Opinion: Bill removes checks on doctors who put conscience over patients’ well-being

More than 200 people gathered to protest Bill 207, a private member’s bill to legislate physician’s conscience rights to refuse treatment or referrals to patients on moral or religious grounds, at the Alberta Legislature building on Saturday, Nov. 16, 2019. Edmonton

Please consider this letter of concern regarding Bill 207 Conscience Rights Protection Act. As practising physicians, we have significant concerns with this legislation.

Physicians have numerous responsibilities, of which the most important is protecting the interests of our patients. Section 4(a) states that “Despite any provision of the Health Professions Act, a regulatory body may not impose a requirement on a health care provider that may result in the health care provider being compelled, directly or indirectly, to perform a health care service that they determine would infringe their conscientious beliefs.”

This provision allows health professionals to refuse medical services or even refuse to refer a patient to another professional who can provide the medically necessary services if such interventions are against their personal beliefs. This can effectively block access for patients to health care services especially in rural areas.

Imagine the consequences of a patient being denied access to a therapeutic abortion even if the woman’s life is in danger only because a physician happens to be against any type of abortions. In May 2019, the Ontario Court of Appeal upheld a requirement of “effective referral” in the situations where physicians object to health care services on moral grounds (Christian Medical and Dental Society v. College of Physicians and Surgeons of Ontario).

Section 4(b) states that “Despite any provision of Health Professions Act, a regulatory body may not impose a requirement or standards on a health care provider to make statements to any person or body that would infringe the health care provider’s conscientious beliefs.” This statement implies that a health professional can withhold information from patients related to their care. Patients presented with incomplete information are unable to engage in informed consent, which is the cornerstone of the principle of autonomy.

The bill goes on to mandate that, in section 5, a regulatory body must “immediately dismiss the complaint on the subject matter of which is a health care provider’s decision not to provide a health care service based on their conscientious beliefs without investigating.” Given this, any practitioner can use the claim of conscientious beliefs to mask their prejudice or malpractice without consequences. This is the most dangerous part of Bill 207. It removes all accountability for us professionals through our regulatory bodies and would leave patients with litigation as their only recourse.

It is easy to appreciate that abortion and medical assistance in dying (MAiD) will be targeted. On a more global scale, several vulnerable populations would be at highest risk of reduced access. First would be those living in rural communities. There are limited numbers of health care professionals in such settings, so a patient does not have a luxury of getting a second opinion for care.

Those living in low socio-economic situations already have limited access to health care resources. LGBTQ groups and our Indigenous population have demonstrated poor medical outcomes due to reduced access to health care services. Giving professionals permission to obstruct care without investigation or consequences will further worsen their outcomes.

Furthermore, this bill has the potential to harm everyone, not just the vulnerable populations in our society. What if there is a physician who views pain as a “will of God” and declines to use pharmacotherapy to relieve pain of patients? This is a hypothetical and morbid scenario. However, this bill effectively removes any mechanism to investigate and penalize those who choose to uphold conscientious beliefs over the well-being of patients.

We oppose Bill 207.

Dr. Michelle Jung is a rheumatologist in Calgary.

On behalf of:

  1. Dr. S. Monty Ghosh, Internal Medicine, Airdrie
  2. Dr. Zuzana Triska, Family Medicine, Banff
  3. Dr. Annelies Noordman, Family Medicine, Bragg Creek
  4. Dr. Sarah Glaze, Gynecologic Oncology, Calgary

  1. Dr. Frances Vettergreen, Family Medicine, Calgary
  2. Dr. Sonja Metcalfe, Family Medicine, Calgary
  3. Dr. Melanie Sohn, Emergency Medicine, Calgary
  4. Dr. Matthew Grabove, Emergency Medicine, Calgary
  5. Dr. Sarah Evans, Family Medicine, Calgary
  6. Dr. Anne Roggensack, Maternal Fetal Medicine, Calgary
  7. Dr. Deidre Young, Family Medicine, Calgary
  8. Dr. Shauna Mercer, Family Medicine, Calgary
  9. Dr. Jacqueline Hakes, Family Medicine, Calgary
  10. Dr. Ayesha Saeed, Family Medicine, Calgary
  11. Dr. Stephanie Mullin, Sport and Family Medicine, Calgary
  12. Dr. Rachel Talavlikar, Family Medicine, Calgary
  13. Dr. Leah Dettman, Family Medicine, Calgary
  14. Dr. Shawna Lamond, Family Medicine, Calgary
  15. Dr. Megan Blades, Obstetrics & Gynecology Resident, Calgary
  16. Dr. Daniela Porter, Physical Medicine and Rehabilitation, Calgary
  17. Dr. Katie Wiltshire, Neurology, Calgary
  18. Dr. Cassandra Millar, Family Medicine, Calgary
  19. Dr. Christine O’Reilly, Family Medicine, Calgary
  20. Dr. Elizabeth McLeman, Emergency Medicine, Calgary
  21. Dr. Kathleen Hicks, Family Medicine, Calgary
  22. Dr. Saumya Selvaraj, Family Medicine, Calgary

27. Dr. Rachel Greenwood, Family Medicine, Calgary

28. Dr. Brienne McLane, Psychiatry, Calgary
29. Dr. Lauren McGruthers, Family Medicine, Calgary

30. Dr. Sheila Caddy, Obstetrics & Gynecology, Calgary

31. Dr. Cindy Kao, Obstetrics & Gynecology, Calgary

32. Dr. Suneina Mohan, Psychiatry, Calgary

33. Dr. Nadia Luca, Pediatric Rheumatology, Calgary

34. Dr. Salima Alladina, Emergency Medicine, Calgary

35. Dr. Judith Paget, Family Medicine, Calgary
36. Dr. Jenn D’Mello, Pediatrics, Calgary

37. Dr. Kailey Birn, General Surgery, Calgary
38. Dr. Ananya Das, Family Medicine, Calgary
39. Dr. Caroline Turner, Family Medicine, Calgary
40. Dr. Nureen Pirbhai, Family Medicine, Calgary
41. Dr. Kristina Moore, Family Medicine, Calgary
42. Dr. Kaitlin Robertson, Family Medicine, Calgary

43. Dr. Shosh Guilfoyle, Family Medicine, Calgary
44. Dr. Rachel Lim, Respirology, Calgary
45. Dr. Megan Barber, Rheumatology Resident, Calgary

46. Dr. Sara Kunneman, Family Medicine, Calgary
47. Dr. Milli Gupta, Gastroenterology, Calgary
48. Dr. Kechi Ozoka, Family Medicine, Calgary
49. Dr. Cindy Du, Family Medicine, Calgary

50. Dr. Christine East, Emergency Medicine, Calgary
51. Dr. Leyla Baghirzada, Anesthesiology, Calgary
52. Dr. Jennifer Graham, Pediatric Emergency Medicine, Calgary

53. Dr. Farrah Yau, Plastic Surgery, Calgary
54. Dr. Stephanie Kerwin, Family Medicine, Calgary
55. Dr. Amanda Hogg, Pediatrics, Calgary
56. Dr. Dr. Manoji Wirasinghe, Family Medicine, Calgary
57. Dr. Fiona Mattatall, Obstetrics & Gynecology, Calgary
58. Dr. Carrie Abrahamson, Family Medicine, Calgary
59. Dr. Jennifer Yu, Family Medicine, Calgary
60. Dr. Margriet Greidanus, Emergency Medicine, Calgary
61. Dr. Rachel Schachar, Orthopedic Surgery, Calgary
62. Dr. Ellen Morrison, Pediatric Emergency Medicine, Calgary

63. Dr. Caylib Durand, Rheumatology, Calgary
64. Dr. Naomi Rittberg, Family Medicine, Calgary
65. Dr. Laura Wood, Family Medicine, Calgary
66. Dr. Chantal McLuckie, Family Medicine, Calgary
67. Dr. Heidi von Engelbrechten, Family Medicine, Calgary
68. Dr. Rosalyn McAuley, Psychiatry, Calgary
69. Dr. Kerry McBrien, Family Medicine, Calgary
70. Dr. Priya Govender, Family Medicine, Calgary
71. Dr. Mihaela Chaudhary, Family Medicine, Calgary

72. Dr. Patricia Ting, Dermatology, Calgary
73. Dr. Amy Chow, Pediatrics, Calgary
74. Dr. Giselle DeVetten, Family Medicine, Calgary
75. Dr. Lynn Peterson, Family Medicine, Calgary
76. Dr. Rachel Ottenbreit, Family Medicine, Calgary
77. Dr. Natalie Ward, Family Medicine, Calgary
78. Dr. Diana Grainger, Family Medicine, Calgary
79. Dr. Hannah Park, Emergency Medicine, Calgary
80. Dr. Katherine Billinghurst, Family Medicine, Calgary
81. Dr. Kendra Lamb, Obstetrics & Gynecology, Calgary
82. Dr. Eileen Kabaroff, Emergency Medicine, Calgary
83. Dr. Michelle Hokanson, Anesthesiology, Calgary
84. Dr. Kathy Lo, Obstetrics & Gynecology, Calgary
85. Dr. Jennifer Nicol, Emergency Medicine, Calgary
86. Dr. Nikolett Raguz, Obstetrics & Gynecology, Calgary
87. Dr. Yasmin Nasser, Gastroenterology, Calgary
88. Dr. Katrina Sawatsky, Family Medicine, Calgary
89. Dr. Erin Brennand, Gynecology, Calgary
90. Dr. Adrienne Lee, Hematology, Calgary
91. Dr. Michaela Walter, Internal Medicine, Calgary
92. Dr. Danielle Diaz, Family Medicine, Calgary
93. Dr. Mark Diaz, Family Medicine, Calgary
94. Dr. Shunaha Kim-Fine, Obstetrics & Gynecology, Calgary

95. Dr. Katherine Bisby, Family Medicine, Calgary

96. Dr. Christine Gibson, Family Medicine, Calgary

97. Dr. Natalie Forbes, Pediatrics, Calgary
98. Dr. Jillian Ratti, Family Medicine, Calgary

99. Dr. Pawel Niemczweski, Family Medicine, Calgary

  1. Dr. Giselle Devetten, Family Medicine, Calgary
  2. Dr. Michelle Jackman, Pediatrics, Calgary
  3. Dr. Sarah Cribby, Rheumatology Resident, Calgary
  4. Dr. Tara Lohmann, Respirology, Calgary
  5. Dr. Ellie Vyver, Adolescent Medicine, Calgary
  6. Dr. Karen Naert, Anatomical Pathology, Calgary
  7. Dr. Emma Morin, Family Medicine, Canmore
  8. Dr. Elaine Desnoyers, Family Medicine, Canmore
  9. Dr. Candice Knoechel, Family Medicine, Cochrane
  10. Dr. Jennifer Corrales, Family Medicine, Cochrane
  11. Dr. Mark Schindel, Anesthesiology, Edmonton
  12. Dr. Natashka Pollock, Ophthalmology, Edmonton
  13. Dr. Rose Yeung, Endocrinology, Edmonton
  14. Dr. Julia Drager, Pediatrics, Edmonton
  15. Dr. Tally Mogus, Family and Addiction Medicine, Edmonton
  16. Dr. Tehseen Ladha, Pediatrics, Edmonton
  17. Dr. Lindsay Bridgland, General Internal Medicine, Edmonton

  1. Dr. Jessica Kirkwood, Family and Addiction Medicine, Edmonton
  2. Dr. Sue Chandra, Maternal Fetal Medicine, Edmonton
  3. Dr. Brenda Law, Neonatology, Edmonton
  4. Dr. Fareeha Nasir, Pediatrics, Edmonton
  5. Dr. Kimberly Dary, Child and Adolescent Psychiatry, Edmonton
  6. Dr. Lynora Saxinger, Infectious Diseases, Edmonton
  7. Dr. Florence Cheng, Family Medicine, Edmonton
  8. Dr. Dawn Young, Pediatrics, Edmonton
  9. Dr. Kathleen Crawford, Emergency Medicine, Edmonton
  10. Dr. Ashley Gillson, Respirology, Edmonton
  11. Dr. Rshmi Khurana, Internal Medicine, Edmonton
  12. Dr. Soumi Sikder, Family Medicine, Edmonton
  13. Dr. Danielle Michaels, Family Medicine, Edmonton
  14. Dr. Neeja Bakshi, Internal Medicine, Edmonton
  15. Dr. Alice Bedard, Family Medicine, Edmonton
  16. Dr. Nadia Giannakopoulos, Pathology, Edmonton
  17. Dr. Yuliya Kolodenko, Family Medicine, Edmonton
  18. Dr. Carmen Young, Maternal Fetal Medicine, Edmonton
  19. Dr. Anthea Peters, Hematology, Edmonton
  20. Dr. Cheryl Mather, Pathology, Edmonton
  21. Dr. Dianna Wang, Neonatology, Edmonton
  22. Dr. Diana Yu, Family Medicine, Edmonton
  23. Dr. Ariane Fielding, Anesthesiology, Edmonton

  1. Dr. Cindy Lee, Family Medicine, Edmonton
  2. Dr. Katherine Ross, Internal Medicine, Edmonton
  3. Dr. Jennifer Minsos, Hospital Medicine, Edmonton
  4. Dr. Christine Froelich, Adult Psychiatry, Edmonton
  5. Dr. Ainslie Gilchrist, Anesthesiology, Edmonton
  6. Dr. Mary Cummins, Psychiatry, Edmonton
  7. Dr. Chantal Moreau, Psychiatry, Edmonton
  8. Dr. Freda Lo, Family Medicine, Edmonton
  9. Dr. Kim Dolynchuk Edmonton. Family practice, Edmonton
  10. Dr. Joanne Baergen, Family Medicine, Edmonton
  11. Dr. Lindsay Paton-Gay, Psychiatry, Edmonton
  12. Dr. Tiffany Van Slyke, Family Medicine, Edmonton
  13. Dr. Jeanelle Sabourin, Gynecologic Oncology, Edmonton
  14. Dr. Shazma Mithani, Emergency Medicine, Edmonton
  15. Dr. Andrea Brown, Family Medicine, Edmonton
  16. Dr. Andrea Estey, Pediatric Emergency Medicine, Edmonton
  17. Dr. Frances Carr, Geriatrics, Edmonton
  18. Dr. Colleen Kjelland, Emergency Medicine, Edmonton
  19. Dr. Amelia Leskiw, Family Medicine, High River
  20. Dr. Julie Smith, Family Medicine, Lethbridge
  21. Dr. Naomi Fridhandler, Obstetrics & Gynecology, Okotoks
  22. Dr. Alyzee Sibtain, Radiology, Red Deer

  1. Dr. Thara Kumar, Emergency Medicine, Red Deer
  2. Dr. Kim Anderson-Hill, Family Medicine & Women’s Health, Sherwood Park
  3. Dr. Gaylene Genge, Family Medicine, Spruce Grove
  4. Dr. Melanie Currie, Family Medicine, Spruce Grove
  5. Dr. Elisabeth Thompson, Family Medicine, Spruce Grove
  6. Dr. Krista Piebiak Patterson, Family Medicine, Spruce Grove
  7. Dr. Carla Laidlaw, Family Medicine, Spruce Grove
  8. Dr. Lindsey Campbell, Family Medicine, Spruce Grove
  9. Dr. Benjamin Lewis, Family Medicine, Spruce Grove
  10. Dr. Bailey Adams, Family Medicine, St. Albert
  11. Dr. Marielle Pratt, Family Medicine, St. Albert
  12. Dr. Athena Bennett, General Surgery, St. Albert
  13. Dr. Samantha Horvey, Family Medicine, St. Albert
  14. Dr. Barbara Fischer, Family Medicine, St. Albert