TORONTO (CCN) — Catholic doctors who won’t perform abortions or provide abortion referrals should leave family medicine, says an official of the College of Physicians and Surgeons of Ontario.
“It may well be that you would have to think about whether you can practice family medicine as it is defined in Canada and in most of the western countries,” said Dr. Marc Gabel, chair of the college’s policy working group reviewing Professional Obligations and Human Rights.
The Ontario doctor’s organization released a draft policy Dec. 11 that would require all doctors to provide referrals for abortions, morning-after pills and contraception. The revised policy is in response to evolving obligations under the Ontario Human Rights Code, Gabel said.
There have been no Ontario Human Rights Tribunal decisions against doctors for failing to refer for abortion or contraception.
Gabel said there’s plenty of room for conscientious Catholics in various medical specialties, but a moral objection to abortion and contraception will put family doctors on the wrong side of human rights legislation and current professional practice.
“Medicine is an amazingly wide profession with many, many areas to practice medicine,” he said.
The draft policy has been posted to the College of Physicians and Surgeons of Ontario website (cpso.on.ca). Doctors and members of the public are invited to comment on it up to Feb. 20. The CPSO policy committee will review the input and then bring a final policy to the full council of the college in May or June.
“Where physicians are unwilling to provide certain elements of care due to their moral or religious beliefs, an effective referral to another health care provider must be provided to the patient. An effective referral means a referral made in good faith to a non-objecting, available and accessible physician or other health care provider. The referral must be made in a timely manner to reduce the risk of adverse clinical outcomes. Physicians must not impede access to care for existing patients, or those seeking to become patients,” reads the proposed new policy.
While the college cannot force doctors to comply with any of its policies, doctors who step outside college policy become much more vulnerable to legal actions.
The new draft policy is similar to a 2008 proposal that was shot down when hundreds of doctors objected to a definition of professional practice that seemed to exclude conscience.
Forcing doctors to provide referrals for services they believe are morally wrong is unnecessary, particularly given the general availability of both abortion and contraception throughout Ontario, said Catholic Civil Rights League president Phil Horgan.
“One of the ways you could deal with that is to put up a sign saying for example, ‘This office cannot be used to access contraceptives, or the morning-after pill.’ Then it could list other clinics within a five-mile radius, or whatever,” said Horgan. “In effect, alternatives are being provided without the physician providing a referral.”
“We’re saying that the discrimination occurs when you are not acting in the best interest of the patient,” said Gabel. “When you are not communicating effectively or respectfully about this with the patient, when you’re not managing conflicts, when you differ from the patient and when you are not respecting the patient’s dignity and ensuring their access to care and protecting their safety. That’s the issue.”
The right of doctors to their own conscience is part of their professional practice. The doctor-patient relationship should not be reduced to mere service provision, said Canadian Catholic Bioethics Institute executive director Moira McQueen.
“It’s a problem. You cannot park your conscience at the door.”
Doctors who have a wide variety of views, whether moral or medical, should be able to rely on their college to be on their side, McQueen said.
“The tone that’s coming from the CPSO is more a warning to doctors that the CPSO won’t be able to protect them if they go against this policy.”