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Ontario: Court forces doctors to refer patients to death

By Alex Schadenberg

ON JAN. 31st, the Ontario Divisional Court ruled unanimously in a 3-0 decision that doctors in Ontario who oppose killing patients who request assisted suicide must provide an effective referral to a physician who will kill them.

Groups representing 4,700 Christian doctors had challenged Ontario’s regulations requiring the referrals, saying that making such a referral was morally equivalent to participating in an assisted death.

Effective referral means a referral for the purpose of the act. Sean Fine, Justice writer for the Globe and Mail reported that Justice Herman Wilton-Siegal wrote:

“The evidence in the record establishes a real risk of a deprivation of equitable access to health care, particularly on the part of the more vulnerable members of our society, in the absence of the effective referral requirements.”

Paula Loriggio, reporting for the Canadian Press, stated: “the divisional court said that though the policy does limit doctors’ religious freedom, the breach is justified.”

Fine reported that Albertos Polizogopoulos, an Ottawa lawyer representing the doctors who were challenging the Ontario regulations, argued that the effective referral mandate violates the freedom of conscience and religion protected in Section 2 of Canada’s Charter of Rights and Freedoms:

“Our position is doctors who opposed assisted suicide or physician-assisted death are put in a position now where they either need to violate their conscience and their religious and moral belief or face being disciplined by the college – and that’s not a good place to be.

“. . . most provinces do not require referrals to willing physicians. Alberta, for example, co-ordinates requests and referrals through a centre that patients can call on their own. The faith groups do not object to referring patients to the centre. Manitoba has a team of physicians willing to help the severely ill end their lives. Ontario has now set up a co-ordinating centre but doctors of faith say they are still concerned that they are responsible for an “effective referral.”

Fine reported that this case is the first to test the constitutional rights of doctors who object to assisted death on grounds of conscience, and the decision comes as doctors opposing assisted suicide struggle to find a middle ground. Some hospitals run by Catholic, Jewish or other religious groups have declined to offer assisted dying. In those cases, patients are transferred to other facilities.

As of Dec. 31, Ontario’s chief coroner has recorded 1,030 deaths by physician-assisted death in Ontario.

The Supreme Court of Canada struck down the previous law on assisted dying in February 2015. The court said nothing in its ruling compelled physicians to provide assistance in dying. It added that it was up to governments and regulatory colleges to reconcile the Charter rights of patients and physicians.

Parliament legalized assisted death on June 17, 2016. The legislation stated in its preamble that doctors have a right to freedom of conscience, and are not required to perform or assist in the provision of an assisted death.

The decision by Ontario’s Divisional Court can be appealed. Those who wish to support the Coalition for Healthcare and Conscience can sign a petition at   TAP

Alex Schadenberg is the International Chair of the Euthanasia Prevention Coalition.

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