Category — religion

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!

I decided what to do about the letter I received from the Ecclesiastical Tribunal: I have decided to let well enough alone and stay out of it. 

I’d be a liar to say I wasn’t curious about the testimony and to know what was said – but I’m curious about it in the same way I’m curious about Angelina Jolie and Brad Pitt’s life when I see the latest cover of People magazine. This annulment case is nowhere near as high-profile as those two, but it’s the same sort of curiosity; morbid and pointless.

Whatever the testimony is, it’s done now. If I were to find something in it to disagree with – and I think I could based on the petition he wrote – I’d have to go in for another interview, provide proof of my complaints and for what purpose? To make the Nice Young Man’s life more difficult? To bring misery and anger to him and his family just to make myself feel superior?

If he has convinced himself he was truthful in that petition, nothing I can say will pursuade him otherwise. If the Church is prepared to give him his annulment so he can remarry – well, that makes him his new wife’s problem and he hasn’t been my problem for a long time in any case.

Why should I ruin his chances for happiness simply because I think poorly of him now? I didn’t always think this badly of him – and even now disappointment is the overwhelming feeling I have – so out of respect for the good things I once felt, I can let this go.

Once upon a time I agreed to marry a Nice Young Man in the Catholic church.

I am not particularly religious, but it was important to him - and to his mother in particular – so in the interest of being a supportive and understanding sort of fiancee, I agreed to it.

We took the marriage course suggested by the priest who would marry us and this course seemed very sensible to me. So many couples get caught up in the wedding – dress, flowers, guests, decorations – that they don’t really talk about actually being married. I’m not saying being married is like having a job, but you can’t just phone it in either. Some effort is required. We talked about everything the course suggested we talk about and still agreed we belonged together.

Soon we are married.

We lived together and for a while everything was good. Sometimes it was even great. But the happiness didn’t last and - for a lot of reasons that I won’t get into here – he told me he wanted a divorce. We both cried over the loss of our relationship but agreed in the end that it was not something we could salvage.

We split up amiably, we didn’t get lawyers involved and everything was pretty cordial; even friendly at times.

Fast forward to the last year or so. The Nice Young Man is now involved with someone he cares for enough that he has proposed marriage – and she has accepted, but there is one snag: to remarry in the Catholic church, you must have your first marriage annulled.

I’m still a little fuzzy on the exact meaning of an annulment – but the basics are this: the marriage contract is invalid if the marriage state was not entered into with the intent to make a lifelong commitment and be open to reproduction. So, in the church’s eyes, we were never married, it was never a union sanctioned by God and is therefore null and void.

I think this a load of bunk myself, but there are millions of Catholics who disagree – including the Nice Young Man, his fiancee and his mother – so an annulment must be procured. I get an email asking if I’d be OK with having the marriage annulled and I said I’d help any way I could. He says that he doesn’t think our marriage was null and void, but that his bride-to-be and his mother are adamant that it be annulled.

So I talked to a priest with the Ecclesiastical Tribunal to get the process of annulment started. The priest asked me a lot of very personal questions pertaining to my former marriage, previous relationships, family history, childhood, medical history, current relationships, sexuality and personal feelings on things I’d rather not discuss with a perfect stranger.

It seemed a lot more like a nosy reporter digging up dirt for a gossip column than a respectful interview. It was very upsetting and intrusive but I answered honestly where I felt I could answer at all. I also omitted certain aspects of my married life with the Nice Young Man to protect both my privacy and his.  

I don’t mind helping him get an annulment to placate his fiancee and mother, but I refuse to lay some rather personal and unpleasant memories and events out for the Church to judge us on. It’s none of their damn business.

The real shocker came when I read the Nice Young Man’s petition for annulment – it was quite possibly the most awful thing I’ve ever read. It was full of half-truths and flat out lies – all of which made him out to be more Christian, kind and tolerant than he really is. I corrected some of those things with the priest, but I still didn’t spill the beans completely. I left that interview nearly in tears – between the lies the Nice Young Man wrote and the interrogation I’d already had from the priest about my personal life I was ready to snap.

I finally decided that angry as I was, it was best to simply move on from everything and everyone involved in it. So when the Nice Young Man emailed to ask how it went, I was truthful.  I told him it had been a horrible experience, one I’d endured only to help him out, and that his petition was the most hateful tissue of lies I’d ever read and to please not contact me again.

He hasn’t – so I let go of the silly revenge fantasies I was concocting in my head and moved on. I had hoped the tribunal would just do whatever it is they do and leave me out of it.

No such luck. I got a letter yesterday from them informing me the investigation is complete and would I please send them an answer stating whether or not I want to read the testimony and know the outcome of the investigation. I have also been told that I can appeal the outcome once I know it, assuming I have new evidence to submit before the ecclesiastical court.

I can’t decide what to do.

The part of me that thinks the Nice Young Man is a liar and a jerk wants to know the outcome only if it’s bad so I can gloat and think “See? This is what happens when you lie to the Church you jerk.” That’s not very Christian of me, but hey, I never said I was Christian – and really – neither is the Nice Young Man.

That same part of me also thinks that if he is granted his annulment that I ought to appeal it and let the full truth of our relationship be known – but since I’d be doing it mostly out of spite maybe that’s bad too.

Most of me wants to throw the stupid letter into the recycle bin and just wash my hands of it. Let them have their silly tribunal and decide whatever they want. It can’t affect my life now, and whether the petition is successful or not, we both know that he is a liar – and if there is a heaven and hell as the Catholics say, he’ll certainly be called to answer for the things he’s said and done.

If I believed in God, I’d be asking for some guidance right now. As it is, I’ll just have to give it a couple of days and see where I’m at.