GESTIÓN EN SALUD PÚBLICA: Canadian court tells doctors they must refer for euthanasia

domingo, 4 de febrero de 2018

Canadian court tells doctors they must refer for euthanasia

Canadian court tells doctors they must refer for euthanasia

Bioedge

Canadian court tells doctors they must refer for euthanasia

by Xavier Symons | 3 Feb 2018 | 3 comments

An Ontario court has told a group of doctors that they must refer for Medical Aid in Dying (MAiD), affirming conscientious objection restrictions imposed by the province’s medical regulator.

Ontario’s Divisional Court ruled Wednesday that the referral requirement was a reasonable limit on doctors' freedom of religion because it protects vulnerable patients from harm.

Without the policy of "effective referral," equitable access would be "compromised or sacrificed, in a variety of circumstances, more often than not involving vulnerable members of our society at the time of requesting services," Justice Herman Wilton-Siegel wrote on behalf of a panel of three judges.

Five doctors and three professional organisations had appealed the conscientious objection restrictions outlined in the MAiD policy issued by the College of Physicians and Surgeons of Ontario, arguing that it infringed their right to freedom of religion and conscience recognised under the Charter of Rights and Freedoms.

The three organisations included the Christian Medical and Dental Society of Canada, the Canadian Federation of Catholic Physicians’ Societies and Canadian Physicians for Life.

Larry Worthen, executive director of the Christian Medical and Dental Society, said physicians who object to medically assisted death live in fear that they will be investigated and disciplined. “It puts them in an impossible situation”.

Yet the Court ruled that the freedom of the physicians was only “minimally impaired” by the effective referral requirement.

Shanaaz Gokool, chief executive of Dying With Dignity, applauded the court’s ruling.

“It’s a stunning decision that really puts the rights of the most vulnerable residents of this province ahead of the rights of clinicians” who object on religious grounds. “It’s a fair balance of rights.”

As of the 31st December, 1,030 patients had received an assisted death in the 18 months since the new law took effect.

*Thanks to Alex Shadenberg from the Euthanasia Prevention Coalition for making available the transcript of the Court ruling.

Saturday, February 3, 2018

For years bioethicists of a utilitarian cast have argued that conscientious objection has no place in medicine. Now Canadian courts are beginning to put their stamp of approval on the extinction of doctors’ right to refuse to kill their patients.

The Superior Court of Justice Division Court of Ontario ruled this week that if doctors are unwilling to perform legal actions, they should find another job (see report in BioEdge).

The case is sure to be appealed, but if the doctors championing conscientious objection fail, the consequences will be dire. Throughout Canada, doctors would be required to refer for euthanasia. If they refuse, they will be hounded out of their profession, or, at best, shunted into specialties where the question will not arise, like pathology or dermatology.

This ruling shows how quickly tolerance vanishes after euthanasia has been legalised. In the Carter decision which legalised it, Canada’s Supreme Court explicitly stated that legalizing euthanasia did not entail a duty on the part of physicians to provide it. Now, however, 18 months and more than a thousand death after legalisation, conscientious objection is at risk.

It also shows how vulnerable religious-based arguments can be. The plaintiffs contended that referring patients violated their right to religious freedom. While this is true, is this the main ground for conscientious objection? As several doctors pointed out in the Canadian Medical Association Journal last year, “Insofar as all refusals of therapy are ultimately justified by the ethical belief that the goal of therapy is to provide benefit and avoid harm, all treatment refusals are matters of conscience.”