Doc­tors on re­li­gious right can’t play God with patient choices

The Sudbury Star - - OPINION | COMMENT - Mman­[email protected]­

On­tario’s top court has ruled for a bal­ance of rights, Michele Man­del says.

Doc­tors can’t just turn their backs on pa­tients seek­ing med­i­cal ser­vices that go against the doc­tors’ re­li­gious views.

The con­sci­en­tious ob­jec­tors don’t have to per­form the dis­puted med­i­cal pro­ce­dure them­selves — whether it’s med­i­cally as­sisted death abor­tion or gen­der re­as­sign­ment surgery — but On­tario’s high­est court has unan­i­mously up­held the re­quire­ment obli­gat­ing physi­cians to re­fer that patient to an­other health-care provider so they can get the care they need.

And no, hand­ing them a phone num­ber for Tele­health isn’t enough.

It’s a wel­come de­ci­sion, es­pe­cially in light of the in­san­ity go­ing on south of the bor­der.

Just this week, 25 men of the Alabama se­nate passed a bill vir­tu­ally ban­ning any abor­tion,

even for a vic­tim of rape or in­cest, ex­cept to save the mother’s life, and even then, a se­cond doc­tor must sign off.

Texas law­mak­ers are con­sid­er­ing not only out­law­ing all abor­tions but also im­pos­ing the death sen­tence on any provider and woman who un­der­goes the pro­ce­dure.

On­tario doc­tors on the re­li­gious right tried to ar­gue their almighty be­lief sys­tem should al­low them to re­strict ac­cess to health care they find morally re­pug­nant: not only abor­tion, birth con­trol and med­i­cally as­sisted death, but also in­fer­til­ity treatments and pre­scrip­tions for erec­tile dys­func­tion medication.

But who made them God? Of course, doc­tors have the right to morally dis­agree with such ser­vices on re­li­gious grounds. They have the right not to per­form them.

But what they don’t have is the right to im­pose their per­sonal views on their pa­tients — es­pe­cially not in a pub­licly funded sys­tem where the care be­ing sought is per­fectly le­gal.

The College of Physi­cians and Sur­geons of On­tario re­quires physi­cians un­will­ing to pro­vide a ser­vice on moral or re­li­gious grounds to of­fer an “ef­fec­tive re­fer­ral” to an­other health-care provider.

The Chris­tian Med­i­cal and Den­tal So­ci­ety of Canada, the Cana­dian Fed­er­a­tion of Catholic Physi­cians’ So­ci­eties, Cana­dian Physi­cians for Life and five doc­tors ar­gued that pol­icy vi­o­lates their free­dom of re­li­gion and con­science pro­tected by the Char­ter.

Last year, the Divi­sional Court unan­i­mously found doc­tors’ rights don’t trump those of their pa­tients.

The On­tario Court of Ap­peal went through a sim­i­lar bal­anc­ing ex­er­cise and has reached the same con­clu­sion.

“Vul­ner­a­ble pa­tients,” wrote Chief Jus­tice Ge­orge R. Strathy on be­half of the three-judge panel, “seek­ing MAiD (med­i­cal as­sis­tance in dy­ing), abor­tion, con­tra­cep­tion and other as­pects of sex­ual health care turn to their fam­ily physi­cians for advice, care and, if nec­es­sary, med­i­cal treat­ment or in­ter­ven­tion. Given the importance of fam­ily physi­cians as ‘gate­keep­ers’ and ‘patient nav­i­ga­tors’ in the health-care sys­tem, there is com­pelling ev­i­dence that pa­tients will suf­fer harm in the ab­sence of an ef­fec­tive re­fer­ral.”

The Chris­tian doc­tor groups had ar­gued that even the sim­ple act of re­fer­ring these pa­tients makes them com­plicit in the “sin” and the most they could do is of­fer a gen­eral in­for­ma­tion num­ber.

But the court rightly found that would un­fairly put the onus on vul­ner­a­ble pa­tients to try to seek out their own care at a dif­fi­cult time.

“This may re­sult in de­lay in ob­tain­ing time-sen­si­tive med­i­cal ser­vices or it may fore­close ac­cess to care al­to­gether. One can rea­son­ably an­tic­i­pate that the loss of the per­sonal sup­port of a trusted physi­cian would leave the patient with feel­ings of re­jec­tion, shame and stigma. Left to their own de­vices when he or she most needs per­sonal sup­port and advice, the patient would be left to ne­go­ti­ate the health sys­tem armed with brochures, tele­phone num­bers and web­sites.”

The de­ci­sion con­cludes: “As mem­bers of a reg­u­lated and pub­licly funded pro­fes­sion, they are sub­ject to re­quire­ments that fo­cus on the pub­lic in­ter­est, rather than their in­ter­ests.”

That may be a cross these doc­tors can­not bear.

If so, it’s time they found an­other call­ing.

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