Physicians and the Ontario Human Rights Code

The following post is from the College of Physicians and Surgeons of Ontario, the state regulatory authority for the practice of medicine in the province:

The College’s Physicians and the Ontario Human Rights Code policy is currently being reviewed. This policy sets out physicians’ legal obligations under the Ontario Human Rights Code (the Code) and the College’s expectations that physicians will respect the fundamental rights of those who seek their medical services. It aims to assist the profession in understanding its existing legal and professional obligations, and provide physicians with guidance about how to comply with these obligations in everyday practice.
View the current policy
To assist with this review, we are inviting feedback from all stakeholders, including members of the medical profession, the public, health system organizations and other health professionals on the current policy. Comments received during this preliminary consultation will assist the College in updating the policy. When a revised draft is developed, it will be recirculated for further comment before it is finalized by Council.

Submissions must be received by 5 August, 2014.

See the full notice on the College website.  It includes a “quickpoll” survey asking visitors to vote for or against freedom of conscience for physicians.

Medical marijuana and conscience rights

The Interim

Paula Kosalka

Some Canadian physicians are anxious that regulatory changes will pressure doctors to prescribe marijuana. Dr. William Pope, the registrar of the College of Physicians and Surgeons of Manitoba, told the Winnipeg Free Press in January that the college is worried that federal reforms will lead more patients to ask doctors for marijuana. “As far as most of us are concerned, there is really no appropriate prescribing,” he said.

Physicians are now permitted to dispense marijuana with the approval of the province. Patients applying for marijuana access no longer have to submit personal health information to Health Canada. It is also easier for individuals with less serious conditions to get medical marijuana. Pot users will not be able to grow their own marijuana anymore, but will have to buy it from commercial growers licensed by the federal government. On April 1, the new rules came into effect. According to the Winnipeg Free Press, officials predict that the number of cannabis users across the country could rise from 37,000 to 450,000 by 2024 as a result. – [Full text]

American veterans dying while on secret wait list: a question of integrity

CNN has reported that at least 40 American veterans at the Phoenix Veterans Affairs Health Care system have died because they did not receive timely medical care.  The report exposes the duplicitous practice of maintaining a “secret” list of patients with actual wait times, and an “official” wait list used to make it appear that all veterans are receiving treatment within 14 to 30 days.  In reality, about 1,400 to 1,600 veterans have been waiting months for treatment.  According to a physician interviewed by CNN and emails obtained by the news agency, staff at Phoenix Veterans Affairs were aware that the practice is unethical.   The physician interviewed described them as “frustrated” and “upset,” but afraid to “speak out or say anything”  because they know they will be fired if they do. [CNN]

Canadian assisted suicide/euthanasia bill lacks protection of conscience provision

Member of Parliament Steven Fletcher has introduced Bill C581 in the Canadian House of Commons, a private member’s bill to legalize physician assisted suicide and euthanasia.  He has also introduced Bill C582 to establish a Canadian Commission on Physician Assisted Death, a body that would “produce public information on physician-assisted death and to support law and policy reform with respect to physician-assisted death.”  Bill C581 does not include a protection of conscience clause for physicians or health care workers who refuse to participate in euthanasia or assisted suicide for reasons of conscience.  Due to Canadian rules of parliamentary procedure and unwillingness of the governing party to revisit the issues, it is highly unlikely that the bills will come to a vote.

Project article on Quebec euthanasia bill published in Turkish law journal

Comparative Current Criminal Law Series, 14: Medicine/Health LawThe three part series Redefining the practice of medicine: Winks and nods and euthanasia in Quebec (Bill 52: An Act respecting end-of-life care) has been translated into Turkish and published in volume 14 of the Comparative Current Criminal Law Series by Özyeğin University in Istanbul.

Midwife ordered to pay $17,000 after opposing abortions at her hospital


Natalia Dueholm

How much does the truth cost?  For a Polish midwife, it could cost up to 50,000 złotych (approximately $17,000).

The management of a private Polish hospital has threatened legal action against Agata Rejman, a midwife, after she discussed abortions performed at the Specialist Hospital Pro-Familia (right) in Rzeszów.

Rejman’s legal troubles began after a January 2014 press conference organized by Senator Kazimierz Jaworski.  During the conference, Rejman described her anguish after having to participate in abortions at the hospital.
[Full text]


Therapeutic homicide in a neonatal unit?

The Mary Dilemma: Case Study on Moral Distress

Sean Murphy

The Canadian Fellowship of Catholic Scholars Journal published  an article in late 2013 about the moral distress suffered by a Catholic nurse who witnessed the death of a newborn infant. The baby was allegedly starved to death in a neonatal intensive care unit at a Toronto hospital between 27 October and 22 November, presumably in 2012 or earlier. . .The Journal article does not disclose the names of the hospital or the people involved “for reasons of confidentiality”. . . While the Journal article raises very interesting questions from the perspective of freedom of conscience and religion for health care workers, it is prudent to withhold further comment on the allegations until it is clear what action, if any, will be undertaken by state authorities in the Province of Ontario.
Full Text

The Mary dilemma – A case study on moral distress

Newborn infant starved to death in Toronto hospital

One of the nurses who was caring for her today looked at me with tears in her eyes and said “this is not right – if they took  her home and didn’t feed her they would be charged – why is it okay for us to do this?”

Fr. Michael Della Penna, ofm*  and Francisca Burg-Feret*

This paper begins with a case study describing the perspective of a Catholic nurse who experienced moral distress while observing the tragic death of a newborn infant named Baby Mary. The purpose of this paper is to raise awareness and educate readers about the concept of  moral distress and promote a greater understanding of the lived experience of Catholic health care providers who undergo this trauma. It also provides an analysis and some recommendations for practice that can help health care professionals make good ethical choices in difficult situations based on their faith.
Full Text

Entrenching a ‘duty to do wrong’ in medicine

Canadian government funds project to suppress freedom of conscience and religion

 Sean Murphy*

A 25 year old woman who went to an Ottawa walk-in clinic for a birth control prescription was told that the physician offered only Natural Family Planning and did not prescribe or refer for contraceptives or related services. She was given a letter explaining that his practice reflected his “medical judgment” and “professional ethical concerns and religious values.” She obtained her prescription at another clinic about two minutes away and posted the physician’s letter on Facebook. The resulting crusade against the physician and two like-minded colleagues spilled into mainstream media and earned a blog posting by Professor Carolyn McLeod on Impact Ethics.

Professor McLeod objects to the physicians’ practice for three reasons. First: it implies – falsely, in her view – that there are medical reasons to prefer natural family planning to manufactured contraceptives. Second, she claims that refusing to refer for contraceptives and abortions violates a purported “right” of access to legal services. Third, she insists that the physician should have met the patient to explain himself, and then helped her to obtain contraception elsewhere by referral. Along the way, she criticizes Dr. Jeff Blackmer of the Canadian Medical Association (CMA) for failing to denounce the idea that valid medical judgement could provide reasons to refuse to prescribe contraceptives. . .
Full Text


Pennsylvania legislator abandons plan to amend state constitution

State Representative Gordon Denlinger has suspended work on a bill to amend the state constitution to ensure freedom of conscience for citizens who refuse to provide services for reasons of conscience or religion.  He explained that he encountered difficulty in drafting the amendment so as to avoid providing a legal pretext for unjust discrimination.  []