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Submission to the College of Physicians and Surgeons of Ontario

Re: Physicians and the Ontario Human Rights Code (3 August, 2014)


Notes

1.  A requirement that an objection physician "advise the patient of other sources of assistance," was introduced by the CMA General Council in June, 1977, and revoked the following year. Geekie D.A. "Abortion referral and MD emigration: areas of concern and study for CMA." CMAJ, January 21, 1978, Vol. 118, 175, 206 (Accessed 2014-02-22);
"Ethics problem reappears." CMAJ, July 8, 1978, Vol. 119, 61-62 (Accessed 2014-02-22).
In 2000, during a telephone conversation with the Project Administrator, Dr. John R. Williams, then CMA Director of Ethics, confirmed that the Association did not require objecting physicians to refer for abortion. He explained that the CMA had once had a policy that required referral, but had dropped it because there was "no ethical consensus to support it." This was clearly a brief reference to the short-lived 1977 revision of the Code of Ethics and ensuing controversy.

2.  For example, in a guest 2006 editorial in the Canadian Medical Association Journal, Professors Sanda Rodgers of the University of Ottawa and Jocelyn Downie of Dalhousie University complained that "[s]ome physicians refuse to provide abortion services and refuse to provide women with information or referrals needed to find help elsewhere." Rodgers S. Downie J. "Abortion: Ensuring Access." CMAJ July 4, 2006 vol. 175 no. 1 doi: 10.1503/cmaj.060548 (Accessed 2014-02-23)

3.  Blackmer J. "Clarification of the CMA’s position on induced abortion." CMAJ April 24, 2007 vol. 176 no. 9 doi: 10.1503/cmaj.1070035 (Accessed 2014-02-22)

4.  "(We decided to proceed by way of these provincial regulatory bodies rather than the CMA, in part, because of the negative reaction of the CMA to the Rodgers/Downie editorial, which made policy reform by the CMA seem unlikely.)" McLeod C, Downie J. "Let Conscience Be Their Guide? Conscientious Refusals in Health Care." Bioethics ISSN 0269-9702 (print); 1467-8519 (online) doi:10.1111/bioe.12075 Volume 28 Number 1 2014 pp ii–iv

5.  Submission of the Ontario Human Rights Commission to the College of Physicians and Surgeons of Ontario regarding the draft policies relating to establishing and ending physician-patient relationships. 14 February, 2008 (Accessed 2014-07-28).

Submission of the Ontario Human Rights Commission to the College of Physicians and Surgeons of Ontario Regarding the draft policy, "Physicians and the Ontario Human Rights Code." 15 August, 2008. (Accessed 2014-03-08)

6.  Submission of the Ontario Human Rights Commission to the College of Physicians and Surgeons of Ontario Regarding the draft policy, "Physicians and the Ontario Human Rights Code." 15 August, 2008. (Accessed 2014-03-08)

7.  Physicians and the Ontario Human Rights Code, p. 4.

8.  Murphy S. "Physicians and the Ontario Human Rights Code: Ontario Human Rights Commission attempts to suppress freedom of conscience." (August-September, 2008)
Protection of Conscience Project

9.  "OMA Urges CPSO to Abandon Draft Policy on Physicians and the Ontario Human Rights Code." OMA President's Update, Volume 13, No. 23 September 12, 2008. "OMA Response to CPSO Draft Policy 'Physicians and the Ontario Human Rights Code.'" Statement of the Ontario Medical Association, 11 September, 2008.

10.  Zuliani, P. "Doctors do not have to violate beliefs." Ottawa Citizen, 23 August, 2008
Responding to Warren, David, "Refusing to do harm." Ottawa Citizen, 20 August 2008.
(Accessed 2014-08-03)

11.  "We do not expect physicians to provide services that are contrary to their moral or religious beliefs." The e-mail acknowledged that a requirement that physicians may be required to help patients arrange for morally objectionable procedures had "raised concerns from respondents."  E-mail from the College of Physicians and Surgeons of Ontario, 20 August 2008.

12.  "Rights Commission threat 'blasphemy against the human spirit': College of Physicians secrecy said unacceptable." Protection of Conscience Project, News Release, 13 September, 2008

13.  College of Physicians and Surgeons of Ontario, Policy Statement #5-08: Physicians and the Ontario Human Rights Code (Approved September, 2008) (Hereinafter “POHRC (2008)”) (Accessed 2014-03-06)

14.  See note 5.

15.  Schuklenk U, van Delden J.J.M, Downie J, McLean S, Upshur R, Weinstock D. Report of the Royal Society of Canada Expert Panel on End-of-Life Decision Making (November, 2011) p. 101 (Accessed 2014-02-23)

16.  Schuklenk U, van Delden J.J.M, Downie J, McLean S, Upshur R, Weinstock D. Report of the Royal Society of Canada Expert Panel on End-of-Life Decision Making (November, 2011) p. 62 (Accessed 2014-02-23)

17.  Devine M, "Doctor risks his career after refusing abortion refusal." Herald Sun, 5 October, 2013. (Accessed 2014-08-02). Australia provides examples of both a mandatory referral law and the controversy surrounding the subject. Murphy S. State of Victoria, "Australia demands referral, performance of abortions: Abortion Law Reform Act 2008." Protection of Conscience Project;  Australian Medical Association Tasmania Ltd., Submission to the Tasmanian Government on the law governing termination of pregnancy. 5 April, 2013; "Protection of conscience provision in new Tasmanian abortion law." Protection of Conscience Project News/Blog, 13 December, 2014.

18.  An Act respecting end-of-life care (Hereinafter "ARELC").

19.  Collège des Médecins du Québec Code of Ethics of Physicians, para. 24 (Accessed 2013-06-23)

20.   "For example, a physician who is opposed to abortion or contraception is free to limit these interventions in a manner that takes into account his or her religious or moral convictions. However, the physician must inform patients of such when they consult for these kinds of professional services and assist them in finding the services requested." Collège des Médecins du Québec, Legal, Ethical and Organizational Aspects of Medical Practice in Québec. ALDO-Québec, 2010 Edition, p. 156. (Accessed 2013-06-23)

21.  Consultations & hearings on Quebec Bill 52 (Hereinafter "Consultations), Wednesday 18 September 2013 - Vol. 43 no. 35: Quebec Association of Health Facilities and Social Services (Michel Gervais, Diane Lavallée), T#017

22.  Consultations, Wednesday, 9 October 2013 - Vol. 43 No. 45: Professor Joceyln Downie

23.  Downie J, McLeod C, Shaw J. "Moving Forward with a Clear Conscience: A Model Conscientious Objection Policy for Canadian Colleges of Physicians and Surgeons." Health Law Review, 21:3, 2013

24.  Murphy S. "NO MORE CHRISTIAN DOCTORS." Protection of Conscience Project, March, 2014

25.  Murphy S. "NO MORE CHRISTIAN DOCTORS": Appendix ‘A.’ Protection of Conscience Project, March, 2014

26.  Levy I. (Medical Officer of Health, Ottawa) and Abdullah A. (President, Academy of Medicine, Ottawa), Letter to the Ottawa Citizen, 1 February, 2014.

27.  College of Physicians and Surgeons of Ontario, All Doctor Search (Accessed 2014-07-29)

28.  Payne E. "Some Ottawa doctors refuse to prescribe birth control pills." Ottawa Citizen, 30 January, 2014  (Accessed 2014-08-03)

29.  Murphy S. ""NO MORE CHRISTIAN DOCTORS": Appendix ‘C’: Radical Handmaids Facebook Timeline." Protection of Conscience Project, March, 2014 (Hereinafter "Radical Handmaids FB"): J___ R____, 29 January, 2014, 5:50 pm. (Accessed 2014-02-10)

30.  Radical Handmaids FB, D___ D___ B___, 29 January, 2014, 5:58 pm (Accessed 2014-02-10)

31.  Radical Handmaids FB, A___ R___, 29 January, 2014, 6:29 pm (Accessed 2014-02-10)

32.  Radical Handmaids FB, M___ A___, 29 January, 2014, 7:19 pm (Accessed 2014-02-10)

33.  Radical Handmaids FB, M___ A___, 29 January, 2014, 8:54 pm (Accessed 2014-02-10)

34.  Radical Handmaids FB, M___ C___, 29 January, 2014, 8:57 pm (Expletive deleted) (Accessed 2014-02-10)

35.  Radical Handmaids FB, S___ W___, 29 January, 2014, 9:36 pm (Accessed 2014-02-10)

36.  Radical Handmaids FB, L___ J___ M___, 30 January, 2014, 9:24 am (Accessed 2014-02-10)

37.  Radical Handmaids FB, T___ D___, 30 January, 2014, 4:25 am; C___ B___, 30 January, 2014, 5:07 am (Accessed 2014-02-10)

38.  Radical Handmaids FB, J___ L___, 29 January, 2014, 10:10 pm (Accessed 2014-02-10)

39.  Radical Handmaids FB, T___ M___, 29 January, 2014, 6:56 pm (Accessed 2014-02-10)

40.  Radical Handmaids FB, C__ F___, 30 January, 2014, 6:53 am (Accessed 2014-02-10)

41.  Radical Handmaids FB, J___ O___, 30 January, 2014, 1:38 pm; Radical Handmaids FB, R___ L___ 29 January, 2014, 7:32 pm; Radical Handmaids FB, K___ N___ H___, 30 January, 2014, 11:48 am; Radical Handmaids FB, L___ C___ 31 January, 2014, 7:52 am. (Accessed 2014-02-10)

42.  Radical Handmaids FB, K___ B___, 29 January, 2014, 7:56 pm (Accessed 2014-02-10)

43.  Radical Handmaids FB, A___ M___ 29 January, 2014, 7:41 pm (Accessed 2014-02-10)

44.  Radical Handmaids FB, R___ V___, 29 January, 2014, 7:52 pm (Accessed 2014-02-10)

45.  Radical Handmaids FB, D___ M___, 30 January, 2014, 5:41 am; Radical Handmaids FB, N___ P___, 30 January, 2014, 8:12 am; Radical Handmaids FB, M___ C___, 30 January, 2014, 3:04 pm; Radical Handmaids FB, A___ O___, 31 January, 2014, 5:26. (Accessed 2014-02-10)

46.  Radical Handmaids FB, N___ P___ 30 January, 2014, 8:40 am. (Accessed 2014-02-10)

47.  Radical Handmaids, 30 January, 2014, 8:45 am (Accessed 2014-02-10)

48.  Radical Handmaids, 29 January, 2014, 8:07 pm (Accessed 2014-02-10)

49.  Payne E. "Some Ottawa doctors refuse to prescribe birth control pills." Ottawa Citizen, 30 January, 2014  (Accessed 2014-08-03)

50.  Glauser W. "Ottawa clinic doctors’ refusal to offer contraception shameful,
says embarrassed patient." Medical Post, 5 February, 2014

51.  Cohn MR. "Doctors who play God can be pastors, not physicians: Cohn." Toronto Star, 29 July, 2014 (Accessed 2014-07-29)

52.  "It is indisputably true that humanism and atheism function as secular religions binding their adherents through common belief and ideology. They are expressed as secularism, which, more and more, has become "aggressive secularism. . . I am arguing that it’s a mistake to accept that secularism is neutral. . . it’s not. It too is a belief system used to bind people together." Somerville M. "Should religion be evicted from the public square?" The Warrane Lecture 2011. Kensington, NSW Australia: Warrane College, August, 2011, p. 12. (Accessed 2014-08-02)

53.  K__ A__ Facebook Page Timeline, Post by S___W___, 31 January, 4:48 am. See also Murphy S, ""NO MORE CHRISTIAN DOCTORS" Part 3: Religious values." Protection of Conscience Project, March, 2014

54.  Selley C. "Quebec's latest niqab panic." National Post, 23 November, 2013 (Accessed 2014-02-08)

55.  POHRC (2008) (Accessed 2014-03-12)

56.  POHRC (2008), p. 4, column 1 (Accessed 2014-03-12)

57.  Protection of Conscience Project Submission to the College of Physicians and Surgeons of Ontario, Re: Physicians and the Ontario Human Rights Code. 11 September, 2008

58.  Maddock J.W. "Humanizing health care services. The practice of medicine as a moral enterprise." J Natl Med Assoc. 1973 November; 65(6): 501–passim. PMCID: PMC2609038 () Accessed 2014-02-18

59.  Somerville M. "Why are they throwing brickbats at God?" MercatorNet, 1 June, 2007 (Accessed 2014-08-03)

60.  Canadian Medical Association, Code of Ethics (2004): Fundamental Responsiblities No. 1. (Accessed 2014-02-15)

61.  Canadian Medical Association Code of Ethics (2004): "21. Provide your patients with the information they need to make informed decisions about their medical care, and answer their questions to the best of your ability." (Accessed 2014-02-22)

POHRC (2008): "Provide information about all clinical options that may be available or appropriate based on the patient’s clinical needs or concerns. Physicians must not withhold information about the existence of a procedure or treatment because providing that procedure or giving advice about it conflicts with their religious or moral beliefs." (Accessed 2014-03-12)

62.  Murray B. "Informed Consent: What Must a Physician Disclose to a Patient?" American Medical Association Journal of Ethics, Virtual Mentor. July 2012, Volume 14, Number 7: 563-566. (Accessed 2014-02-22)

63.  Canadian Medical Association Code of Ethics (2004): "12. Inform your patient when your personal values would influence the recommendation or practice of any medical procedure that the patient needs or wants." (Accessed 2014-02-22)

POHRC (2008): "Communicate clearly and promptly about any treatments or procedures the physician chooses not to provide because of his or her moral or religious beliefs."(Accessed 2014-03-12)

64.  Canadian Medical Association Code of Ethics (2004): "45. Recognize a responsibility to give generally held opinions of the profession when interpreting scientific knowledge to the public; when presenting an opinion that is contrary to the generally held opinion of the profession, so indicate." (Accessed 2014-02-22)

65.  Canadian Medical Association Code of Ethics (2004): "22. Make every reasonable effort to communicate with your patients in such a way that information exchanged is understood." (Accessed 2014-02-22)

66.  POHRC (2008): ". . .physicians should not promote their own religious beliefs when interacting with patients, nor should they seek to convert existing patients or individuals who wish to become patients to their own religion." (Accessed 2014-03-12)

67.  Singer P. Practical Ethics (2nd Ed.). Cambridge: Cambridge University Press, 1993, p. 3; Kreeft P. Fundamentals of the Faith. San Francisco: Ignatius Press, 1988, p. 74-80. On line (Chapter 11) as "The Uniqueness of Christianity." (Accessed 2007-11-08)

68.  This presumption obviously underlies standard bioethics texts. See, for example, Beauchamp TL, Childress JF, Principles of Biomedical Ethics (7th ed) New York: Oxford University Press, 2013

69.  Benson, I.T., "Seeing Through the Secular Illusion" (July 29, 2013). NGTT Deel 54 Supplementum 4, 2013. (Accessed 2014-02-18)

70.  Chamberlain v. Surrey School District No. 36 [2002] 4 S.C.R. 710 (SCC), para. 137 (Accessed 2014-08-03). Dr. Benson adds: "Madam Justice McLachlin, who wrote the decision of the majority, accepted the reasoning of Mr. Justice Gonthier on this point thus making his the reasoning of all nine judges in relation to the interpretation of ‘secular.’" Benson I.T., "Seeing Through the Secular Illusion" (July 29, 2013). NGTT Deel 54 Supplementum 4, 2013.  (Accessed 2014-02-18)

71.  Submission of the Ontario Human Rights Commission to the College of Physicians and Surgeons of Ontario Regarding the draft policy, "Physicians and the Ontario Human Rights Code." 15 August, 2008. (Accessed 2014-03-11), citing Norton K.C. "Letter to Ontario's Attorney General expressing concern about allowing public officials to refuse to marry same-sex couples." (Accessed 2014-03-11)

72.  Submission of the Ontario Human Rights Commission to the College of Physicians and Surgeons of Ontario Regarding the draft policy, "Physicians and the Ontario Human Rights Code." 15 August, 2008. (Accessed 2014-03-11)

73.  ". . . if, despite being a belief system, secularism is not excluded from the public square, then religious voices should not be excluded on that basis. The mistake is in taking a disjunctive (either secularism or religion) approach to a situation that requires a conjunctive (both this and that, secularism and religion) approach. We need all voices to be heard in the democratic public square." Somerville M. "Should religion be evicted from the public square?" The Warrane Lecture 2011. Kensington, NSW Australia: Warrane College, August, 2011, p. 12. (Accessed 2014-08-02)

74.  Waldron, MA, "Campuses, Courts and Culture Wars." Convivium, February/March 2014, p. 33

75.  The distinction between ethics and morality is mainly a matter of usage. Recent trends identify ethics as the application of morality to a specific discipline, like medicine or law. In a broader and older sense, ethics is concerned with how man ought to live, while the study of morality focuses on ethical obligations. See the entry on "Ethics and Morality" in Honderich T. (Ed.) The Oxford Companion to Philosophy (2nd Ed.) Oxford: Oxford University Press, 2005.

76.  "The question of neutrality has been profoundly obscured by the mistake of confusing neutrality with objectivity... neutrality and objectivity are not the same... objectivity is possible but neutrality is not. To be neutral, if that were possible, would be to have no presuppositions whatsoever. To be objective is to have certain presuppositions, along with the manners that allow us to keep faith with them." Budziszewski J., "Handling Issues of Conscience." The Newman Rambler, Vol. 3, No. 2, Spring/Summer 1999, P. 4.

77.  Murphy S. "Redefining the Practice of Medicine- Euthanasia in Quebec, Part 6: Participation in Killing." Protection of Conscience Project, July, 2014.

78.  Marmor A. Law in the Age of Pluralism. New York: Oxford University Press, 2007, p. 218

79.  Mackay B. "Sign in office ends clash between MD's beliefs, patients' requests." CMAJ January 7, 2003 vol. 168 no. 1 (Accessed 2014-02-16 )

80.  Cannold L. "The questionable ethics of unregulated conscientious refusal."  ABC Religion and Ethics, 25 March, 2011. (Accessed 2013-08-11)

Human Rights Council, Twentieth session, Agenda items 2 and 3: Annual Report of the Office of the United Nations High Commissioner for Human Rights- Technical guidance on the application of a human rightsbased approach to the implementation of policies and programmes to reduce preventable maternal morbidity and mortality (2 July, 20012) para. 61, 30 (Accessed 2013-08-11)

O'Rourke A, De Crespigny L, and Pyman A. "Abortion and Conscientious Objection: The New Battleground" (July 10, 2012). Monash Law Review (2012) Vol 38(3): 87-119. (Accessed 2013-08-18)

Finer L., Fine JB., "Abortion Law Around the World: Progress and Pushback."  American Journal of Public Health, Apr 2013, Vol. 103 Issue 4, p. 585. (Accessed 2013-08-18)

Human Rights Council, 23nd Session - June 3, 2013.  Agenda Item 3: Presentation of Reports by the Special Rapporteur on Violence against Women. "Oral Statement: Center for Reproductive Rights."  (Accessed 20-13-08-11)

81.  Gardner J. "Complicity and Causality," 1 Crim. Law & Phil. 127, 129 (2007). Cited in Haque, A.A. "Torture, Terror, and the Inversion of Moral Principle." New Criminal Law Review, Vol. 10, No. 4, pp. 613-657, 2007; Workshop: Criminal Law, Terrorism, and the State of Emergency, May 2007. (Accessed 2014-02-19)

82.  Haque, A.A. "Torture, Terror, and the Inversion of Moral Principle." New Criminal Law Review, Vol. 10, No. 4, pp. 613-657, 2007; Workshop: Criminal Law, Terrorism, and the State of Emergency, May 2007. (Accessed 2014-02-19)

83.  Murphy S. "Redefining the Practice of Medicine- Euthanasia in Quebec, Part 9: Codes of Ethics and Killing." Protection of Conscience Project, July, 2014.

84.  Email to the Administrator, Protection of Conscience Project, from P__ H__ (present at College Council meeting 18 September, 2008) (2014-02-11, 10:10 am)

85.  Wiesel E. "Without Conscience." N Engl J Med 352;15 april14, 2005 (Accessed 2014-02-24)

86.  Trinity Western University v. College of Teachers, [2001] 1 S.C.R. 772, 2001 SCC 31 (Accessed 2014-07-29)

87.  Cromwell, Oliver, "Declaration of the Lord Lieutenant of Ireland." (January, 1649) Carlyle, Thomas, Oliver Cromwell’s Letters and Speeches, with elucidations. Boston: Estes and Lauriat, 1886, Vol. I, Part 5, p. 18.

88.  This section of the paper draws from an extended discussion of the subject in Murphy S, Geunis S.J. "Freedom of Conscience in Health Care: Distinctions and Limits." J Bioeth Inq. 2013 Oct; 10(3): 347-54 

89.  POHRC (2008), p. 3, column 1 (Accessed 2014-03-12)

90.  POHRC (2008), p. 3, column 1 (Accessed 2014-03-12)

91.  POHRC (2008), p. 3, column 1 (Accessed 2014-03-12)

92.  College of Physicians and Surgeons of Ontario, Agreement with Dr. Stephen Thomas Dawson (2002) (http://www.consciencelaws.org/background/policy/regulators-001.aspx )

93.  POHRC (2008), p. 1, column 1 (Accessed 2014-03-12)

94.  POHRC (2008), p. 3, column 2 (Accessed 2014-03-12)

95.  POHRC (2008), p. 2, column 1 (Accessed 2014-03-12)

96.  POHRC (2008), p. 3, column 2 (Accessed 2014-03-12)

97.  Barbeau et al v. British Columbia (Attorney General) 2003 BCCA 251, para. 133. (Accessed 2008-09-08.) Cited in POHRC (2008) as EGALE Canada Inc. v. Canada (Attorney General) (2003), 13 BCLR (4th) (BCCA).

98.  POHRC (2008), p. 3, column 2 (Accessed 2014-03-12)

99.  Trinity Western University v. College of Teachers, [2001] 1 S.C.R. 772, 2001 SCC 31. (Accessed 2008-09-09)

100.  Trinity Western University v. College of Teachers, [2001] 1 S.C.R. 772, 2001 SCC 31. (Accessed 2014-03-11)

101.  POHRC (2008), p. 3, column 2. (Accessed 2014-03-12)

102.  R. v. Big M Drug Mart Ltd., [1985] 1 S.C.R. 295 (Accessed 2014-03-12)

103.  R. v. Big M Drug Mart Ltd., [1985] 1 S.C.R. 295 (Accessed 2014-03-12)

104.  "The Canadian Charter of Rights and Freedoms guarantees the rights and freedoms set out in it subject only to such reasonable limits prescribed by law as can be demonstrably justified in a free and democratic society." Constitution Act, 1982, Part I: Canadian Charter of Rights and Freedoms, Section 1 (emphasis added).

105.  POHRC (2008), p. 3, column 2, citing Ross v School District No. 15 (1996) 1 SCR 825. (Accessed 2014-03-11) and Syndicat Northcrest v. Amselem, [2004] 2 S.C.R. 551, 2004 SCC 47 (Accessed 2014-03-12)

106.  Ross v School District No. 15 (1996) 1 SCR 825. (Accessed 2014-03-11)

107.  Syndicat Northcrest v. Amselem, [2004] 2 S.C.R. 551, 2004 SCC 47 (Accessed 2014-03-12)

108.  Fernandez-Lynch, Holly, Conflicts of Conscience in Health Care: An Institutional Compromise. Cambridge, Mass.: The MIT Press, 2008, p. xii-xiii (hereinafter "Conflicts.") p. 217-218

109.  Conflicts, p. 217-219, 222

110.  American Medical Association Policy E-2.06: Capital Punishment (June, 1998) (Accessed 2014-08-03)

111.  American Medical Association Policy E.2.067: Torture. (Accessed 2014-08-03)

112.  Lee, Jenny, "Official slams 'sex selection' blood test: Gender of fetus can be seen five weeks into pregnancy." Vancouver Sun, 13 August, 2005. (Accessed 2005-10-10)

113.  "Organ Trade GP suspended." BBC News, 15 October, 2002. (Accessed 2014-08-03)

114.  POHRC (2008), p. 4, column 1. (Accessed 2014-03-12)

115.  POHRC (2008), p. 4, column 1. (Accessed 2014-03-12)

116.  Consultations, College of Physicians of Quebec (Tuesday 17 September 2013 - Vol. 43 no. 34), T#154

117.  Consultations, Tuesday, 17 September 2013 - Vol. 43 no. 34: College of Physicians (Dr. Charles Bernard, Dr. Yves Robert, Dr. Michelle Marchand), T#154

118.  "However rude it may be these days to say so, there are some moral truths that we all really know - truths which a normal human being is unable not to know. They are a universal possession, the emblem of a rational mind, an heirloom of the family of man. That doesn't mean that we know them with unfailing perfect clarity, or that we have reasoned out their remotest implications; we don't and we haven't. Nor does it mean that we never pretend not to know them even though we do, or that we never lose our nerve when told they aren't true; we do, and we do. It doesn't even mean that we are born knowing them, that we never get mixed up about them, or that se assent to them just a readily whether they are taught to us or not. That can't even be said of 'two plus two is four.'" Budziszewski J., What We Can't Not Know: A Guide. Dallas: Spence Publishing, 2003, p. 19.

119.  Murphy S. "Redefining the Practice of Medicine- Euthanasia in Quebec, Part 9: Codes of Ethics and Killing." Protection of Conscience Project, March, 2014

120.  "OMA Urges CPSO to Abandon Draft Policy on Physicians and the Ontario Human Rights Code." OMA President's Update, Volume 13, No. 23 September 12, 2008. "OMA Response to CPSO Draft Policy ‘Physicians and the Ontario Human Rights Code.’" Statement of the Ontario Medical Association, 11 September, 2008.

121.  Carleton University, Centre on Values and Ethics. John R. Williams, Curriculum Vitae. (Accessed 2014-08-03)

122.  Mackay B. "Sign in office ends clash between MD's beliefs, patients' requests." CMAJ January 7, 2003 vol. 168 no. 1 (Accessed 2014-02-16)

123.  Canadian Medical Association Policy: Induced abortion. Approved by the CMA Board of Directors, December 15, 1988. (Accessed 2014-02-21)

124.  Joint Statement on Preventing and Resolving Ethical Conflicts Involving Health Care Providers and Persons Receiving Care (1998) Approved by the Canadian Medical Association, Canadian Healthcare Association, Canadian Nurses' Association, Catholic Health Association of Canada.

125.  General Medical Council (United Kingdom) Personal Beliefs and Medical Practice (2008) (Accessed 2014-08-01)

126.  General Medical Council, Personal Beliefs and Medical Practice (Effective 22 April, 2013) (Accessed 2014-07-31)

127.  Protection of Conscience Project, Submission to the General Medical Council of the United Kingdom Re: Personal Beliefs and Medical Practice: A Draft for Consultation (June, 2013)

128.  United Kingdom Parliament, House of Lords Select Committee on Assisted Dying for the Terminally Ill Bill: Selections from the First Report.

129.  Joint Committee On Human Rights Twelfth Report: Assisted Dying for the Terminally Ill Bill, Para. 3.11 to 3.16. (Accessed 2014-08-01)

130.  "There is no requirement on them any longer to refer the patient to another physician who might be willing to assist. This deals with what I think was a constant concern of many commentators about the Bill, and I think it is right that if a physician has a conscientious objection, he or she should be entitled to withdraw completely. This, of course, applies not only to the physician but to the whole medical team, including the nurses and social workers and everybody involved." United Kingdom Parliament, House of Lords Select Committee on Assisted Dying for the Terminally Ill Bill: Examination of Witnesses (Questions 70 - 79) , Thursday, 16 September, 2004, Q70. (Accessed 2014-08-01)

131.  Director of Public Prosecutions, Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide. February, 2010, para. 43.14 () (Accessed 2014-08-03)

132.  General Medical Council (United Kingdom) Personal Beliefs and Medical Practice. (2008)  (Accessed 2014-07-31)

133.  General Medical Council, Personal Beliefs and Medical Practice (Effective 22 April, 2013) (Accessed 2014-07-31)

 

 

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