Therapeutic Homicide and Suicide in Canada:Collaboration, Conscription, Coercion and Conscience

Presented at the Central Oregon Right to Life Conference
Redmond, Oregon
10 September, 2016

Sean Murphy*

Preface

Thank you for the invitation to make this presentation on behalf of the Protection of Conscience Project.

Rather than use our time to talk about the Project, I have made background information and materials available in the display. After the presentation, I can answer questions or speak privately with people who would like to know more.

The presentation today is about therapeutic homicide and suicide in Canada. More specifically it is about expectations of collaboration, conscription of health care workers, and ongoing attempts to compel participation in morally contested services. [Full text]

 

Quebec euthanasia statistics

10 December, 2015 to 9 June, 2016

Introduction

Quebec passed An Act Respecting End of Life Care (ARELC) in June, 2014, purporting to legalize euthanasia in the province.  In February, 2015, the Supreme Court of Canada effectively ordered the legalization of physician assisted suicide and physician administered euthansia in Canada by striking down the criminal law to the extent that it prohibited the services (Carter v. Canada).  The Court suspended the ruling for a year and later extended the suspension to give governments the chance to enact new legislation.  Amendments to the Criminal Code were finally passed in June, 2016.

ARELC did not come into effect until 10 December, 2015.  It is more restrictive than the Supreme Court ruling and the Criminal Code provisions in that it does not permit assisted suicide and imposes some limits on euthanasia not found in the Supreme Court decision.

Health and social services agencies established by the government throughout the province are the state agencies responsible for responsible for the delivery and coordination of health care in the province administrative regions.  These are called Centres intégrés de santé et de services sociaux (CISSS) and Centres intégrés universitaires de santé et de services sociaux [CIUSSS).  Some administrative regions (like Montreal and the Quebec City region) have more than one CISSS or CIUSSS.

In June, 2016, these agencies sent reports to the commission established by ARELC to monitor the administration of euthanasia in Quebec (Commission sur les soins de fin de vie).

The Project has compiled the statistics in tables and charts to make them readily available.  An Excel file with all tables and charts and links to the original reports can be downloaded here.

Euthanasia requests

Response to euthanasia requests

Euthanasia requests fulfilled

Reasons euthanasia requests not fulfilled

Frequency of euthanasia requests

Frequency of euthanasia

Mortality rates

Quebec, Belgium and Netherlands

Submission to the Parliamentary Inquiry into Freedom of Conscience in Abortion Provision (United Kingdom)

. . . Abortion has developed technologically and now includes medical and surgical methods, but, generally speaking, remains the deliberate killing of a developing human individual at some point between implantation in the uterus and birth, either directly or by premature delivery intended to cause death. The moral arguments against abortion have been refined and somewhat expanded since 1967, but their focus is substantially unchanged. . .
Project Submission

Christian doctors challenge Ontario’s assisted-death referral requirement

Globe and Mail

Sean Fine

Groups representing more than 4,700 Christian doctors across the country have launched a court challenge to Ontario regulations that require them to refer patients to physicians willing to provide an assisted death, arguing the referrals are morally equivalent to participating in the procedure.

The College of Physicians and Surgeons of Ontario, however, takes issue with the faith groups’ position. “An effective referral does not foreshadow or guarantee an outcome,” college spokeswoman Tracey Sobers said in an e-mail.

Ewan Goligher, a doctor who works in the intensive care unit at Mount Sinai Hospital in Toronto, said he considers himself a conscientious objector to doctor-assisted dying and supports the court challenge. “I think the patient is of greater value than their preference, and I cannot lift my hand to destroy that which is of fundamental value,” he said in an interview. . . [Full Text]

 

Effective referral – toll free crisis line

For any ethical medical service, what physician would set out to make an “ineffective referral”? 

Dr. Will Johnston, M.D.

“Effective referral” – what a bland phrase.  Yet the Nova Scotia the Ontario Colleges of Physicians and Surgeons have adopted this euphemism to mean “removing your discretion as to whether to send a suicidal patient to a doctor who would have no compunctions about killing them if some basic criteria are present.”

For any ethical medical service, what physician would set out to make an “ineffective referral”?  An imaginary referral?  A recreational referral?  On the other hand, what kind of physician would force a colleague to do something they believed to be wrong?

No, “effective referral” is, in our current Troubles, the code phrase for “compulsory referral.”

“Effective referral” is a red flag, useful for identifying those who find it inconvenient that Section 2 of the Charter talks about freedom of conscience and religion.

“Effective referral” is a flashing blue light duct-taped to the heads of College officials and academics who feel competent to remake the ethics of medicine in their own image.


telephone-symbol Pressured to violate your conscience rights?
Not sure what to do?
CALL US TOLL FREE – 1-855-239-0622

Medical professionals who hold to traditional Hippocratic medical ethics are facing difficult times.  Some of our members have been attacked in the media for their beliefs, students and residents face pressure to perform acts contrary to their religious beliefs or morals, and it was necessary for Canadian Physicians for Life to join a legal challenge against a regulatory college because its policies require physicians to violate their consciences.

For these reasons, we are providing a crisis line that our members can call in times of difficulty, when their personal or professional integrity is under attack for any reason.  Whether you are a student being challenged by an attending physician, or a physician being written about in the press, Canadian Physicians for Life is just a phone call away.

What is the Crisis Line?  By calling our toll-free number at 1-855-239-0622, members will have the opportunity to speak for an hour with a lawyer.  Depending on the circumstances, members will also have access to a network of pro-life physicians and professionals who can offer advice on media strategies, dealing with institutional politics, handling difficult ethical circumstances and crisis communications.

There is no cost to use the Crisis Line.  For more information, call or visit www.cp4l.ca/crisis.


Dr. Will Johnston is President of Canadian Physicians for LifeCanadian Physicians for Life seeks to promote public awareness of and professional adherence to the time-honoured Hippocratic medical tradition, which affirms the inviolability of every human life. Founded in 1975, we are a non-profit, charitable organization of Canadian physicians dedicated to the respect and ethical treatment of every human being, regardless of age or infirmity. We are pro-life physicians, retired physicians, medical residents, and students dedicated to building a culture of care, compassion, and life.  P.O. Box 65136, RPO Merivale, Nepean, Ontario K2G 5Y3  Ph. 613-728-LIFE(5433) TF 1-855-239-0622  F 613-319-0837

 

Ontario physicians oppose referrals for assisted suicide, seek judicial review of CPSO requirement

News Release

Coalition for HealthCARE and Conscience

TORONTO, ONT. (June 20, 2016) – The Coalition for HealthCARE and Conscience, representing more than 5,000 physicians and 100 healthcare facilities across Canada, is heartened that federal legislation for assisted suicide specifically states that no one should be compelled to participate in euthanasia.

However, the coalition is deeply troubled that this directive in Bill C-14 is already being ignored and that doctors who oppose assisted suicide over conscience concerns will be required to help take the lives of patients — at least in Ontario.

The College of Physicians and Surgeons of Ontario (CSPO) demands that doctors who conscientiously object to assisted suicide refer patients seeking to end their lives to other physicians who will provide the procedure.

No other foreign jurisdiction that has legalized assisted suicide requires doctors to perform or refer for this procedure. Other provinces have already implemented guidelines to protect doctors who object to providing or referring for assisted suicide.

“The current approach of the CPSO demands that doctors set aside their morals and go against their conscience to directly refer for assisted suicide,” said Larry Worthen, Coalition member and Executive Director of the Christian Medical and Dental Society of Canada. “In our view, effective referral and participating in assisted suicide are morally and ethically the same thing.”

To ensure that conscience rights are respected for Ontario doctors, three physician groups in the Coalition are seeking an expedited judicial review asking the court to determine whether the approach by the CPSO is unconstitutional.

Members of the Coalition fully support the right people clearly have to refuse or discontinue the use of life-sustaining treatment and to allow death to occur.  However, they also hold strong moral convictions that it is never justified for a physician to help take a patient’s life, under any circumstances.

“By requiring effective referral, the CPSO is forcing people of conscience and faith to act against their moral convictions. This threatens the very core of why they became physicians, which is to help to heal people. This is discrimination. It is unnecessary,” Worthen said.

The Coalition is calling on the College to make accommodations that would allow people who have conscientious objection to assisted suicide to continue to practice medicine.

Protecting conscience rights of health practitioners would require only minor accommodations, such as allowing patients direct access to an assessment or allowing complete transfer of care to another physician.

“There are ways to respect patients’ wishes while protecting conscience rights,” Worthen said. “Not to do so is discrimination against people for their morals and convictions, which are protected in the Canadian Charter of Rights and Freedoms.”

A strong majority of Canadians are on side with the coalition’s beliefs on conscience protection. A recent Nanos Research poll found that 75% of Canadians agreed that doctors “should be able to opt out of offering assisted dying,” compared with 21% who disagreed.

The coalition continues to urge Canadians with concerns about assisted suicide legislation to visit CanadiansforConscience.ca where they can communicate directly with their elected members of provincial or federal parliament.

The coalition represents several like-minded organizations committed to protecting conscience rights for health practitioners and institutions. Members of the coalition include the Catholic Archdiocese of Toronto, the Christian Medical and Dental Society of Canada, the Catholic Organization for Life and Family, the Canadian Federation of Catholic Physicians’ Societies, the Canadian Catholic Bioethics Institute, Canadian Physicians for Life, Evangelical Fellowship of Canada, Archdiocese of Vancouver, and the Catholic Health Alliance of Canada.

 About The Coalition for HealthCARE and Conscience:

The Coalition for HealthCARE and Conscience represents a group of like-minded organizations, including representing more than 110 healthcare facilities (with almost 18,000 care beds and 60,000 staff) and more than 5,000 physicians across Canada, that are committed to protecting conscience rights for faith-based health practitioners and facilities. We were brought together by a common mission to respect the sanctity of human life, to protect the vulnerable and to promote the ability of individuals and institutions to provide health care without having to compromise their moral convictions.

The Conscience Protection Act – Policy Lecture with Dr. John Fleming (R-La.)

News Release

Family Research Council

Despite longstanding protections in federal law to keep pro-life doctors, nurses, churches, and religious organizations from being forced to pay for or perform abortions, President Obama’s HHS has repeatedly ignored and refused to investigate clear violations of the law. In 2014, California, and recently New York, have imposed sweeping abortion mandates requiring all employers, including churches, to pay for abortions on-demand in their health insurance plans regardless of any moral and religious objections. The Conscience Protection Act (H.R. 4828) (CPA), introduced by Dr. Fleming (R-La.), would protect pro-life healthcare providers and organizations from just this sort of government discrimination. CPA codifies long-standing federal conscience laws, and provides a critical private right of action so that healthcare providers facing discrimination for refusing to participate in abortion can sue in federal court to protect their conscience rights. Nobody should have to choose between practicing medicine and practicing their religion. Join Family Research Council and Dr. John Fleming as he speaks on this crucial and commonsense measure.

Dr. John Fleming (R-La.), the author of the Conscience Protection Act of 2016 (H.R. 4828), is both a Navy veteran and medical doctor. He has represented Louisiana’s 4th Congressional district since 2009, and is currently a candidate to be the GOP nominee for Louisiana’s open Senate seat this November.

In the House, Dr. Fleming has worked in Congress for sensible health care reforms, authoring legislation urging all Members of Congress to participate in the same health care system that they create for the American people. Dr. Fleming serves on two House Committees: Armed Services and Natural Resources where he is Chairman of the Subcommittee on Water, Power and Oceans. He serves as Co-Chairman of the GOP Doctor’s Caucus, a group that includes 14 physicians who work to develop patient-centered health care reforms.

Dr. Fleming has personally witnessed the miracle of life not only as a father of four children with his wife of 37 years, Cindy, and a grandfather of three, but also as a doctor who has delivered hundreds of babies. In 2007, he was even named the Louisiana Family Doctor of the Year. During his time in Congress, Dr. Fleming has championed conscience protections for medical personnel who choose not to participate in abortion practices.

Due to Congressional scheduling, please be advised that the start time of this lecture event is subject to change. If the live webcast does not begin at noon, stay tuned.

Light refreshments will be served.

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Ontario hospitals allowed to opt out of assisted dying, raising conscientious accommodation concerns

National Post

Sharon Kirkey

Ontario will allow hospitals to opt out of providing assisted death within their walls, provoking charges from ethicists that conscientious accommodation has gone too far.

Elsewhere in the country, a divide is already shaping up, with half of voluntary euthanasia cases in Quebec reportedly occurring in Quebec City hospitals — and few in Montreal.

The situation highlights the messy state of the emotionally charged debate as the provinces wrestle with the new reality of doctor-assisted death, and as the Senate takes a proposed new law further than the governing Liberals are prepared to go. . . [Full Text]

 

Winnebago County LPN Sues Over Loss Of Job Due To Religious Beliefs

Northern Public Radio

A licensed practical nurse is suing the Winnebago County Health Department over allegedly violating her religious conscience.

Sandra Mendoza worked in the pediatrics unit until it was consolidated with women’s health and began offering contraception and abortion referrals.  Citing her Catholic beliefs, she petitioned for an accommodation from the hospital.  Her attorney, Noel Sterett, says what was offered in July of last year, either inspecting food or nursing home work, amounted to a demotion. . . [Full Text]

  

Uncertainty, confusion reign for physicians over assisted suicide

Catholic Register

Michael Swan

With no law in place to govern assisted suicide, physicians and vulnerable patients face uncertainty, confusion and more opinions than facts.

“It’s a matter of weeks before people (in healthcare) are going to have to choose between their conscience and their career,” said Deacon Larry Worthen, executive director of the Christian Medical and Dental Society.

Doctors have told Worthen that some hospitals have already put in place procedures and protocols for doctor-assisted death. Some hospitals will force objecting doctors to refer for assisted suicide, even though, said Worthen, “our physicians are just unable to refer” for reasons of conscience.

Worthen and the doctors he represents want Bill C-14 passed, but they also want the Senate to add specific conscience protections for objecting doctors and health-care institutions.

“We’re pleased with what’s there, but we want to be more specific,” he said. “We want to protect facilities. We want to protect against the requirement to refer.” . . . [Full Text]