If Supreme Court decriminalizes physician-assisted suicide, doctors may be obligated to help with euthanasia

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SHAFAQNA (International Shia News Association)- Doctors may be forced to support euthanasia over their own religious objections if the Supreme Court of Canada decides to decriminalize physician-assisted suicide in a landmark ruling expected Friday.

The court announced Monday it is set to rule on the Carter case launched on behalf of B.C. women Kathleen Carter and Gloria Taylor, who have since died.

Ahead of the ruling, the College of Physicians and Surgeons of Ontario, which regulates medical doctors in Ontario, has been seeking public input on a draft policy that would force the province’s doctors to help patients access any services to which they are legally entitled. It will finalize the policy after the comment period ends on Feb. 20.

Whatever its policy ultimately looks like, the college is clear: a patient’s right to access services outweighs a doctor’s right to refuse them. “We prioritize the interests of our patients in facilitating access,” says Dr. Marc Gabel, past president of the college and chair of the policy’s working group.

Not quite, says Ottawa lawyer Albertos Polizogopolous, who acted for two major Protestant and Catholic physicians’ groups when the Supreme Court heard arguments on the Carter case in October. “There’s no right to receive a procedure from a specific doctor,” he said, adding that doctors have a Charter right to refuse a procedure on moral or religious grounds.

Canada’s Criminal Code makes it a crime to help anyone commit suicide — an offence that can result in up to 14 years in prison.

But support for assisted suicide is growing across Canada. An Ipsos Reid poll last October found that 84% of the more than 2,500 Canadians surveyed supported assisted dying in some capacity. Last month, two senators — one Conservative, one Liberal — introduced a bill to remove criminal penalties for doctors who help patients end their lives, based on a private member’s bill first introduced to the House of Commons last March by Conservative MP Stephen Fletcher.

The college itself polled 800 Ontarians on the question in May, and found 71% believe that physicians should not be allowed to refuse a treatment or procedure on moral or religious grounds. A full 92% said doctors who refuse to provide a service themselves should identify another physician who would; 87% said that the refusing physician should actually coordinate a referral to that other doctor. If approved, the new policy would require doctors to make those referrals. In an emergency, doctors would even have to provide services themselves, regardless of religious belief.

Similar policies are already in place in Alberta, Manitoba, Quebec and New Brunswick, Dr. Gabel says: “This is nothing new.”

In fact, the Saskatchewan College of Physicians and Surgeons drafted a similar policy in January allowing physicians to deny patients legally permissible services in the case of personal objections. But like the Ontario policy, they too would have to refer patients to a willing health-care provider or provide the service themselves if the patient’s well-being is at risk. The college is seeking public feedback and plans to finalize the policy after March 6.

Some religious physicians, on the other hand, see the draft policy as a sudden and unconstitutional attack on their livelihood.

“This is a question of whether people who have certain creeds or religious beliefs should be protected in law from the desire of a regulator to basically drive us out of the practice of medicine,” says Larry Worthen, executive director of the Christian Medical and Dental Society, which represents more than 1,500 doctors across Canada. “We’re simply saying there’s certain procedures we cannot participate in because of conscience and religious freedom. That’s in the Charter of Rights and Freedoms.”

For their part, some physicians may have already had enough. Mr. Worthen said he knows of several doctors who plan to retire early in order to avoid having to carry out procedures that conflict with their beliefs.

Others are pouring their concerns onto the college’s online forum.

“Faced with a request for assisted suicide from a patient, I would be required, by this college policy, to refer them to a physician who is ‘non-objecting, available and accessible’ to facilitate the assisted suicide. This in conscience I could not do,” wrote one doctor on Jan. 23.

“It would be as much complicit in the action as actually doing it,” wrote another on Jan. 5.

Exactly how the college would apply its draft policy if the Supreme Court decriminalizes assisted suicide is isn’t yet clear, said college spokesperson Prithi Yelaja. Disciplinary penalties range from a written warning to revoking of a physician’s certificate if professional misconduct is found.

A conflict between a patient’s right to access services and a doctor’s right to refuse them on religious grounds could end up back at the Supreme Court of Canada, as a test of the Charter of Rights and Freedoms. “Courts will consider how directly the act in question interferes with a sincerely held religious belief,” Dr. Gabel said.

 

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