Ontario Court of Appeal supports ‘effective referral’ for morally contested procedures, including euthanasia


Court unanimously affirms right of state to compel participation in homicide, suicide, etc.

News Release

Protection of Conscience Project

On 15 May, 2019, three judges of the Ontario Court of Appeal unanimously upheld a lower court ruling that physicians can be forced to facilitate procedures they find morally objectionable, including euthanasia and assisted suicide, by connecting patients with willing providers (“effective referral”).

The Court of Appeal judgement concerned a 2018 decision by the Ontario Divisional Court that had been appealed by the Christian Medical and Dental Society of Canada and others. The litigation was a response to a compulsory “effective referral” policy imposed by Ontario’s state medical regulator, the College of Physicians and Surgeons of Ontario.

The Protection of Conscience Project, Catholic Civil Rights League and Faith and Freedom Alliance jointly intervened at trial and in the appeal in support of freedom of conscience.

The Divisional Court and the Court of Appeal both acknowledged the joint intervention, but neither considered the arguments it proposed because the case was decided solely on the basis of freedom of religion claims. The Court of Appeal held that the evidence at trial was “insufficient to support an analysis of freedom of conscience.”

“To the extent the individual appellants raise issues of conscience,” said the Court, “they are inextricably grounded in their religious beliefs,” so that, “at its core, the appellants’ claim is grounded in freedom of religion.”[para. 85]

Since the arguments in the Project’s intervention were not addressed at trial or in the appeal, Project Administrator Sean Murphy believes that they are unaffected by the decision.

“The focus of the Court was on religiously-motivated refusal to participate in perceived wrongdoing,” said Murphy. “The analytical framework proposed in the joint intervention could easily have been adapted and applied to that particular form of the exercise of religious freedom. The evidentiary record would have been sufficient for that purpose.”

“However, the Court did not do this, so the arguments still stand, and they can be raised again in another appropriate case.”

The decision demonstrates that the judges uncritically adopted the view of the College that euthanasia, assisted suicide, abortion, contraception, sterilization, sex change surgery, etc. are acceptable forms of medical treatment or health care. They further noted that abortion, euthanasia and assisted suicide “carry the stigmatizing legacy of several centuries of criminalization grounded in religious and secular morality.” [para. 123]. On the other hand, they gave no weight to contrary views held by the plaintiffs.

The Court of Appeal also supported the College’s assertion that objecting physicians unwilling to comply with the demand for effective referral could change their scope of practice and move into fields like “sleep medicine, hair restoration, sport and exercise medicine, hernia repair, skin disorders . . . obesity medicine, aviation examinations, travel medicine . . . administrative medicine or surgical assistance.”[para. 71]

The appellants have 60 days to consider and appeal to the Supreme Court of Canada.

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Contact: Sean Murphy, Administrator
Protection of Conscience Project
Email: protection@consciencelaws.org

Canada’s bishops allow Catholic hospitals to host consultations for euthanasia

LifeSite News

Lianne Laurence

OTTAWA, April 18, 2019 (LifeSiteNews) – Canada’s bishops were consulted on and agreed to secret guidelines by Catholic health sponsors that allow third-party euthanasia assessments of medically frail patients in Catholic health care facilities, LifeSiteNews has learned.

And while the Catholic health sponsors who drafted the guidelines in collaboration with ethicists and bishops concluded such assessments were not formal cooperation with evil, they failed to consider there are instances when material cooperation is gravely wrong, as is the case here, says Catholic moral theologian, Dr. E. Christian Brugger. . . [Full text]

No agreement and disappointment after lengthy End of Life Choice bill hearing

Stuff

Ruby Macandrew and Thomas Manch

It took 16 months, almost 40,000 submissions, and a nationwide tour of 14 cities.

The result was a report that found no agreement on whether the End of Life Choice Bill should be passed, made no substantive recommendations, drew few conclusions and disappointed those on both sides of a hard-fought debate.

Both advocates and opponents of the bill – which seeks to legalise voluntary euthanasia – have resumed their default positions for a familiar battle that will span months to come.

The report, tabled in Parliament on Tuesday, did not address any contentious aspects of the prospective law, with the eight Justice Select Committee MPs declining to “consider substantive policy issues on a conscience bill”. . . [Full text]

Study Reveals Alarming Statistics on Nurse Burnout

nurse.org

Chaunie Brusie

Healthcare market research and consulting company PCR recently announced the results of its National Nursing Engagement Report. The report was based on survey findings from over 2,000 healthcare partners and revealed key data about nurses in the workforce today, as well as what the future will hold for nurses and how hospital administrators can help support nurses going forward.

The Buzz on Nurse Burnout

One of the main focuses of the study was to examine how many nurses in the workplace today report feeling burned out. According to the report, 15.6% of all nurses reported feelings of burnout, with the percentage rising to 41% of “unengaged” nurses. . . . [Full text]

Protection of conscience bill passes in Indiana

Sean Murphy*

Indiana Senate Bill 201, proposed by Senator Liz Brown, passed the Indian Senate by a vote of 38-8 and will be sent to Goveror Eric Holcomb for signature. Existing Indiana law protects freedom of conscience for physicians, nurses and institutional employees in relation to surgical abortion. Bill 201 amends the statute to include medical abortion and extends protection to physician assistants and pharmacists.

Pope Francis: Freedom of conscience in danger in ‘Christian countries’

Catholic News Service

Courtney Grogan

Rome, Italy, Mar 31, 2019 / 03:45 pm (CNA).- Pope Francis decried the regression of freedom of conscience in “Christian countries” during an in-flight press conference Sunday, telling reporters on his return trip from Morocco, “let’s not accuse Muslims”.

When asked by a French reporter about a criminal law in Morocco that prohibits enticing a Muslim to convert to another religion, Francis responded, “Let’s not accuse Muslims. Let’s accuse also ourselves.”

“Today, we Christians have the danger that some governments will take away our freedom of conscience, which is the first step toward freedom of worship,” Pope Francis said March 31.

“Think of the Christian doctors and hospital institutions that do not have the right of conscientious objection, for example, for euthanasia. How? The Church has moved on and you Christian countries go backwards?” he told the French reporter. . . [Full text]

Doctors threaten legal action in abortion services row

The Business Post

Francesca Comyn

The issue of GP-led abortion services has proved highly contentious for various reasons including conscientious objection, workload and an existing services contract perceived by many to be sub-standard

The professional body for GPs is facing the threat of legal action from its members if it does not row back on its refusal to hold and extraordinary general meeting on the provision of abortion services. . .[Full text]

Bishops condemn bills to expand abortion, repeal conscience protection

Catholic News Service

Jacob Comello

The bishops from Illinois’ six dioceses March 28 made a decisive stand against state legislators’ efforts to remove all abortion restrictions in the state, as well as the right of physicians to object to the practice.

At a news conference livestreamed from the Illinois Capitol in Springfield, Catholic Conference of Illinois Director Bob Gilligan told reporters on no uncertain terms that “we are here today to oppose these bills.”

. . . The Senate and House bills Gilligan is referring to are S.B. 1942 and H.B. 2495. Either, if passed, would greatly alter current Illinois law. . . . [Full text]

Right to Conscientious Objection to Abortion Burning Issue in Croatia

Total Croatia News

HINA

ZAGREB, March 27, 2019 – Health Minister Milan Kujundžić on Wednesday called for compliance with the legislation when it comes to honouring the right to conscientious objection concerning the issue of abortion, while at the same time that procedure should be made available.

“Anything that is in contravention with ethical and moral principles deserves condemnation,” Kujundžić said, and commenting on the case of a woman in Dubrovnik who underwent an abortion procedure without anaesthesia due to the anaesthesiologist’s refusal to participate in the procedure, the minister said that the hospital should have engaged other doctors in such cases when their colleagues invoke the conscientious objection clause which allows them to refuse to participate in the termination of pregnancy. . . [Full text]

Australian Medical Association Updates Advice to Doctors with Conscientious Objections

News Release

Australian Medical Association

The AMA has released its updated Position Statement on Conscientious Objection 2019 (replacing the Position Statement on Conscientious Objection 2013). The policy was reviewed as part of the AMA’s routine, five-year policy review cycle.

A conscientious objection occurs when a doctor, as a result of a conflict with his or her own personal beliefs or values, acknowledges that they cannot provide, or participate in, a legal, legitimate treatment or procedure that would be deemed medically appropriate in the circumstances under professional standards.

A conscientious objection is based on sincerely-held beliefs and moral concerns, not self-interest or discrimination.

AMA President, Dr Tony Bartone, said today that doctors are entitled to have their own personal beliefs and values, as are all members of the community.

“However, doctors have an ethical obligation to minimise disruption to patient care and must never use a conscientious objection to intentionally impede patients’ access to care,” Dr Bartone said.

The AMA advises that a doctor with a conscientious objection should:

  • inform the patient of their objection, preferably in advance or as soon as practicable;
  • inform the patient that they have the right to see another doctor and ensure the patient has sufficient information to enable them to exercise that right;
  • take whatever steps are necessary to ensure the patient’s access to care is not impeded;
  • continue to treat the patient with dignity and respect, even if the doctor objects to the treatment or procedure the patient is seeking;
  • continue to provide other care to the patient, if they wish;
  • refrain from expressing their own personal beliefs to the patient in a way that may cause them distress;
  • inform their employer, or prospective employer, of their conscientious objection, and discuss with their employer how they can practise in accordance with their beliefs without compromising patient care or placing a burden on their colleagues; and
  • always provide medically appropriate treatment in an emergency situation, even if that treatment conflicts with their personal beliefs and values. 

Changes since 2013

The tone and emphasis of the Position Statement has been amended. Rather than taking a prescriptive line, the Position Statement now takes a reflective approach where a doctor is asked to focus on what really should matter the most: the impact of their decisions on the patient in front of them.

A new statement has been included that an objecting doctor should be aware that certain treatments or procedures are time critical.

A new section on institutional conscientious objection has been included. It advises institutions that do not provide particular treatments or procedures due to institutional conscientious objection to inform the public of this so (potential) patients can seek care elsewhere. This section also advocates that a doctor working within such an institution should be allowed to refer a patient (already admitted) who seeks such a service to another doctor outside the facility.

The AMA Position Statement on Conscientious Objection 2019 is at https://ama.com.au/position-statement/conscientious-objection-2019


CONTACT:        John Flannery                     02 6270 5477 / 0419 494 761

                            Maria Hawthorne               02 6270 5478 / 0427 209 753