Patients’ right to quality care trumps doctors’ freedom of religion: Editorial
In its attempt to protect doctors’ freedom of religion, Ontario’s medical regulator is unacceptably threatening patients’ right to adequate care.
Dave Carter
/ The Guelph Mercury
Should doctors have the right to refuse treatment to a patient on moral or religious grounds?
At an Ottawa walk-in
clinic last winter, Kate Desjardins requested a prescription for birth
control and was denied. Instead, she was handed a letter explaining that
the one doctor on duty that day wouldn’t provide contraception “because
of reasons of my own medical judgment, as well as professional ethical
concerns and religious values.” Desjardins left the busy waiting room
shocked and humiliated. Surely this was illegal, she thought, or at
least a breach of professional conduct.
In fact, it was
neither. The longstanding policy of the College of Physicians and
Surgeons of Ontario (CPSO), and other medical regulators across the
country, is that doctors can refuse to provide treatment on moral or
religious grounds as long as the case is not an emergency and the
patient can access care elsewhere.
The policy, which is
currently under review in Ontario, ought to be overturned. In its
attempt to protect a doctor’s freedom of religion, it unacceptably
threatens a patient’s right to adequate care.
Desjardins, who is 25
and married, was able to find a doctor at another clinic to write her a
prescription. But what if she had lived in a more remote area with fewer
accessible doctors? What if the doctor at the next clinic also
objected?
After all, refusal to
treat on moral grounds is not uncommon. Two other doctors at the same
clinic in Ottawa also refuse to provide birth control, as does a Calgary
physician who was in the news last week. And many GPs decline even to
refer patients to doctors who will provide the treatment they object to.
Canada’s medical
regulators, who, after all, oversee a publicly funded system, should be
able to guarantee timely, comprehensive care for all, regardless of the
moral world view of the doctors who happen to be nearby. In the case of
Desjardins, a physician effectively denied her access to the services of
a facility she helped pay for because he didn’t like the common and
medically accepted drug she requested.
Moreover, the doctor’s
objection was communicated in a way that actually did harm. “I felt
truly embarrassed having to leave in front of a group of people because
of something that someone thinks is shameful and not right,” Desjardins wrote
of the incident. Had she been younger and less self-confident, might
the implicit moral judgment of the letter have deterred her from making
the trek to another clinic, waiting for hours and raising the issue with
a new doctor? No public health facility should see that as an
acceptable possible outcome.
Marc Gabel, the president of the CPSO, described to the Globe and Mail
the reasonable standard by which his organization will evaluate the
policy during the current review, the result of which will be known in
August: whether “it still takes care of professional responsibilities in
a way that serves the public of Ontario.” But a policy that allows for a
young woman with a standard, legitimate medical request to be turned
away from a clinic untreated, embarrassed and unsure what the next
doctor’s office holds clearly does not serve the public.
Of course, it’s
reasonable to attempt to protect physicians from being asked to deliver
care they find morally reprehensible. But when that entails patients
being denied common, medically uncontroversial treatments by public
health facilities, it’s an accommodation too far.
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