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Column: Should doctors have the right to refuse you?

When a physician has a moral objection to a particular treatment, where does that leave patients?
Northern Life and Managing Editor Mark Gentili weighs in on whether doctors should have the right to refuse to provide treatment.

There’s an interesting court case being heard in Ontario right now.

Five doctors and three professional organizations that represent physicians are fighting a policy put in place by the College of Physicians and Surgeons of Ontario (CPSO) that says doctors who have a moral or religious objection to a certain treatment or service sought by a patient can refuse, but only if they refer that patient to another physician who won’t.

The dispute raises a couple of good questions: Should doctors, under any circumstances, have the right to refuse to provide a treatment on religious or moral grounds? And, when doctors and patients are at moral odds, whose rights have trump: the patient seeking treatment or the doctor who has an ethical and professional duty to provide care?

We’re talking about legitimate medical procedures here. We’re not talking about physicians refusing to provide magnet therapy, energy treatments or any other form of quackery.

What we’re talking about, mainly, is abortion, physician-assisted dying and contraception. You’ll note that two of those three target, for the most part, female patients.

This fight has actually been waged, off and on, for about a decade. Back in 2008, the college took a pretty hard stance on the issue, saying, in effect, doctors had to check their personal beliefs at the door when it comes to providing a treatment with which they have a moral or religious objection.

In a society such as ours where individual rights are held in high regard, the balancing of one individual’s rights against another’s is especially delicate. The college’s heavy-handed approach in 2008 ignored doctors’ individual rights, so it shouldn’t be surprising that hard stance was met with a backlash, including from the Ontario Medical Association. And as a result, the CPSO softened its position.

That softening amounted to the current policy mentioned above, under which the doctor can refuse on moral or religious grounds only if a referral is provided. 

To me, that’s reasonable. It ensures patients’ rights and needs are respected, while ensuring a physician isn’t breaching his or her own sincerely held beliefs. That’s what compromise is all about, and it’s win-win, as far as I’m concerned.

But then along came these five doctors and three religious-based professional physicians organizations: the Christian Medical and Dental Society of Canada, the Canadian Federation of Catholic Physicians and Canadian Physicians for Life.

They don’t like the referral policy. They seem to be of the mind that providing a referral for a treatment they disagree with makes them morally culpable. Personally, I think that’s a real stretch. If the court agrees, it would, in effect, be saying the beliefs of the doctor outweigh the needs of the patient.

That, to me, is not only untenable, it’s wrong.

The rights of both the doctor and the patient must be respected, and the college’s referral policy does just that. It protects a doctor from having to do something to which he or she has a deep moral objection, while ensuring patients can still receive a treatment to which they are entitled.

That last phrase is key. Abortion, contraception and physician-assisted dying may be morally divisive, but they are legal and acceptable in Canadian society.

Like it or not, women in Canada have the right to determine what happens to their own bodies, and that includes ending an unwanted pregnancy. Women in Canada have a right to have sex without worrying about an unwanted pregnancy. Canadians have a right to seek to end their life, in a medical setting, if certain criteria are met.

You can disagree all you want with the morality or legality, but what you can’t do (or shouldn’t be allowed to do) is force another to live according to your moral code. Why should a doctor’s belief about these procedures carry more weight than a patient’s right to seek them out? The referral policy is a fair compromise.

Allowing doctors to opt out, as it were, would elevate the rights of one group over another. That’s just plain wrong.

And if doctors don’t like it, well perhaps it’s time for a career change. People go to doctors to receive health care, not lessons in the doctor’s morality. The court case is ongoing. It will be interesting to see how it plays out.


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Mark Gentili

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