Protection of Conscience Project
Protection of Conscience Project
Service, not Servitude

Service, not Servitude

Physicians and the Ontario Human Rights Code

Ontario Human Rights Commission attempts to suppress freedom of conscience (August-September, 2008)

Letter to the College of Physicians and Surgeons of Ontario

Reproduced with permission
Timothy E. Lau M.D. F.R.C.P.(C), MSc.
Assistant Professor, Faculty of Medicine, University of Ottawa
Department of Psychiatry, Geriatrics, Royal Ottawa Hospital
August 15, 2008

Dr. Preston Zuliani
Chair, Executive Committee
College of Physicians & Surgeons of Ontario

Dear Dr. Zuliani,

I understand that the Ontario College has developed a new draft policy entitled Physicians and the Ontario Human Rights Code and has asked for feedback on this important topic by August 15 2008.

I am deeply concerned that while the draft document includes the statement that appears to recognize that religious and moral beliefs are central to the lives of physicians and their patients, I am worried that the interpretation of what is meant by the statement that "there will be times when it may be necessary for physicians to set aside their personal beliefs in order to ensure that patients or potential patients are provided with the medical services they require."

I am worried specifically about 1) "potential patients" and 2) "medical services they require."

With regards to potential patients, are you referring to an obligation to patients we have not attended to or have accepted the care of. Practically this could include any person who wants to see you, even in a non-emergency situation, even though you feel strongly no therapeutic relationship is possible. This would include even if you felt threatened by them. Imagine if you were a Jew and your 'potential' patients were blatantly anti-Semitic, or if they knew you were Catholic and they held a personal grudge against the Church. They may demand something of you, not so much because they want it, but because they do not want you to practice your faith because of their distain for it. With regards to required medical services, who defines this? What about if the physician disagrees with them about what is required or necessary.

I will use four cases which will illustrate some of my concerns.

1) Euthanasia
2) Abortion
3) Drug addiction
4) Gender identity disorder

Case 1. 78 year old male who has a chronic illness and is severely suffering. Hypothetically speaking, the private members bill that has already been introduced by a Bloc MP, has been passed. The man is a member of the Hemlock Society. He demands to be put out of his misery. The person in this scenario could have a chronic treatment resistant depression. The physician disagrees but now is forced to either kill the man or refer him to someone who will.

Case 2. 38 year old woman who is in her third trimester of her pregnancy. She discovers during her second ultrasound that the baby is a girl. She overheard her boyfriend say he would marry her since she was carrying his son. She believes her boyfriend only wants a boy, therefore she wants an abortion. Although most physicians in Ontario have moral/ethical problems with abortions after 20 weeks, and practically are reluctant to perform them (they are sent quietly to a clinic in the US at the taxpayers expense), the patient reads the new draft of the College and demands that you end the life of her baby. They discover you are a practicing (Jew, Christian, Muslim etc) and are therefore compelled to believe they are being discriminated against.

Case 3. 24 year old male heroine drug addict that wants narcotics and believes that harm reduction is the way to go. Unfortunately, he has been seeing many doctors for "harm reduction" at many clinics and you suspect he is selling the narcotics. He is increasingly threatening and you are afraid of him. You believe the best thing for him would be an abstinence based approach similar to the twelve steps program, which has a spiritual foundation. He not only threatens you but says you are not respecting hi complaint with the College and the Human Rights Commission as he is an atheist that rejects the twelve steps.

Case 4. 32 year old man who believes he is a woman. He is physically attracted to men. He has depression, an anxiety disorder, and a substance use disorder. He feels needs to have surgery to become a woman and be complete. As a physician you feel he needs to see a psychiatrist. He is convinced you are impinging on his rights and accuses you of discrimination. He reads the new college policy and makes a complaint to both the human rights commission and disciplinary board of the CPSO. He feels the treatment is necessary, indicated and required.

Please reconsider forcing physicians to go against their conscience. With the a new euthanasia bill on the horizon and the lack of any limitation to abortion for any reason or at any stage, it is clear to me that taking this stand will endanger the principled, conscientious, and responsible care of our patients, not just now but in the years to come.


Tim Lau, MD,