Religion and medicine don’t mix

At least, that’s what the College of Physicians and Surgeons of Ontario say (see the National Post article here).

A new draft proposal by the college is looking to strip Ontario doctors of their right to exercise their religious or moral conscience when practicing medicine.

As it is now, a doctor can refuse to do things like prescribe the morning after pill, give a patient an abortion and can refuse to refer a patient to another physician who will do those things if the treatment being asked for goes against their religion or conscience.

I think the college is making a mistake with this approach.

I do agree that doctors should have to refer a patient they will not treat themselves – I don’t think it’s for a doctor to decide a patient shouldn’t be treated at all simply because the treatment goes against the doctor’s conscience or religion. Those patients the doctor will not treat should be referred immediately to a doctor who will.

Forcing a doctor to treat a patient when the doctor has made it clear the treatment in question goes against everything he believes in is a bad idea. I think no matter how careful the doctor is to treat that patient’s physical needs - the quality of care and compassion that is normally involved in medical treatment drops off pretty sharply when the doctor actively disagrees with a patient’s own moral or religious decision.

For instance, if I went to a doctor for an abortion and the doctor told me “My conscience and religion forbid this treatment, but since I don’t want to be disciplined or sued, I’ll do it.” Could I really trust that doctor to then be careful with my physical and mental well being? Do I want an important decision and procedure like that handled by a doctor who has made it clear he does not respect my right to have the procedure in the first place?

I’m pretty sure the answer is no.

Force these doctors to simply refer the patient elsewhere and, if necessary, end the physician-patient relationship so the patient can seek appropriate care with a physician who supports their right to the treatment they need or want.

The proposal states that ending a physician-patient relationship based on personal beliefs could “contravene the Code and/or constitute professional misconduct.” I think this is fairly asinine. I would much prefer my doctor say “I am going to refer you to another doctor who is accepting new patients, as my religious and moral beliefs are making it difficult for me to treat you with the respect, compassion and level of care you deserve.”

Instead, those cases where a doctor does want to terminate his relationship with a patient, refuse care of an existing patient or refuse to take on a new patient, the doctor must do so “for reasons related to his or her own clinical competence” according to the proposed code.

It seems to me that this approach encourages doctors who wish to live by their personal beliefs to lie. If a doctor lies about his “clinical competence”, does this mean the College can examine whether he should hold a medical licence?

The code also says the first step in ending a physician-patient relationship should be a referral to specialist – and in the case of a GP not wanting to do heart surgery or something equally specialized, this makes sense. I don’t want a GP trying his hand at a triple bypass surgery. Where the doctor in question does not want to provide a young girl with birth control pills because he thinks she’s too young to be sexually active or his religious and moral beliefs brand her as an adulterous slut- what specialist could you possibly refer her to?

The code advises the following in those cases: “…proceed cautiously.”

The well being of the patient should always come first – I agree with the College on that completely. However, sometimes the well being of the patient is best addressed by the physician admitting “I’m not the right doctor for you because of my religious or moral beliefs. Let me refer you to a doctor I think you’ll connect with better.”

That sort of honesty is what makes a physician good – that honesty ensures the patient will always come first.

The feeling of being processed is already rampant in doctor’s offices across the country. Patients get a maximum of 15 minutes and two issues to bring to the table before they are ushered out the door. If the doctor is spending any of those minutes giving poor quality care to a patient he was forced to treat, his ability to do his job is severely compromised.

Forcing a doctor to treat a patient they cannot be objective about or kind to will only serve to highlight and compound existing issues in the health care system. Make it a rule that no doctor can refuse a to refer a patient – if the doctor in question loses many of his patients because he refuses to treat them, he has no one to blame but himself. 

You can read the proposed code here. Click View Backgrounder under the Human Right Consultation section (this will allow you to view a .PDF file) scroll to the Physicians and the Ontario Human Rights Code link and click that for the full version of the proposed code.

If you wish to comment on the proposed code, do so no later than August 15, 2008 by sending a letter to:

Andrea Foti
College of Physicians and Surgeons of Ontario
80 College Street
Toronto, ON, M5G 2E2

or email Andrea at: afoti@cpso.on.ca

Anything done in Ontario can easily be adopted by other Provinces – so speak up now!