Dialogue Volume 14 Issue 1 2018 - Page 28

POLICY MATTERS “The goal of ensuring access to healthcare, in particular equitable access to healthcare, is pressing and substantial,” wrote Justice Herman J. Wilton-Siegel. access to health services in Ontario,” said Dr. Steven Bodley, College President. “We are pleased that the Court affirmed our concern that the alternatives proposed by the applicants could, in some cases, compromise access to care, including care for vulnerable patients.” The decision also affirmed that the emergency provision in the College’s Professional Obligations and Human Rights policy represents reasonable limits on religious freedom, demonstrably justified in a free and democratic society. The applications were dismissed in their entirety. “The goal of ensuring access to healthcare, in particular equitable access to healthcare, is pressing and substantial. The effective referral requirements of the policies are rationally connected to the goal. The requirements impair the Individual Applicant’s right of religious freedom as little as reasonably possible in order to achieve the goal,” wrote Justice Herman J. Wilton-Siegel on behalf of a three-member panel. The Professional Obligations and Human Rights policy articulates physicians’ professional and legal obligations to provide health services without discrimination and sets expectations of physicians who limit the health services they provide because of their personal values and beliefs. The policy establishes the duty to provide an effective referral if a physician has a conscientious or religious objection to providing a service; and the duty to provide the service in an emergency despite any objection. The College’s Medical Assistance in Dying policy advises of the legal framework and professional expectations of physicians with respect to medical assistance in dying, as shaped by federal legislation, provincial legislation, and relevant College policies. The MAID policy also provides that where a physician declines to provide medical assistance in dying for reasons of conscience or religion, the physician must not abandon the patient, and an effective referral must be provided. The MAID policy does not require physicians, in any circumstance, to provide MAID or conduct assessments for MAID contrary to their conscientious or religious beliefs. The goal of these provisions is to protect the public, prevent harm to patients and facilitate access to care for patients in multicultural, multi-faith society, by guiding all physicians on how to uphold their professional and ethical obligations of non-abandonment and patient-centred care within the context of Ontario's public health-care system. They aim to protect all Ontario patients, with an emphasis on ensuring that the most vulnerable are not exposed to harm when their physician objects to providing an otherwise appropriate and available medical service. The College defence of patient access to health services was backed by a number of interveners, including the Attorney General of Ontario and Dying with Dignity Canada. • The Christian Medical and Dental Society of Canada v. College of Physicians and Surgeons of Ontario, 2018 ONSC 579 • For more facts about MAID, please see our Fact Sheet at www.cpso.on.ca under policies. 28 DIALOGUE ISSUE 1, 2018 MD