested that the student failed because he ran afoul of university policy. That policy apparently dictates that med students  must inform patients of any and all options available to them that fall within the medical standard of care. So even pro-life students are  obligated to tell patients about abortions and, if necessary, refer them to abortionists. Magwood claims that the reports are off-base.

 “What I can tell you is that the media coverage that has gone out so far has been incomplete or inaccurate,” he says, “and that we are following this according to our academic policy and procedure.” Beyond that, he refused to comment on the case, citing privacy concerns.

 But Murphy says that the trials of this one student clearly illustrates the need for some kind of protection-of-conscience legislation in Canada, which would save religious individuals from violating their faith by being compelled to do things professionally that they cannot countenance in good conscience. “I can tell you that the notion that the student is required to refer or perform abortions, for example, or other controversial procedures, is inconsistent with the policy of the physicians of Manitoba,” he says. “But the problem that arises with  medical students is that people in positions of influence and power are able to use that influence and power to bring about a situation that is inconsistent with official policies.”

 There are those who maintain that it’s not up to the physician to practice in ways that mesh with their own values, since those principles might not be shared by the patient. Joyce Arthur, a spokesperson for the Pro-Choice Action Network in Vancouver, says all students, including pro-life ones, should be compelled to learn about abortions and refer patients to pro-choice doctors, whether they like  it or not. “It’s sort of an obligation that they learn about this basic and very common medical procedure,” she says. She adds that if  prolifers cannot stomach this, then “they shouldn’t be a doctor” and they’d have to find a different profession.

 Arthur contends the Canadian Medical Association (CMA) has a policy that  supports her belief that, at the very least,  pro-life doctors have an obligation to refer women seeking an abortion to a prochoice doctor, but that’s not quite true. According to a 1998 CMA policy, “A physician whose moral or religious beliefs prevent him or her from recommending or performing an abortion” has an obligation merely to  “inform the patient” of this, “so that she may consult another physician.”

 At the heart of the issue may be the question of whether patients have the right to whatever procedures are available to them, or whether  doctors are free to dispense information based on their medical knowledge as well as their personal moral judgment. “Nothing in medicine, its codes of conduct, or medical ethics gives a ‘trump right’to a patient seeking a particular medical service that involves vexed ethical questions,” wrote Iain Benson. Benson is the executive director of the Ottawa-based Centre for Cultural Renewal, a non-profit group focusing on keeping religion integrated in public policy, in response to the Manitoba case.

 Even Canadians who are pro-choice and who are genuinely at “peace” with the regulatory status quo in this country should be concerned about the human rights implications of the case, says Murphy. The right for faithful doctors to dissent from a society’s secular value system is critical in any democratic society, he notes, but it also raises some thorny questions. What if a devout Muslim doctor refused to treat women because it violated his beliefs?² Ultimately, says Murphy, “we know we have a controversy.” But the bottom line, he maintains, is ensuring that there is at least some dialogue about things like this. Otherwise the “social peace” means nothing more than those that speak up for their principles end up silenced.  Should doctors be forced to abandon their faith?

From the Project letter to the Western Standard:

1.   . . . In the first place, the Project followed the case from the outset, and the student was provided with the same kind of service extended to others in similar situations. His relationship with the Project has been cordial, but it is incorrect to describe me as "a friend of the would-be doctor." We have never met.

2.  More important, the final paragraph attributes to me statements that I did not make. While I am, nonetheless, in agreement with a number of the points made, I did not suggest that a devout Muslim doctor might refuse to treat women, nor make any statement to a similar effect.