Med­i­cal pro­fes­sion­als dragged into difficult po­si­tions

Prairie Post (East Edition) - - News -


The de­bate around in­di­vid­ual rights in Canada is com­pli­cated and emo­tion­ally-charged. I can think of no bet­ter ex­am­ple than the dis­cus­sion in re­cent months around the sanc­tity of con­science rights, par­tic­u­larly those of med­i­cal pro­fes­sion­als.

Con­science forms the ba­sis of a med­i­cal pro­fes­sional’s mo­ti­va­tion to pur­sue their par­tic­u­lar field.

Doc­tors prac­tice ev­ery day with the knowl­edge that it is their con­science that mo­ti­vates them to test the lim­its of their ex­per­tise and skill. They know that patient care will suf­fer if they are de­prived of the abil­ity to live with in­tegrity and fol­low their con­science. They know the im­por­tance of these be­liefs to them­selves and their pa­tients far bet­ter than any­one else.

For a great many Cana­dian doc­tors, the core of their con­science pro­hibits their par­tic­i­pa­tion in tak­ing a life. In­deed, many doc­tors re­main devoted to the black and white of the an­cient Hip­po­cratic Oath - a pledge which pro­hibits the ad­min­is­tra­tion of a poi­son to any­one.

In Canada, the re­al­ity is that the pro­vi­sion of a life-end­ing ‘poi­son’ is now per­mit­ted by the law of the land. Three years ago, tak­ing a patient’s life through med­i­cal means was cul­pa­ble homi­cide. Doc­tors were not ob­li­gated by any means to pro­vide these ser­vices to pa­tients. In 2016, these once un­wa­ver­ing rights were rad­i­cally chal­lenged through the Lib­eral gov­ern­ment’s le­gal­iza­tion of physi­cianas­sisted sui­cide, or med­i­cal as­sis­tance in dy­ing (MAiD), through bill C-14. The Lib­er­als’ at­tempt to pro­vide pro­tec­tion for doc­tors con­sisted solely of a rudi­men­tary clause which stated that “noth­ing... com­pels an in­di­vid­ual to pro­vide or as­sist in pro­vid­ing med­i­cal as­sis­tance in dy­ing.”

How­ever, this pro­vi­sion lacked the teeth needed for its effective en­force­ment, as ev­i­denced by the on­go­ing pres­sure ex­erted on physi­cians by their reg­u­lat­ing bod­ies.

It should be noted that even the premise of C-14 – the Supreme Court of Canada’s Carter v. Canada de­ci­sion – ex­plic­itly said that the le­gal­iza­tion of euthana­sia did not en­tail a duty of physi­cians to pro­vide it. De­spite this as­sur­ance, as­sisted sui­cide/euthana­sia now ex­ists in this coun­try and, while the law now per­mits it, many doc­tors’ con­sciences will not.

Through the availabili­ty of as­sisted sui­cide on-de­mand across Canada, threats to con­science are no longer con­fined to the rhetoric of the court room – they are in­creas­ingly present in the ex­am­i­na­tion room.

That is why I be­lieve it is time to take action in de­fence of con­science rights that have stood the test of time for gen­er­a­tions. My Pri­vate Mem­ber’s Bill, C-418, seeks to amend the Crim­i­nal Code to make it an offence to in­tim­i­date a med­i­cal prac­ti­tioner, nurse prac­ti­tioner, phar­ma­cist or any other health care pro­fes­sional for the pur­pose of com­pelling them to take part, di­rectly or in­di­rectly, in the pro­vi­sion of physi­cian-as­sisted sui­cide.

C-418 would also make it an offence to dis­miss from em­ploy­ment or to refuse to employ a med­i­cal prac­ti­tioner, nurse prac­ti­tioner, phar­ma­cist or any other health care pro­fes­sional for the rea­son only that they refuse to take part, di­rectly or in­di­rectly, in the pro­vi­sion of physi­cian-as­sisted sui­cide. My bill would pro­vide the teeth that C-14 acutely lacks.

Are these pro­tec­tions nec­es­sary? You bet. Through­out the leg­isla­tive process, I have spo­ken with doc­tors who feel overt pres­sure to leave fam­ily medicine be­cause of their con­sci­en­tious be­liefs. I have heard of pal­lia­tive care doc­tors in On­tario who have stopped prac­tic­ing al­to­gether.

Nurses feel in­creas­ingly bul­lied, choos­ing to shift their fo­cus or re­tire early. The pres­sure on these pro­fes­sion­als ex­ists, and they are look­ing for re­lief.

What is more, re­gional as­so­ci­a­tions, such On­tario’s Col­lege of Physi­cians and Sur­geons, have in­tro­duced regulation­s com­pelling con­sci­en­tiously-ob­ject­ing physi­cians to par­tic­i­pate by pro­vid­ing ‘effective referrals’ for physi­cian-as­sisted sui­cide. A re­cent court de­ci­sion has up­held this di­rec­tive, con­tra­ven­ing the as­sur­ances pro­vided in Carter v. Canada and cre­at­ing an even more ur­gent need among physi­cians for pro­tec­tion.

My bill does not ad­dress the so­cial ac­cept­abil­ity of euthana­sia and as­sisted sui­cide. Pro­tect­ing physi­cians’ con­science rights is not at all a physi­cian vs. patient sce­nario. By pro­tect­ing physi­cians’ con­science rights and re­ly­ing on them as the ex­perts, pa­tients’ rights are en­hanced. C-418 is about pro­tect­ing the fun­da­men­tal free­dom of con­science and re­li­gion guar­an­teed to all Cana­di­ans in the Char­ter of Rights and Free­doms.

Par­lia­men­tar­i­ans from all par­ties can­not ig­nore the groundswel­l of sup­port my bill, C-418, has re­ceived from across Canada.

Cana­di­ans be­lieve it is time to stand up for doc­tors and health care providers who aren’t will­ing to leave their core ethics be­hind when they’re at a patient’s bed­side.

David An­der­son, Grass­lands MP

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