Rights of doctors and medics

September 29, 2016

Dear Mr. Smith (MPP),

Earlier this summer, I had emailed with my concerns for conscience rights for doctors and medical professionals in Ontario. I remain very much troubled and concerned about this issue, and have outlined some of my concerns.

Ontario will lose doctors if Conscience Rights are not protected.

Ontario’s physicians who have conscience objections to assisted suicide/euthanasia are now in an impossible position, and Ontario stands to lose many good highly qualified physicians and specialists if their fundamental rights are not protected. Physicians who conscientiously object and are not willing to refer, would lose their medical licenses or have huge fines imposed on them. There are some 5000 physicians across Canada (a great number of these work in Ontario), who oppose and will likely lose there medical licenses, retire or move to work elsewhere. Other provinces/territories could be gearing up to recruit doctors out of Ontario who refuse to refer patients for physician assisted suicide, leaving Ontario with an even greater shortage of doctors. These doctors are strongly committed to the highest patient care and are the very ones we cannot afford to lose. I have not yet seen much support for these doctors, from the government of Ontario. It is my understanding that we need more doctors and specialists across Ontario, especially in rural communities – not less. As your constituent, I would ask that you consider bringing this matter before the legislature as you resume sessions in September.

The wording and language of Bill C14 is not being upheld by the CPSO who is in fact, compelling doctors to participate against their conscience.

Since Bill C 14 was passed into law on June 17th, some provincial regulators have remained firm on policies that require physicians to “at minimum, refer their patients for assisted suicide”. This goes against the very language in Bill C-14 which suggests that no health care professional should be compelled to provide or assist in providing these procedures. Yet the College of Physicians and Surgeons of Ontario (CPSO), has not budged on their mandate that all doctors be required to give an “effective referral” if asked by a patient to die by assisted suicide. The CPSO, claims that it is not forcing physicians to participate directly, but simply asking that they refer patients to a doctor who is willing to participate, and thus being able to wash their hands of it. This however, is NOT how these physicians see it. Many who have conscience objections, also strongly object to direct referrals.

By requiring referrals from doctors, the CPSO is undermining the fundamental purpose of doctors.

In giving a referral, the physician is essentially saying that this is the best course of treatment for the patient. That all other options have been considered and weighed and this is the best possible treatment for the patient, and a referral even goes so far as to say, that he/she recommends it as such. What if that is not true? What happens when there are other treatments that would help the patient? Would it not be abandoning the patient as a doctor and ignore what training and knowledge they have of treatments, pain management etc. to then agree with the patient’s own wishes. Rarely do we as patients know the right course of treatment, or even what options are out there to help us – this is why we rely on the vast knowledge of our doctor. Is the CPSO suggesting that the patient knows better than the physician, as to what course of treatment is best for them? This completely undermines the knowledge and wisdom of the physician.

Fundamentals Freedoms (of Conscience and of Religion) need to be upheld by the Ontario government. The CPSO is not doing so.

Objecting physicians are not able to participate in assisted suicide/euthanasia for reasons of conscience, ethics, religious convictions or the Hippocratic Oath. Many are members of religious traditions that consider referral of any kind, as forms of participation in assisted suicide/euthanasia. It is not for the CPSO to judge what their conscience should be on the matter. Conscience is a very personal matter, and the objection can only be made only by the one who is being required to participate. With the right to conscience it quite frankly does not matter what the CPSO, or the government believes, or even what I believe. Physicians should themselves have the right to choose whether they object or not. Unless we ourselves are in the position of being asked to recommend that someone should be killed at the hand of another doctor, what right do we have to force them in this way? Do physicians not deserve the fundamental freedoms the same as any other Canadian citizen – freedom of conscience, and freedom of religion? Are they not Canadian citizens? Why won’t Ontario respect these fundamental rights?

Palliative care units, long-term care facilities and seniors’ residences required to allow euthanasia and assisted suicide on their premises

Physician assisted suicide is NOT part of palliative care. Palliative care, by very definition improves quality of life and relieves suffering, and according to WHO’s definition, “affirms life and regards dying as a normal process”. Palliative care affirms the dignity of each person as they near the end of life. Proper palliative care not only provides support to the patient, but to the family as well. How can the government think it’s okay to have physician assisted suicide performed in the one place that offers sanctuary and solace, peace and comfort to those who are most vulnerable. It would be terrifying to families who would give anything for a few more months or weeks. to know that their loved ones (being very vulnerable) might be talked into ending their lives early. Terrifying as well to the patients knowing that the very doctors and nurses who care for them would also be so willing to end their life. It undermines the fragile trust they have for the care workers and physicians. And to ask the very nurses and palliative care physicians who give so much of themselves to sustain and support lives on one hand, and then to take lives on the other hand and is incomprehensible. These are patients they truly care about. and it would be hard enough for them to lose a patient to a natural death, let alone at their own hand. Further than that, many of these health care facilities are faith-based and the professional themselves in many cases, also have conscience objections to assisted suicide.

The burden is now on the Ontario government to work with Provincial regulators, to find a solution suitable to all perspectives.

By leaving conscience protections out of the law, the federal government left this issue wide open for abuses, intimidation tactics, discrimination and worse, by the provincial regulators toward those who would conscientiously object. This is where the provincial and territorial governments need to step in. Some already have, and have set up provincial registers or central numbers where patients can call to be connected with doctors who are willing to participate. Surely, Ontario can find a way forward, as other provinces have, to ensure that our health care system respects all perspectives on this issue. I would ask you again to make every effort to raise this issue with your colleagues, the health Minister, and the CPSO as soon as possible.

I look forward to hearing from you, and I thank you for listening to my concerns.

Joanna Wease,

Bancroft, Ontario