one province, one public healthcare system
conscientious objections in healthcare
Public services that are intended for the whole community, especially those funded by public money, should be provided in a secular context.
Challenging Alberta's Religious Privilege
As it stands now, Alberta doctors who don't want to perform certain services must refer the patient to someone or to a service that can
The Refusal to Provide Health Care in Canada
A Look at “Conscientious Objection” Policies in Canadian Health Care
Many people may be unaware that in Canada, doctors have the “right” to refuse to provide legal and necessary treatments based on their personal or religious beliefs. Further, doctors usually don’t even have to refer patients to someone who can provide the objected-to service. This permitted abandonment of patients is not monitored and there are rarely any repercussions for doctors who may cause harm to patients as a result.
Alberta College The College adopts the CMA Code of Ethics and Professionalism, but also has a Conscientious Objection policy that requires objectors to refer patients to someone who can provide the service, OR to a resource that will provide accurate information on options. This means that no effective referral is required. CPSA Code of Ethics and Professionalism: 30 A regulated member must comply with the CMA Code of Ethics & Professionalism adopted by the College in accordance with section 133 of the Health Professions Act and the College bylaws.
Conscientious Objection (June 2016): 31 1. A regulated member must communicate promptly and respectfully about any treatments or procedures the regulated member declines to provide based on his/her Charter freedom of conscience and religion. 2. A regulated member must not withhold information about the existence of a procedure or treatment because providing that procedure or giving advice about it conflicts with his/her Charter freedom of conscience and religion. 3. A regulated member must not promote his/her own moral or religious beliefs when interacting with patients. 4. When Charter freedom of conscience and religion prevent a regulated member from providing or offering access to information about a legally available medical or surgical treatment or service, the regulated member must ensure that the patient who seeks such advice or medical care is offered timely access to: a) a regulated member who is willing to provide the medical treatment, service or information; or b) a resource that will provide accurate information about all available medical options. The second option to refer to a “resource” that can provide “accurate information” can be used as an escape clause by refusers. Information is not care, and the definition of “accurate information” can mean something different to an anti-choice physician who is convinced that abortion harms women. The Alberta College’s Medical Assistance in Dying32 Standard of Practice states that refusers “must ensure that reasonable access to the Alberta Health Services medical assistance in dying care coordination service is provided to the patient without delay.” This is basically an effective referral, although to a MAiD coordination agency33 rather than a MAiD physician.
Conflict with Anti-discrimination Clauses Policies that allow belief-based treatment refusals conflict directly with anti-discrimination clauses in the ethical codes of the CMA and most provincial Colleges of Physicians and Surgeons. These clauses generally prohibit refusal to treat for reasons of medical condition or illness, gender/sex, and other grounds (ethnicity, disability, etc). Belief-based treatment refusals in reproductive health care are discriminatory because such care is largely delivered to women and the LGBTQI2S+ community, especially abortion care. Unwanted pregnancy is a medical condition, for which the standard of care is induced abortion. Refusal to provide MAiD due to personal beliefs is also discriminatory based on grounds of the patient having
Religion and science are arguably two of the most powerful drivers in human existence. Many consider them different types of truth and both valid while others try to combine them or reject one for the other. Faith-based rejection of medical care has cost the lives of many including children and poses challenges to providers.
MLA Dan Williams (Peace River), has introduced the “Conscious Rights (Health Care Providers) Protection Act” in Alberta, so that “Health care providers should never have to choose between their most deeply held beliefs and their jobs”.
The bill has now passed the first reading and will now go to a standing committee.
“Under this new bill, doctors will be able to refuse to both treat and offer referrals to patients for healthcare to which they are personally morally opposed”
Under this new bill, doctors will be able to refuse to both treat and offer referrals to patients for healthcare to which they are personally morally opposed. This could include things like abortion or birth control.
When you make the decision to go spend years of your life working towards becoming a doctor in a country where abortion is legal, it’s something a patient may ask you for a referral for. You have a responsibility to provide that care, and frankly, it’s something you should have considered over your many years of schooling if that belief is so deeply held. Likewise for birth control.
When you choose to practice medicine, you are choosing to swear an oath and to provide care to other people. Please consider what that means before you enter the field, and if it isn’t right for you, find a different career.
Religious belief is on the decline in the U.S., and medical knowledge is on the increase. This makes it particularly ironic that so much of our health care system is accountable at the highest levels not to science or patient preference but to the dictates of faith and of theology. Metaphorically, more and more medical decisions get made with the Catholic Bishops in the room, regardless of whether the patient wants them there. Not only that, but the Bishops have a religious veto that can trump both doctor and patient.
Thanks to corporate mergers and laws that privilege religious institutions, many communities across the United States have few or no secular options when it comes to medical care and no legal mandate that patients be told about the full range of medically appropriate services. In Washington State, to cite one egregious example, almost half of hospital beds and affiliated care systems fall under the authority of the Catholic Church, and many counties have no alternative.
Let’s be clear why this creates an irreconcilable conflict of interest. A medical system with religious authorities and corporations at the top means the following:
· Patients kept in ignorance about the full range of medically appropriate treatments if some of these are judged to violate the theology of the provider or institution
· Providers who don’t get continuing education about medical advances that a religious hierarchy disapproves
· Pharmacies that don’t stock drugs and devices that religious owners disapprove of
· Public health dollars used to promote specific religious beliefs and the notion that “faith” is a reasonable way of determining what medical care should be provided
· A medical culture that denies the very methods of science: evidence, hypothesis testing, and accountability
· Religious institutions or individual believers given a religious veto over the deeply personal medical decisions of individual patients
· Couples denied the means to time their childbearing, which leaves more families mired in poverty
· Less prenatal diagnosis and a greater percent of children born with birth defects
· Families stripped of decision making power after tragic accidents because “every life is sacred”
· Dead women kept on life support as human incubators
· Higher costs to families for health treatments that are excluded from insurance
· A growing number of religious health professions who demand to keep their jobs without fully doing their jobs
· Religious allied health professionals second guessing doctors’ orders and patient requests
· A powerful lobby undermining anti-discrimination laws that protect queers and females
· A powerful lobby advocating exemptions to living wage laws and worker rights
· Soaring public health costs as a consequence of religious meddling in end of life and beginning of life decisions
The fact that religion has the final say in so much of our healthcare system is an artifact of history.
Religion may not poison everything, as the late Christopher Hitchens alleged, but it can poison healthcare. And from there the poison seeps into society more broadly, because in order to maintain their privilege in the healthcare system, Churches and Religious corporations fight legal battles that undermine human rights in society at large. They have argued that the conscience rights of institutions and corporations should be able to trump individual conscience. They have challenged anti-discrimination laws, and won, effectively establishing legal precedent that freedom from discrimination is not a constitutional right. They have argued that they should be exempt from labor organizing because giving workers the right to organize impinges on their sovereignty. Driven by dogma, lawyers find circuitous arguments and judges uphold “rights” that under any other light would look patently immoral.