Health Care Workers' Conscience Protection Act (1998)
An expert team of doctors, nurses and lawyers worked with
Scarborough West MPP Jim Brown to research and develop the following
bill. In the spring of 1998 he was pressured to drop the bill by
three other MPP's, including the Party Whip. Then Ontario Health
Minister Elizabeth Witmer is reported to have said later that "the
government had no intention of even considering such legislation."
As a result of opposition from cabinet members and senior
bureaucrats, this bill has not yet been introduced for first reading
in the legislature.
For those unfamiliar with Canada's party politics, the Whip is a
party functionary whose job is to make all party members conform to
party policy. Conformity can be enforced by threats of demotion ,
discrimination in promotion to important positions, ejection from
the party, and refusal to permit the nomination of the
non-conformist for future election. Members may even be threatened
that their constituents will be deprived of beneficial government
programmes . Party members need special permission from their
leaders to vote according to their consciences rather than party
policy . In practice, such permission is rarely granted
Perhaps one of the reasons there is no conscience legislation in
Canada is that proposals must survive in a political environment
that stresses and enforces conformity, and is therefore hostile to
the principle of respect for individual conscience.
The bill permits individual health care workers to refuse to assist
or participate in any designated health care service, except for
delivering nutrition or hydration, which is contrary to their religious
or conscientious convictions. It prohibits health care authorities from
coercing workers in such matters and it sets out penalties for such
coercion. In effect, it would ensure that no health care worker would
lack legal protection if pressured to act against his or her conscience
- whether through the threat of dismissal, demotion, or refusal to hire
or give professional certification, or other forms of discrimination
A health care worker who intends to exercise a right under this act is
required to give notice of that as soon as possible and is protected
from liability for damages and from discrimination for exercising the
An Act to provide for the Protection
of Consciences of Health Care Workers
Her Majesty, by and with the advice and consent of the
Legislative Assembly of the Province of Ontario, enacts as follows:
1. In this Act,
"designated health care" means anything that is done for a
therapeutic, preventive, palliative, diagnostic, cosmetic, prognostic,
research, counseling, family planning, treatment, referral or other
health-related purpose, and includes,
(a) personal assistance services and community services that are
related to health care,
(b) examination and assessments of an individual to determine the
individual's physical or mental state in order to determine the
health care that the individual needs,
(c) advising, counseling or giving prescriptions or referrals to an
individual for the purpose of health care, and
(d) the compounding, dispensing or selling of a drug or the selling
of a device, equipment of any other item to an individual, or for
the is of an individual, pursuant to a prescription,
but does include the delivering nutrients or hydration to an
individual; ('soins de sante designes")
"health care institution" means a public or private corporation,
partnership, association, organization, agency or other legal entity
that is involved in providing designated health care, and includes a
hospital, a clinic, a physician's office, a medical school, a nursing
school and any other institution or facility that provides training in
providing designated health care; ("establissement de soins de sante")
"health care professional" means an individual who practices a
health profession within the meaning of the Regulated Health
Professions Act, 1991; ("professionnel de la sante)
"health care worker" means a health care professional or an
individual who is employed by or who works for a health care
professional or a health care institution' ("travailleur de la sante")
"personal assistance services" means assistance with or
supervision of hygiene, washing, dressing, grooming, eating, drinking,
elimination, ambulation, positioning or any other routine activity of
living; ("services d'aide personnelle")
"Religious or conscientious conviction" means the religious or
conscientious requirements or prohibitions by which an individual
believes oneself to be bound in conscience. ("convictions religieuses or
Right of Conscience
2(1) Subject to subsection (2), a health care worker has the right to
refuse to provide designated health care or to refuse to assist or
participate directly or indirectly in providing designated health care
on the basis that doing so would,
(a) violate the worker's religious or conscientious convictions;
(b) necessarily involve work that would violate the worker's
religious or conscientious convictions.
2(2) As soon as practicable after a health care worker becomes aware
of a potential or actual conflict between the worker's religious or
conscientious convictions and the designated health care that the worker
is required or requested to provide, the worker shall make reasonable
efforts to give notice of the intention to exercise a right under
subsection (1) to the individual who is to receive the designated health
care and to one of the following persons:
1. The person or health care institution who employs the worker
or for whom the worker works.
2. The physician who has prescribed the designated health care, if
the worker is not the physician.
3(1) Despite any other Act, no person or health care institution
shall require a health care worker to do work that the worker refuses to
do on the basis of exercising a right under section 2.
No civil liability
3(2) Despite any other Act, a health care worker who exercises a
right under section 2 to refuse to do work shall not be liable in
damages to any person of health care institution for the refusal.
3(3) Despite any other Act, no person or health care institution
shall subject a health care worker to any of the following treatment for
exercising a right under section 2:
1. Termination or threats of termination of employment or
2. Discrimination in hiring for employment or contract work.
3. Discipline, penalties, retaliation or discrimination in
employment or contract work, including in privileges, benefits,
remuneration, promotion and transfer from existing duties and
4. Discrimination in the admission to or the renewal of registration
in an educational or training program.
5. Discipline, penalties, retaliation or discrimination in the
participation in or the graduation from an educational or training
6. Discipline, penalties, retaliation or discrimination in respect
of a grant or other financial compensation.
7. Discipline, penalties, retaliation or discrimination in respect
of a health care professional by a College of a health profession
within the meaning of the Regulated Health Profession Act, 1991.
8. If the health care worker is a health care professional who
is otherwise qualified for a registration as a member of a College
of a health profession within the meaning of the Regulated Health
Professions Act, 1991, the refusal to grant, continue or renew the
3(4) Despite subsection (3), a health care institution or a part of
it may refuse to employ or retain the services of a health care worker
who exercises a right under section 2 to refuse to do work or may
terminate the employment or work contracts of the worker if,
(a) the institution is established for the primary purpose of
providing the forms of designated health care that the worker
refuses to do; and
(b) the institution has made a diligent effort to find employment or
a work contract, as the case may be, of equivalent value for the
worker in the institution if the worker is qualified for it.
3(5) This Act does not apply to designated health care which is
necessary in an emergency situation to treat a patient who has a disease
or injury which puts that patient at imminent risk of sustaining bodily
harm or death when the health care worker who has a religious or
conscientious objection is the only worker available to provide the
designated health care.
Application to Crown
4. This Act binds the Crown, every agency of the Crown and every
employee in the service of the Crown or an agency, board, commission,
authority, corporation or person that exercises any function assigned or
delegated to it by the Crown.
5. Nothing in this Act suspends or affects any civil or other remedy
that a health care worker may have.
6. This Act applies despite any agreement or waiver to the contrary.
7. (1) A person is guilty of an offence if the person,
(a) contravenes subsection 3 (1) or (3); or
(b) attempts to require, direct, or induce a health care worker to
do work that the worker refuses to do on the basis of exercising a
right under section 2.
7 (2) It is an offence for any director or officer of a corporation
to cause, authorize, permit, or participate or acquiesce in the
commission by the corporation of an offence mentioned in subsection (1).
7(3) A person other than a corporation who is convicted for an
offence under this Act is liable to,
(a) for a first conviction, a fine of up to $2,000 or
imprisonment for up to one year or both; and
(b) for a second or subsequent conviction, a fine of up to $10,000
and imprisonment for up to one year or both.
7 (4) A corporation that is convicted of an offence under this Act is
(a) for a first conviction, a fine of up to $2,000; and
(b) for a second or subsequent conviction, a fine of up to $10,000.
8. Subsection 76 (1) of the Employment Standards Act, as
amended by the Statutes of Ontario, 1991, chapter 43, section 2, is
further amended by striking out "or" at the end of clause (h) by adding
"or" at the end of clause (i) and by adding the following clause:(j) has
exercised a right to refuse work under section 2 of the Health Care
Workers" Protection Act, 1998.
9. This Act comes into force on the day it received Royal Assent.
10. The short title of this Act is the Health Care Workers'
Conscience Protection Act, 1998.