By Lethbridge Herald Opinon on November 21, 2019.
Enhanced protections for conscience rights would be a boon to health-care system
Andre Schutten, John Sikkema and Anna Nienhuis
Recently, Alberta MLA Dan Williams tabled Bill 207, the “Conscience Rights Protection Act.” It would protect both individual health-care providers and health-care facilities from being required to provide services that conflict with their religious or conscientious beliefs, ethical judgment or cultural traditions.
One of the bill’s stated purposes is to provide certainty to health-care providers and religious health-care organizations with respect to exercising their Charter-protected freedoms of conscience and religion. This is greatly needed in a time when both individual providers and religious health-care organizations face pressure to provide or facilitate access to services that conflict with their core beliefs, not to mention longstanding principles of medical ethics.
Of course, Bill 207 does not release health service providers and organizations from any and all professional obligations. It is not a licence to abandon patients. We expect the bill to be attacked in this way, with the implicit assumption that religious health-care providers would be ready and willing to abandon patients, leaving vulnerable, sick people to find themselves a new health-care provider. But that is not the case. It means only that a particular service need not be provided or facilitated (such as by referring the patient to a willing euthanasia provider) by the conscientiously objecting provider.
We can all understand why conscience rights matter to doctors – they want the freedom to practise medicine in a way that does not conflict with their moral or religious beliefs. They want to do medicine as they believe they ought to do medicine.
But respecting health-care providers’ conscience rights is good for the health-care system as a whole. First of all, not respecting conscience rights limits the number of people who will enter or remain in a health profession. If practising medicine required being willing to perform abortions or euthanize patients, for example, people with ethical commitments in line with the Hippocratic Oath and strong consciences would count themselves out. But surely, these are the type of people we want in medicine.
Effectively excluding such people from the medical profession would cause care facilities run by Catholics, Evangelicals, Jews and others to shut down, as would requiring such facilities to provide ethically objectionable services (such as “medical aid in dying”). Yet many people wish to be cared for by organizations and individuals with strong commitments to the sanctity of life.
For any patient, religious or not, knowing that her doctor will never provide or recommend euthanasia can give a patient a sense of peace that their life is valued by their doctor. Likewise, a pregnant woman may wish to be cared for by a doctor who values the life of her pre-born child, despite any prenatal diagnosis the child may receive. In contrast, knowing that your doctor is willing to be your or your preborn child’s executioner may cause a loss of trust in the relationship.
Conscience rights are never challenged when a doctor recommends diet and exercise for a patient who demands liposuction, or when a doctor refuses to do a circumcision, a tongue splitting, or an elective amputation. Doctors regularly advise patients on the best course of action for their health, and patients may disagree. Yet, there is no consequence for a doctor in these cases. Rather, conscience rights tend to be challenged when it comes to politically charged treatments, where activists demand conformity and bristle at disapproval. If a doctor refuses to assist with suicide or abortion, or recommends counselling instead of a penectomy for a gender dysphoric male, suddenly his judgment is questioned.
The fact that conscience rights have become so politically charged should concern us all. We must not treat doctors and nurses like vending machines. A doctor is not a mere service provider on demand. A doctor is a person, and a professional. His or her professional advice is based on their education, experience, and best judgment, all of which are grounded in their moral convictions.
Bill 207 permits doctors to act with integrity in the Alberta health-care system. Where health-care providers are free to think and act according to their professional medical opinion without political interference, we are more likely to avoid groupthink and (im)moral conformity within these professions. This is good not only for health-care providers, but also for patients, who are better off in a health-care system that welcomes practitioners with solid ethical convictions and strong consciences.
Andre Schutten and John Sikkema are constitutional lawyers with ARPA Canada. Anna Nienhuis is research director with WeNeedaLAW.ca.