Religion out of medicine, a new message for Ontario doctors

[Dion]

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."

http://www.nationalpost.com/news/story.html?id=726616

[Eric Vail]

The title of this thread should read, conscience removed from medicine.

[Hemi-Cuda]

• [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."

sounds right to me. doesn't seem to be forcing the doctors to do anything except guide a patient to the right physician if they are unwilling to take the patient. since doctors are employees of the government, then they should fall under separation of church and state. we wouldn't want our political leaders letting religion dictate their decisions, so why should doctors be any different?

[T@T]

Originally Posted by Hemi-Cuda

sounds right to me. doesn't seem to be forcing the doctors to do anything except guide a patient to the right physician if they are unwilling to take the patient. since doctors are employees of the government, then they should fall under separation of church and state. we wouldn't want our political leaders letting religion dictate their decisions, so why should doctors be any different?

Agreed, physicians shouldn't put what they believe in over a patients anyway.

[Thor]

Originally Posted by T@T

Agreed, physicians shouldn't put what they believe in over a patients anyway.

Other than they should follow do no harm and help those in need.

If they want to deal with their own outdated dogmatic religous text, do so in a private witch burning, or diagnose those with mental illness as possesed by demons

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.

Good, tell her to clearly label her as medicine for Catholics. Ironically, medicine without science, well we'd have leeches and bleeding as the forefront of their medicine. I'm sure they'd all be for that.

It is believed that Ontario would be the only province to change its conscience guidelines if the new rules are adopted.

A big round of applause for Ontario. About time Doctors went by mandate of healing/respecting patients over their own ridiculous beliefs. Lets just ask ourselves if this offends you, would you respect a doctor with scientology as their religion if they would defy sending your son/daughter to a psychologist.

[Ice]

Doctors need to do whatever is necessary, including reasonable requests for treatment and medication for patients, even if it violates their own personal beliefs. The only exception, IMO, would be a doctor who didn't want to perfrom an abortion, and I don't think that's what they're talking about here. But I can understand that a doctor who believes an abortion is ending life shouldn't be required to do so, because in their mind that violates the oath they took when they became a doctor. I doubt its an issue anyway, because those doctors would not be working in that field.

Originally Posted by Thor

A big round of applause for Ontario. About time Doctors went by mandate of healing/respecting patients over their own ridiculous beliefs. Lets just ask ourselves if this offends you, would you respect a doctor with scientology as their religion if they would defy sending your son/daughter to a psychologist.

What I don't understand in these discussions is why people are so colossally biased and negative about people who have religious beliefs. Its as if finding out someone believes in a higher power is stupid, and simply having that belief is offensive. To refer to it as "ridiculous beliefs" is hugely judgmental and unreasonable. They way one acts with respect to their belief might be ridiculous. I think most of us can agree there has been some questionable and ridiculous BEHAVIOR blamed on beliefs (Tom Cruise springs to mind), and forming an opinion on how one acts is much more reasonable that painting with such a broad brush to say all believers are ridiculous.

[transplant99]

I thought most Canadians were AGAINST the government mandating what people can or cant do with regards to their religious beliefs?

I guess the whole seperation of church and state only applies when they deem it necessary?

Seems just a tad hypocritical to me.

What I don't understand in these discussions is why people are so colossally biased and negative about people who have religious beliefs. Its as if finding out someone believes in a higher power is stupid, and simply having that belief is offensive. To refer to it as "ridiculous beliefs" is hugely judgmental and unreasonable. They way one acts with respect to their belief might be ridiculous. I think most of us can agree there has been some questionable and ridiculous BEHAVIOR blamed on beliefs (Tom Cruise springs to mind), and forming an opinion on how one acts is much more reasonable that painting with such a broad brush to say all believers are ridiculous

Very well said....kudos.

I have no religious affiliation whatsoever, yet I would never claim that those who have beliefs based on such were "ridiculous". Pretty high and mighty statement to make IMO.

[simonsays]

If a Doctor can't prescribe birth control pills or the morning after drug or what-have-you because of their religious beliefs, then they shouldn't have to. They should be required to connect the patient with someone who can/will, but the government shouldn't be determining what each doctor must do with his/her own practice. Medicine isn't fast food, not every establishment needs to offer the exact same burger.

Originally Posted by Thor

A big round of applause for Ontario. About time Doctors went by mandate of healing/respecting patients over their own ridiculous beliefs. Lets just ask ourselves if this offends you, would you respect a doctor with scientology as their religion if they would defy sending your son/daughter to a psychologist.

Firstly I think that a doctor who has a case which goes against their personal beliefs must connect their patient with another doctor. But secondly, yeah, I'd respect a Scientology doc if he/she were competent and upfront about their ethical limitations.

If this type of legislation went the other way, all of us atheists would be up in arms. Outside of the laws that bind us as a society the government should not be in the business of telling us what we must do. I hope that this bill fails.

[Dion]

Originally Posted by Ice

What I don't understand in these discussions is why people are so colossally biased and negative about people who have religious beliefs. Its as if finding out someone believes in a higher power is stupid, and simply having that belief is offensive. To refer to it as "ridiculous beliefs" is hugely judgmental and unreasonable. They way one acts with respect to their belief might be ridiculous. I think most of us can agree there has been some questionable and ridiculous BEHAVIOR blamed on beliefs (Tom Cruise springs to mind), and forming an opinion on how one acts is much more reasonable that painting with such a broad brush to say all believers are ridiculous.

That's what you get sometimes when religion is raised within a topic. I agree that the broad brush some use is over the top and a tad unfair.

[Mike F]

Originally Posted by transplant99

I thought most Canadians were AGAINST the government mandating what people can or cant do with regards to their religious beliefs?

I guess the whole seperation of church and state only applies when they deem it necessary?

Seems just a tad hypocritical to me.

Canadians are generally FOR a government that keeps religion out of public institutions, and so long as medicine in Canada is a public institution, people should be able to receive medical care without the public providers imposing their religious beliefs on them.

[mykalberta]

This is like saying that corporations should have no conscious and only look out for what is best for the company at the expense of all others.

What a world we live in when people arent allowed to make decisions based on conscious. Time for docs in Ontario to leave for greener pastures.

[LChoy]

Originally Posted by simonsays

Medicine isn't fast food, not every establishment needs to offer the exact same burger.

But they still need to offer the same full menu as other similar establishments, and a patient could get "pickles" on their burger even if the cook had a moral objection to them. As we are under a universal health care system, all Canadians should have the right to have access to the same level of services and advice between what ever doctor's office, clinic, hospital, or primary care centre they go to. The doctor is within his rights to talk about the negative side effects of the pills, like he should for anything they prescribe. However, if the physician can not prescribe or perform a procedure for moral (non-medical) reasons, then the onus is on the physician to arrange the most expedient method to get their patient access to whatever they need.

Now where it becomes tricky, and a reason why Ontario is moving in this direction is that like us, Ontario is having a health worker shortage. Patient don't have a luxury of choosing between doctors. As a real world example, there was a situation where there was 1 GP that served 3 towns but the GP wasn't comfortable with prescribing birth control. The three communities have a higher demographic of teen pregnancies and complaints were launched due to this GP's sometimes refusal to give access for non-medical reasons. It was eventually resolved and I believe the physician is still there today. We have other problems as well of rural family GPs that are against vaccinations, and whole communities remain unvaccinated, leading to government interventions when we a measles, mumps, or other vaccine preventable outbreaks. The new law seems harsh at first, but it merely reinforces what is already in the physician's oath of service.

For abortion, that's still a little bit of a grey area. Because most abortions aren't covered by health care (except in emergency and medically necessary situations), most people go to private facilities to get the procedure done, so those docs with moral objections wouldn't be working there anyways

[Bagor]

Originally Posted by mykalberta

This is like saying that corporations should have no conscious and only look out for what is best for the company at the expense of all others.

Wouldn't it be what's best for the consumer?

Originally Posted by lchoy

We have other problems as well of rural family GPs that are against vaccinations, and whole communities remain unvaccinated, leading to government interventions when we a measles, mumps, or other vaccine preventable outbreaks.

Wouldn't this be a case of negligence if they refuse to give it? It's one thing to be against it but on the other hand to refuse something that every Canadian is entitled to and actually recommended by public health authorities to get.

[Mike F]

Originally Posted by mykalberta

This is like saying that corporations should have no conscious and only look out for what is best for the company at the expense of all others.

For publicly traded companies, the directors have a duty to do essentially that.

[Calgaryborn]

Before I was born my mother had a Jewish Doctor who insisted that we be circumcised. According to Mom he said he wouldn't deliver me if she didn't promise to have the circumcision done. I probably complained a little bit at a time but, I'm OK with it now.

We have a shortage of Doctors. I say let them do whatever their conscience and expertise allows. If a Doctor's personal values really becomes a hindrance to reasonable treatment it's because he resides in an area where there aren't alternative physicians to go to. If that predicament ever arises it can be dealt with on a case by case level.

[Displaced Flames fan]

Wow, big argument against nationalized helath care right there.

People should have a right to choose their doctor. I'm guessing Canadians don't, otherwise this is a non-issue.

[photon]

In theory we have a right to choose our doctor, in practice we don't simply because there isn't enough doctors, if you move to Calgary and need family doctor.. well good luck with that.

If there were enough doctors and it was easy to get a referral to one that would do the thing in question then it wouldn't be much of an issue, but if you CAN'T get to another doctor then I think this is warranted. Or think of cases in small places where there's maybe only one doctor... does every woman in town not get birth control pills because the doctor's Catholic?

I know landlords that complain about having to rent to non-married couples that are living in sin or homosexual couples.

The doctors have a job to do, though they themselves may find a specific treatment goes against their morals, it's the requirement of the job to provide all options as long as they are legal and effective. So I think their conscious can be fine with it; it's society that's allowing birth control, not the doctor specifically.

[Calgaryborn]

Originally Posted by photon

In theory we have a right to choose our doctor, in practice we don't simply because there isn't enough doctors, if you move to Calgary and need family doctor.. well good luck with that.

If there were enough doctors and it was easy to get a referral to one that would do the thing in question then it wouldn't be much of an issue, but if you CAN'T get to another doctor then I think this is warranted. Or think of cases in small places where there's maybe only one doctor... does every woman in town not get birth control pills because the doctor's Catholic?

I know landlords that complain about having to rent to non-married couples that are living in sin or homosexual couples.

The doctors have a job to do, though they themselves may find a specific treatment goes against their morals, it's the requirement of the job to provide all options as long as they are legal and effective. So I think their conscious can be fine with it; it's society that's allowing birth control, not the doctor specifically.

You are only making the shortages worse. Instead of going against his or her conscience they could just leave the province. A more positive approach would be to recruit doctors to rural communities that aren't going to have moral issues that limit their procedures.

If the only doctor willing to work in Tim-buck-two won't preform an abortion Tim-buck-two is still better off with her than no Doctor at all.

[Antithesis]

Originally Posted by Ice

What I don't understand in these discussions is why people are so colossally biased and negative about people who have religious beliefs. Its as if finding out someone believes in a higher power is stupid, and simply having that belief is offensive. To refer to it as "ridiculous beliefs" is hugely judgmental and unreasonable. They way one acts with respect to their belief might be ridiculous. I think most of us can agree there has been some questionable and ridiculous BEHAVIOR blamed on beliefs (Tom Cruise springs to mind), and forming an opinion on how one acts is much more reasonable that painting with such a broad brush to say all believers are ridiculous.

First of all, thank you for saying this so clearly and eloquently, Ice. One of the most frustrating things about CP 'religion' discussions is the mentality that can go into each side. Very well put.

On topic, I have to wonder if it might be a case of 'tough beans' for the doctors here. If you were thinking of being a doctor you probably should consider that you might be put into situations that go against your spiritual beliefs. I would think that your joining the profession would be implicit agreement with that as doctors are at the highest level obligated to do whatever is best for their patient. I am not comfortable with the idea that a doctor might consider themselves some kind of judge of people's behavior or some moral compass for people when that is not their job.

[photon]

Originally Posted by Calgaryborn

You are only making the shortages worse. Instead of going against his or her conscience they could just leave the province. A more positive approach would be to recruit doctors to rural communities that aren't going to have moral issues that limit their procedures.

If the only doctor willing to work in Tim-buck-two won't preform an abortion Tim-buck-two is still better off with her than no Doctor at all.

I don't think making the decision based on if you're going to gain or lose doctors is the right approach. The key issue here is delivery of health care and if a doctor has a right to refuse to deliver specific remedies or advise specific things based on their personal set of morals.

Examine some boundary conditions, I mentioned the small town example and birth control, I think your suggestion is a good one though I'm not sure how well that would work in practice (or if it's even legal, you're basically selecting and rejecting doctors for specific positions based on religion).

What about a doctor who refuses to give blood transfusions based on their religion? That strikes me as a clear case where either they do it or aren't allowed to be doctors in the first place. So that's the extreme example of where a doctor should be compelled to take action contrary to their beliefs.. the question is do these fall into that category.

Maybe each specific thing needs to be examined individually, it's a pretty broad scope of things.. while asking a doctor to give out birth control when they are Catholic is about the same as asking a video store clerk to rent out R rated movies though they'd never watch them themselves, asking a doctor to perform an abortion is a different thing.

As for the calling beliefs ridiculous being judgmental, well yeah in some people's judgment they are ridiculous. Everyone makes judgments about things every day. I don't think it's unreasonable either, everyone is allowed to retain and express an opinion on if a belief is good or bad, silly or sound, etc. What I think is unreasonable is that for some reason religious beliefs aren't allowed to be questioned like any other belief. In any statement substitute NDP for religion and if all of a sudden the statement is OK, then it's ok to say for religion too.