Beliefs trump care, survey concludes
Majority backs a doctor’s right to deny treatment
A slight majority of Canadians believe doctors should have the right to deny a patient a medical treatment based on moral or religious beliefs, the nation’s biggest medical licensing authority is discovering.
More than 14,000 individuals have responded so far to an online poll conducted by the College of Physicians and Surgeons of Ontario as part of a review of its policy on doctors and Ontario’s human rights code.
The unscientific “quick poll,” open to the public and members of the profession, asks whether physicians “should be allowed to refuse to provide a patient with a treatment or procedure because it conflicts with the physician’s religious or moral beliefs.”
As of Wednesday, 14,207 individuals had voted. Of those, 56 per cent support allowing doctors to restrict medical care based on their personal beliefs while 43 per cent are opposed. One per cent said they “don’t know.” The college has received 742 comments as well on the discussion forum, and is inviting public feedback until Aug. 5 on its website (cpso. on.ca).
“This is clearly an issue of relevance to both the public and members of the profession,” said college spokeswoman Kathryn Clarke, who called the amount of feedback “exceptional.” The college last year began promoting its public consultations using Twitter and Facebook, in addition to its website and Dialogue magazine.
But the debate has been stoked by headlines involving doctors in two Canadian cities denying medical care on religious grounds.
Last month, the Calgary Herald reported a doctor working at a walkin clinic was refusing to prescribe contraception due to her personal beliefs. A sign in the window at the Westglen Medical Centre informed patients “the physician on duty today will not prescribe the birth control pill.” Patients looking for the pill were provided with a list of other clinics willing to prescribe it.
In January, the Ottawa Citizen re-
This is clearly an issue of relevance to the public KATHRYN CLARKE
ported that three family doctors were refusing to provide birth control pills, or any form of artificial contraception, including the “morning after” pill, saying in letters to patients that doing so conflicts with their “medical judgment, professional ethical concerns and religious values.”
On the College’s discussion page, one member of the public wrote, “If I come to you for medical care, I expect to get the scientifically determined best care for my condition. If you can’t or won’t provide it because of your beliefs, find a new job.”
One physician said he would never ask a patient “to act against her own conscience when making difficult choices about treatment. Who do you think you are to make me, because I have chosen a profession in the service of others, act against mine?”
The College’s current policy, approved in 2008, sets out a doctor’s legal obligations under the Code as well as the college’s expectations “that physicians will respect the fundamental rights of those who seek their medical services.”
When it comes to moral or religious beliefs, the policy advises doctors to “proceed cautiously,” warning that restricting medical services based on moral or religious beliefs may be “contrary to the Code.”
Canadian ethicist Arthur Schafer said doctors and other health-care providers should be allowed to exercise “conscientious objection.”
“But that’s not an absolute right,” said Schafer, director of the University of Manitoba’s Centre for Professional and Applied Ethics.
What trumps that right are the life and health of the patient, he said. In addition, he said a doctor who announces on a sign a religious objection to birth control pills isn’t just refusing to provide a patient with a prescription they might get from another clinic across the street.
“She’s saying, ‘I have certain religious scruples and I don’t believe in sex outside marriage and I don’t believe in artificial birth control because my church teaches that it’s wicked.’
“That means that you can’t give them counselling. It means you can’t perform the most fundamental health promotion and disease prevention function in a big domain — the domain of sexual activity — for anyone who is having sex outside marriage, or for anyone who wants to use an IUD or condom or birth control pill,” Schafer said. “She’s not fit to be a family doctor. That sign in her office says, ‘don’t talk to me about condom use or sexually transmitted diseases. In fact, don’t talk to me about anything that might lead me to condemn you as a morally unfit person.’”