Magazines 2018 Mar - Apr Making room in Health Care for minorities

Making room in Health Care for minorities

14 March 2018 By Bruce J. Clemenger

An Ontario policy that requires doctors to violate their conscience is wrong and hurts our society


It is a critical case and a troubling decision. An Ontario court upheld the policy of the College of Physicians and Surgeons of Ontario that requires effective referrals. That means doctors can be forced to contribute to procedures that violate the religious beliefs or consciences of doctors.

Why does a referral matter? Well, if any medical professional were to refer a patient for an illegal procedure, they could be charged for being complicit in the act. Now that Canada allows assisted suicide and euthanasia in some circumstances, along with abortion – and provides them by our health care system – what happens to health care workers who still believe those procedures are morally wrong? They do not want to be complicit in a moral wrong.

Other provinces – in fact all other jurisdictions in the world that allow assisted suicide or euthanasia – have found ways to provide the procedure without requiring objecting doctors to be involved. But Ontario wants to compell medical professionals to violate their conscience.

Conscientious objectors in health care are faced with options such as leaving Ontario, retiring or finding a new specialty that would make them less likely to receive a request. All these options pose a significant cost for holding to your religious beliefs, particularly on an act that was illegal only a few years ago.

These professionals do not want to abandon their patients. They just don’t believe properly caring for a dying patient includes killing them. They want to be there with patients to the end of their journeys, not to cut those journeys short. They are committed to caring, comforting and ensuring patients have the best available care.

The good news is the court found the policy a significant violation of freedom of conscience and religion. This was disputed by the College of Physicians and Surgeons, but the court was clear this freedom spelled out in the Canadian Charter of Rights and Freedoms was indeed violated by the policy.

However, the court found the violation was justified. Under the Charter, our guaranteed rights and freedoms can be reasonably limited if doing so is justifiable in a free and democratic society. Our rights and freedoms are not absolute. Freedoms must be balanced with other freedoms, rights or interests, in this case the interests of patients to avail themselves of what is termed medical assistance in dying.

Most doctors do not object to providing information about options. They just do not want to be part of the process of providing the procedure. And while there is no evidence a doctor’s conscientious objection prevented a patient from receiving timely help – and while other jurisdictions have come up with processes that respect the conscience rights of doctors – the Ontario court felt the possibility that at some time a patient might not be referred, but need to make a phone call or connect with another doctor or health care provider, was sufficient to compel doctors to comply.

This case does not only impact doctors in Ontario. It should concern us all. This kind of forced referral policy is admittedly easier for provinces than providing alternative ways of connecting patients with willing providers that respect religion and conscience – so other provinces may follow Ontario’s lead and take the easier path.

The province has chosen to provide access to a morally controversial procedure. (The Supreme Court did not create a right to assisted suicide, they only said that in some circumstances it should not be illegal to assist.) When a province provides a procedure, it must provide it for all who qualify.

But with a forced referral policy, the province is imposing its burden of providing equal access for legal medical services onto every individual doctor in the province. Each doctor must act as if they are governed by the Charter in their medical practice, a Charter which applies to governments and not individuals, and which guarantees religious freedom.

Does being paid by the government mean you relinquish your rights and freedoms? Some doctors dissent from the public’s moral acceptance of euthanasia and abortion, and they are compelled to participate.

And what of other professions or those in the civil service? Will the responsibility of governments to provide equal access on whatever is legal be imposed on all their employees, regardless of their convictions? What of moral disagreements or religious objections? Will there be no need to attempt to accommodate?

We live in a society of deep differences – religiously, philosophically, morally, ideologically. The test of a free and democratic society is how we treat each other, particularly our minorities who should be free to hold their convictions and participate in the life of our society, including contributing to the public good in public service.

Sometimes accommodating others may be inconvenient. It may take creativity. It will require understanding and dialogue. This is the cost of living in a free and democratic society. Doing so where we can is also part of loving our neighbours as ourselves.

Bruce J. Clemenger is President of The Evangelical Fellowship of Canada. Please pray for our work and support us at or 1-866-302-3362.