In a recent column on the CBC website, Brian Bird, an assistant professor of law at the University of British Columbia, argued: “It has long been accepted that health-care workers in Canada have a right to distance themselves from procedures that they consider unethical.”
Here are some examples he gave of medical professionals being forced, as he sees it, to give up their freedom of conscience.
The Irene Thomas Hospice in Delta was shut down last April after it refused to permit terminally ill residents to have medical assistance in dying (MAID).
The facility cited religious objections, but as a consequence, elderly residents would have been forced to give up their final place of residence and move to an unfamiliar setting to die.
What kind of conscience can live with that? The facility has since been reopened by the Fraser Health Authority under new leadership.
Next, Brian Bird complains that a court in Ontario ordered that, as he put it, “doctors can be forced to facilitate procedures they deem immoral.”
In fact, the court determined that in certain circumstances, physicians do not have to participate in procedures they oppose. Instead, as a compromise, the court ruled they would have to provide a referral to a doctor who is willing to perform the procedure in question.
Bird renders this perfectly reasonable middle ground thus: “If you believe it is wrong to rob a bank, would you be willing to plan the robbery?”
He then protests that a medical student at the University of Manitoba was expelled after posting on Facebook that doctors who perform abortions should be charged with first-degree murder.
The student also claimed that abortion can be likened to the “Final Solution,” a reference to Nazi Germany’s extermination of Europe’s Jews.
Now, in fact, the Manitoba Court of Queen’s Bench upheld the student’s appeal, ruling the university’s disciplinary committee failed to grant the student due process. His case is to be re-examined.
But ask yourself, is someone fit to practise medicine who considers his soon-to-be colleagues murderers who should go to prison?
Let’s return to what I believe is the crux of the matter.
First, people who choose to train as medical professionals (or indeed members of any profession) thereby accept the ethical standards of the profession in question. They don’t get to impose their own views about how its rules apply.
What about that Ontario court ruling? Two procedures in particular were central: MAID and medically assisted abortion.
Laughably, one of the groups demanding “freedom of conscience” argued: “There is no evidence that patients would be harmed by not receiving a referral.”
Do these people not understand how difficult it is to find any kind of physician these days, far less a stand-in?
Those of us in B.C. who worked in health care during the early 1990s recall the successive attempts to kill Dr. Garson Romalis, a Vancouver gynecologist who worked in an abortion clinic.
We recall the crowds of screaming protesters who gathered at the doors of such clinics, and subjected arriving women to a gauntlet of abuse.
These protests were quieted by legislation establishing safe zones around the clinics. At the time, legal experts warned the statute would be ruled unconstitutional.
But the Supreme Court of Canada thought otherwise. It decided (uncontroversially, I would have thought) that women had a right to be safeguarded when attending a medical clinic.
Now we have a law professor reopening the whole debate, no doubt unintentionally, by questioning the moral foundations of this and other professionally accredited, lawful procedures. No good can come of that.
To be fair, I think it sometimes is OK for a doctor or nurse to cite moral objections if an alternative is readily available. There is no need to be heavy-handed.
But when it comes to determining the ethical principles underlying the practice of medicine, that responsibility rests with the profession’s oversight body — the College of Physicians and Surgeons.
If individual practitioners can repudiate those principles at will, we don’t have a profession, we have a free-for-all.
