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Building a Culture of Life

By Mary Deutscher

 

07/15/2015

It’s summer. And if you’re anything like I am, you’re probably beside yourself with excitement because the College of Physicians and Surgeons of Saskatchewan (CPSS) has opened a new public consultation on their Conscientious Objection policy!

Having spent the past two years of my PhD studies devoted to the topic of conscience issues in health care, there is one thing I can tell you: this policy is pretty confusing stuff. Given that the policy is intended to provide “clear guidance to physicians and the public” in situations where a patient wants a treatment that his or her doctor is morally opposed to providing, I thought it would be worth it to spend some time clarifying a few things before I encourage everyone to join in the consultation.

As it stands, there are many good points in the policy and it is evident that a lot of energy has been put into its development. However, there are still a few wrinkles that need to be smoothed out.

First, there is a lot of ambiguous language in the policy. For example, the policy says that doctors will need to “make arrangements” for their patient to receive morally contentious treatments. What exactly does this mean? Does it include making a formal referral? Will it force physicians to become accomplices in actions they believe are morally wrong?

As I mentioned, the whole purpose of this policy is to provide clear guidance, so it will be worth the effort to reword it in a way that more clearly outlines a doctor’s obligations. The policy could read something along the lines of: “the physician must provide the patient with information to allow the patient to arrange timely and effective access to medical service.” This wording actually comes from a flow chart created by the CPSS to clarify the policy, so I hope the council will be open to using it.

Second, the policy runs into a few problems in its section on emergency care. This section begins with a fair statement that “physicians must provide care in an emergency, where it is necessary to prevent imminent harm. . . .” However, it goes on to use more ambiguous language, requiring the physician to provide treatment to safeguard a patient’s “health and wellbeing” and to provide treatment that must be “provided within a limited time to be effective.”

To the average person this phrasing may seem harmless, but it is much more problematic if you start thinking like someone deliberately looking for loopholes (i.e., a lawyer). Imagine a scenario: a woman comes into a rural clinic looking for a chemical abortion. She is in the early stages of her pregnancy, but needs to use the pills soon if they are going to be effective. There is no other doctor in her town, and a trip to the next closest doctor is not possible for her. The current wording of the CPSS policy will require the doctor in this example to participate in this woman’s abortion because the pills must be “provided within a limited time to be effective.”

Much of the language used in the section on emergency care is unclear and unnecessary. Patients should be protected from imminent harm, but they do not have a right to demand whatever they want from their physicians.

The CPSS’s public consultation will only be open until Aug. 7. This summer consultation does not leave Saskatchewanians with a lot of time to respond, and there’s also the problem of this issue being so complicated that the average person will find it remarkably difficult to express their opinions. But don’t worry. I can help!

I have written many formal letters to many different official bodies this year, and I’ve found the best approach has been to write a first draft that sounds like an eight-year-old’s letter to her pen pal. If I were to sit down today to write a letter to the CPSS, the first draft would sound something like this:

“Hi. Thanks for asking for my feedback. There are a lot of good things in your new draft, but it sure is confusing. Could you use simpler language so I can understand it? Also, it really bothers me that you have expanded emergency care to include things that I don’t think belong there. I’m not sure how you should reword the policy, but my friends at the Christian Medical and Dental Society do. You should listen to them because I’m afraid that some of my doctor friends will move away if you don’t. That will make me sad. Thanks again!”

Despite the summer months being upon us, I hope many Prairie Messenger readers will take the time to participate in the CPSS’s public consultation. The CPSS can be reached by mail or through their website, www.cps.sk.ca, and more information can be found by visiting the Christian Medical and Dental Society at www.cmdscanada.org.

Again, the deadline for feedback is Aug. 7. All feedback will be good feedback, whether it is written in the style of a PhD student specializing in conscience issues in health care, or in the style of an eight-year-old who just wants to get her point across.

Deutscher holds an MA in Public Ethics from St. Paul University in Ottawa. She is currently pursuing a PhD in Public Policy at the University of Saskatchewan.