Bill-84 prompts medical professionals to reinforce moral freedoms
By Michael Swan
Photo caption: NDP health critic France Gelinas said MPPs are feeling the pressure on Bill-84, particularly from those who would protect doctors’ conscience rights. (Michael Swan)
With more than 22,000 emails and letters in their in-boxes, Ontario legislators have rarely been under as much pressure to amend a bill as they have been over conscience rights for doctors in Bill-84.
In response, Ontario Health Minister Dr. Eric Hoskins has promised to have a “care co-ordination service” up and running as early as May.
The service would make it possible, without a doctor’s referral, for patients, their families or any member of their care team to begin the process of assessment to find out whether a patient is eligible for an assisted suicide.
However, Hoskins and the Liberals have so far avoided saying they would override the policy of the College of Physicians and Surgeons of Ontario which requires doctors to refer for medically assisted death even against their moral, religious and ethical convictions.
Going into third reading in the next month, Bill-84 is intended to put provincial laws in line with the federal law which made assisted suicide legal last year. But the CPSO’s “duty to refer” policy has inspired a grassroots uprising demanding Queen’s Park overrule the independent regulator and free Ontario doctors to practice medicine without referring their patients for assisted death assessments.
“We’re under tremendous pressure,” said NDP health critic France Gelinas, a member of the committee holding hearings into Bill-84, on March 30.
The Coalition for Conscience and HealthCARE web site (canadiansforconscience.ca), with support from Catholic, Protestant, Jewish and Muslim leaders, has prompted over 40,000 electronic letters sent to both federal and provincial politicians and officials. More than 22,000 of them have landed at Queen’s Park.
“We’re trying to sort our way through this,” said Ottawa Liberal MPP John Fraser, the main Liberal spokesperson at committee hearings on Bill-84. “For us it’s all about access. If the patient has access to the service, that’s our goal.”
Progressive Conservative health critic Jeff Yurek has vowed to propose an amendment that would protect physician conscience rights before the bill passes third reading.
London urologist Philippe Violette accused the Liberals of “deliberate misinformation” when he appeared with his wife, Dr. Ramona Coelho, before the Bill-84 committee.
“Effective referral is not a solution we can work with,” said Violette.
The CPSO policy requires an effective referral from an objecting physician to an available, accessible and willing doctor. Objecting physicians say such a referral makes them part of a process that, unless the patient fails the assessment, ends in killing the patient.
Violette argued that the CPSO policy is aimed at weeding out doctors who don’t think assisted suicide is medicine.
“Coercion can only result in a mono-culture of doctors with the same ideologies and many physicians discriminated against and forced to leave the practice of medicine,” he said.
CPSO president Dr. David Rouselle defended his college’s policy.
“An effective referral does not guarantee the procedure (assisted death) or imply a doctor’s approval,” Rouselle told the committee.
The college does not object to a province-wide, self-referral system similar to those operating in other provinces, but it’s not enough to make the CPSO change its mind on effective referral, said Rouselle.
The CPSO position was challenged at the hearings by the Ontario Medical Association.
“Creative solutions” could ensure patients who want MAID will get it, while at the same time allowing doctors to opt out of referring for euthanasia, said OMA spokesperson Barb LeBlanc.
In a June 29, 2016, letter to the Ministry of Health and Long-Term Care, OMA president Dr. Virginia Walley said the doctors support the goal of timely, unobstructed access to MAID, but “this can be achieved while allowing all physicians to maintain their moral convictions.”