Friday, August 22, 2008

Doctors must always have right to follow conscience

Susan Martinuk
Calgary Herald
Friday, August 22, 2008

(Just doing the copy - paste kind of blogging again, but these people know better than me what they are talking about...)

Some 2,500 years ago, doctors were both healers and killers. Abortion and euthanasia were commonplace, and the type of medical service rendered depended on who was paying the bill or how the 'payee' asked the 'doctor' to take care of the patient. That ended in 400 BC, when a Greek physician named Hippocrates decided that patients deserved better and wrote an oath to affirm the sanctity of life and the doctor's duty to protect it.

Doctors who took the Hippocratic oath could then offer patients an element of trust and care that was previously non-existent and, for obvious reasons, Hippocratic physicians became the physicians of choice.

Well-known anthropologist Margaret Mead commented on this marked shift in the physician's role by saying, "For the first time in our tradition there was a complete separation between killing and curing. Throughout the primitive world, the doctor and sorcerer tended to be the same person. He with the power to kill had power to cure . . . (but now) One profession . . . (would) be dedicated completely to life under all circumstances . . .

"This is a priceless possession which we cannot afford to tarnish, but society is always attempting to make the physician into a killer -- to kill the defective child at birth, to leave the sleeping pills beside the bed of the cancer patient . . . it is the duty of society to protect the physician from such requests."

This oath became an important symbol of a doctor's integrity and commitment to protect life at all stages. But as with most traditions, it has increasingly fallen out of favour with medical schools. So, too, society seems to have come full circle in terms of its expectations of physicians -- the sanctity of life is no longer as important as our own convenience and demands.

The proof of this is in a draft proposal put forth by the College of Physicians and Surgeons of Ontario that will severely compromise the ethical integrity of physicians by limiting their ability to practice according to their own freedom of conscience and moral/religious beliefs. It would force physicians to set aside their moral consciences to fulfil all demands by all patients -- including providing or assisting patients in obtaining morally controversial services such as abortion, birth control and reproductive technologies for same-sex couples.

If physicians ignore the guidelines, they would be considered to have contravened the human rights code and their licences could be suspended; not because of incompetence or inappropriate activities -- but because of their religious beliefs.

Such tolerance is coming to Ontario physicians, courtesy of their government and its plan to expand the scope of the Ontario Human Rights Commission and increase the number of cases it hears from 150 to 3,000 per year. Sadly, this has motivated the commission to insert its misguided, Orwellian human rights policies into the realm of the physician-patient relationship.

Of course, a 2,000 per cent increase in cases doesn't equal a 2,000 per cent increase in human rights. Rights remain a very circular concept in that there are only so many to go around. Giving more rights to one group inevitably means taking rights from another. That means the commission will be taking away a whole bunch of rights from unsuspecting Ontarians. In this case, it's the physicians who lose.

All of this is disturbing on many levels. The college knew this would be controversial. A 2006 guest editorial in the Canadian Medical Association Journal that called for all physicians to be forced to make referrals for abortion generated such a firestorm that the CMA's director of ethics had to publish a statement saying CMA policy would not require this, since it would violate the conscientious or religious beliefs of many physicians.

Yet, in an indication of how much tolerance and freedom this new era of rights will bring, the college developed this proposal behind closed doors. There were no press releases and, despite placing an Aug. 15 deadline on consultations with physicians, no attempt was made to inform physician groups that will be most affected by/and want to comment on the policy. Since this proposal only came to light on Aug. 14, the college has now graciously responded to outraged demands by extending the consultation deadline to Sept. 12.

Section 2 of the Charter of Rights and Freedoms guarantees freedom of conscience to all Canadians. Yet, for some reason, the college (that should be defending the rights of its members) is eager to prematurely cede these rights at the mere suggestion of a human rights complaint. This willingness to give up suggests that college leaders may be moonlighting as motivational speakers for the Toronto Maple Leafs.

The fact is that every physician operates on some sort of moral framework, whether it be religious or secular or adamantly anti-religious. Just as one physician might encourage a patient to consider other options than abortion, another physician may withhold such information and suggest abortion is the only option. If we discriminate against one doctor's framework for practising medicine, we will inevitably discriminate against others. No doctor will be safe to practise or offer any human interpretation of, or context to, the medical facts.

We have an obligation to not let that happen.

Susan Martinuk's column appears every Friday.
© The Calgary Herald 2008