Ontario physicians could be stripped of their right to exercise religious or moral conscience if a new set of guidelines is accepted by their regulating body next month, critics say.
Doctors across Canada are now allowed to opt out of such things as prescribing birth control or morning-after pills or doing abortions when it goes against their conscience. Physicians are also allowed to refuse to do referrals in such cases.
But a new draft proposal from the College of Physicians and Surgeons of Ontario could change that for doctors in the province.
"I'm really concerned with the new principle that the college is promulgating and that is that doctors do not have the right to be guided in the conduct of the practice by their conscience," said Joseph Ben-Ami, president of the Centre for Policy Studies, an Ottawa-based think tank. "That's a sweeping broad principle to establish -- and once you've established it the field is wide open for further changes."
For example, he said a doctor might refuse to help a same-sex couple to use reproductive technology to have a child.
"There are a lot of doctors who feel uncomfortable with this and think it's detrimental to the child's welfare down the road. The way were reading this draft document is a doctor could be hit with a misconduct" if the new rules are adopted.
Some of the provisions included in the draft document are:
• [A] physician's responsibility is to place the needs of the patient first, [so] there will be times when it may be necessary for physicians to set aside their personal beliefs in order to ensure that patients or potential patients are provided with the medical services the require."
• "Physicians should be aware that decisions to restrict medical services offered ... or to end physician-patient relationships that are based on moral or religious belief may contravene the Code and/or constitute professional misconduct."
• "Tell patients about their right to see another physician with whom they can discuss their situation and ensure they have sufficient information to exercise that right. If patients or potential patients cannot readily make their own arrangements to see another doctor, physicians must ensure arrangements are made, without delay, for another doctor to take over the case."
Rene Leiva, a Catholic family doctor in Ottawa, and a former board member of the Canadian Physicians for Life, said if the new rules were adopted it would make it nearly impossible for him to operate in the province.
"This would put a burden on physicians like myself to conform to a view that basically puts my conscience under somebody's else's power," said Dr. Leiva. "And the key aspect is moral integrity and the right of physicians to act in a way that does not harm the patient.
Jill Hefley, a spokeswoman for the college, said the reason for the draft was because of changes being made to the Ontario human rights system that could see doctors facing more complaints from patients who feel they are being discriminated against.
She said the draft document was a way of alerting doctors that they could be facing more legal issues from the human rights system.
But Mr. Ben-Ami said that explanation makes no sense.
"If this was just a matter of cautioning members of the college that there may be some problems in exercising their conscience that would be fair," he said. "They seem to go from that into a discussion about professional misconduct and then setting out guidelines about what is misconduct and that becomes very problematic to us because I don't think you can make a sweeping declaration that a doctor or any professional has to ignore matters of conscience in the conduct of their affairs. I don't think this has been thought through."
The Ontario Medical Association, the professional group that represents doctors, would not comment but said they are sending a submission to the college next week.
It is believed that Ontario would be the only province to change its conscience guidelines if the new rules are adopted.