Should provinces permit medical professionals to refuse to provide controversial services? Think of some of the biggest hot-button, controversial issues in medicine today. How does a doctor respond to a request for an abortion or for various forms of contraception? Can a Christian hospital refuse to provide euthanasia? Or think of medical transitioning. What can a doctor do if a male patient says they want to ‘transition’ to become a woman?  Is it ok if the doctor only needs to refer the patient to another doctor who will provide the service?

Many of the conversations around conscientious objection have been around the issue of euthanasia and assisted suicide, ever since it was legalized in 2016. The conversation also extends to whether certain facilities can refuse to provide euthanasia. However, provincial conscience policies typically apply to any legally available medical procedure.  A few recent developments highlight some of the problems with how our healthcare system treats conscientious objection.

New Policy in Nova Scotia 

At the end of May, the College of Physicians and Surgeons of Nova Scotia released a new document regarding conscientious objection. The policy leaves no ambiguity about what services physicians must effectively refer for. At the outset of the College’s “Professional Standards Regarding Conscientious Objection,” the College clarifies that it applies to, but is not limited to, “Medical Assistance in Dying (MAiD), immunization, reproductive care and gender affirming care.”

Proponents of the policy will be quick to say that no medical professional is required to participate in providing a service they object to. Yet, the policy requires physicians to provide information (even if it conflicts with their conscience) and to facilitate a procedure by providing an effective referral. An effective referral is defined as “a referral made in good faith to a non-objecting, available, and accessible physician, healthcare professional, or agency or service that oversees the delivery of the care being sought.”

So, the physician must ensure that the patient is connected with a non-objecting physician or service, thereby placing the patient on the path towards receiving a service that the physician objects to. Many doctors believe they are complicit if they provide an effective referral. Although they are not directly providing the procedure, they are still required to facilitate it.

Currently, only Nova Scotia and Ontario directly require effective referral. But there is increasing pressure for other provinces to implement similar policies. Health Canada’s Model Practice Standard for MAiD recommends that all provinces implement effective referral policies, at least for euthanasia. The College of Physicians and Surgeons of Alberta tried to do this recently, but received enough pushback that they did not end up incorporating such language.

Some of the negative consequences of Nova Scotia’s new policy are already clear. Not only is it wrong to force doctors to violate their conscience, but doctors are ready to leave the province as a result. When the College was considering this new policy, CTV News Atlantic reported that at least 24 physicians in Nova Scotia indicated that they cannot follow the policy and may need to leave the province or retire early. Likely, there are more. As of June 2024, there were over 160,000 Nova Scotians on a wait list for a family doctor in the province. Losing more doctors will exacerbate Nova Scotia’s healthcare shortage.

MAiD-Free Health Care

In two other provinces, conscience protection in faith-based institutions continues to be targeted. In 2023, the National Assembly of Quebec passed a law which stated that no palliative care hospice may refuse to provide euthanasia. The Archbishop of Montreal, who leases property to a Catholic-supported hospice in Montreal, has launched a legal challenge against the law in Quebec. A Court decision responding to an exemption request stated that the public interest in ensuring access to euthanasia is of fundamental importance.  You can read more about that case here.

Meanwhile, in British Columbia, St. Paul’s Hospital also does not provide euthanasia. The hospital is operated by Providence Health, a Catholic organization that refuses to provide euthanasia in any of its 18 facilities. After public uproar when a woman was forced to transfer hospitals before she could be euthanized, the provincial government agreed with Providence Health to create a separate clinical space next to the hospital where patients would be able to access euthanasia.

Such a compromise was not enough for some patients. One woman was diagnosed with stage 4 cancer in 2023. Upon receiving that diagnosis, she wanted to die by euthanasia, but was being treated at St. Paul’s Hospital in Vancouver. She was heavily sedated to be transferred to another facility and died hours later. Her mother, along with a palliative care doctor who quit over Providence Health’s policy to not allow MAiD in its facilities, has launched a lawsuit against the province of British Columbia and Providence Health Care, alleging that the “forced transfer” caused “egregious physical and psychological suffering, and denied her a dignified death.”

In addition to the obvious concerns about forcing conscientious objectors to provide euthanasia, there are many patients who want health care that does not include euthanasia. This is, of course, true of those for whom euthanasia is immoral. But it is also true of those that may support euthanasia in principle, but do not want it for themselves.

Some disability advocates, for example, worry about ableism in health care and the idea that you are “better dead than disabled.” They worry about whether MAiD will be provided against their wishes or in a moment of weakness. They want care that never includes the killing of people with disabilities. Such advocates speak of safe spaces, or MAiD-free health care, where patients do not have to fear being euthanized.

Conscience protection more necessary than ever

Euthanasia has become entrenched in our society. It is increasingly seen as a right. It’s not simply something that is legal as a last resort, nor is it even one option among many that patients may choose. Rather, it is seen by some as an obligation that doctors must provide in order to avoid patient suffering. Meanwhile, palliative care as a means of relieving suffering is seen as less important.

Canadians must continue advocating for freedom of conscience in healthcare, not just for doctors but also for patients. Stay tuned for further developments and action items as they arise.

The College of Physicians and Surgeons of Alberta has proposed changes to its policy on conscientious objection by requiring all doctors to provide “effective referrals”.

The College licenses and regulates doctors in the province. It has the power to investigate and discipline any doctors who do not follow the College’s policies.

Albertans can share their views on this proposed change until January 15. This is an opportunity to stand up for ethical, conscientious doctors. We offer some advice on how to do so at the end of this article.

Proposed ‘Conscientious Objection’ Policy

The College’s proposed policy would require doctors to clearly state their conscientious objection, to provide accurate information about available services, and to continue providing care for a patient as long as required. But it would also require doctors to “proactively maintain an effective referral plan for the frequently requested services they are unwilling to provide.” Similarly, it requires members not to “expose patients to adverse clinical outcomes due to a delayed effective referral.” In other words, although the policy does not require doctors to provide objectionable services (such as abortion or physician-assisted death), it requires them to facilitate a patient’s timely access to such services.

Effective Referral

Currently, only Ontario and Nova Scotia explicitly require an effective referral, with Alberta set to become the third if this policy is adopted. While the CPSA does not define ‘effective referral,’ others have defined it as “Taking positive action to ensure the patient is connected to a non-objecting, available, and accessible physician, other health-care professional, or agency.” Essentially, an ‘effective referral’ requirement ensures that a doctor facilitates euthanasia or abortion by connecting a patient with a doctor or resource that will help the patient receive the requested service. Effective referral policies violate doctors’ consciences and undermine our healthcare system. You can read more about effective referral and why it is a concern here.

Participate in the Consultation

Any Albertan can provide feedback directly to the College. There are two ways to do so. First, you can fill in a comment box on the College’s website and select whether to make your comment public or not. Second, you can fill out a brief survey, consisting of 14 questions – just be aware that the survey touches various aspects of the proposed policy besides effective referral. Choose the option that is best for you and share your thoughts by January 15, 2024.

Suggested Talking Points

Here are some talking points that you can use to help form a response to the consultation.

Once again, please send your thoughts to the College by January 15, 2024. We encourage you to use the ideas in this article, expand on them, and present them in your own words.

**Update**

As of January 11, 2024, the College has updated its consultation page with the following:

“Based on initial feedback received, the term ‘effective referral’ will be removed from the Conscientious Objection standard. Those that provide feedback during the consultation period will be consulted again during the re-consultation phase and see additional edits before final approval.”

While we have yet to see what a revised policy looks like, the decision to remove the term ‘effective referral’ is a promising development for which we can be thankful. We encourage you to still weigh in on the proposed policy, and also support the College in their decision to remove the term ‘effective referral.’ 

In recent weeks, the story of one terminal cancer patient who had to be transferred out of Providence Health so that she could be euthanized was reported on by various news outlets. These stories prompted Health Minister Adrian Dix to promise that he would talk to Providence Health and pressure them to provide euthanasia on site.

Providence Health, “inspired by the healing ministry of Jesus Christ… is a Catholic health care community dedicated to meeting the physical, emotional, social and spiritual needs of those served through compassionate care, teaching and research,” according to its mission statement. For the past decades, denominational health care providers have operated through a master agreement between the province and the denominational health care facilities association. This agreement allows religious health care providers to partner with the provincial government but still retain “the right to determine in the context of their respective values and traditions the mission and values of the owner so as to preserve the spiritual nature of the facility.”

In other words, this agreement allowed religious health care providers like Providence Health to opt out of providing things they thought were immoral, such as abortion, contraception, or euthanasia.

But now the provincial government is under pressure to scrap or renegotiate this agreement. This would lead to the province either defunding Providence Health and possibly taking over their facilities (as happened already with Delta Hospice) or forcing Providence Health to provide euthanasia against their ethical, conscientious, and religious convictions. Unlike Delta Hospice, Providence Health is a big player in health care in Vancouver. It operates ten different institutions in Vancouver and is in the midst of building a brand new, 548-bed St. Paul’s Hospital at a cost of $2.1 billion in partnership with the provincial government.

In his promise to pressure Providence Health into providing euthanasia, Minister Dix ignores two key pieces of history and an important legal reality.

First of all, the government is relatively new to delivering health care. Until the late twentieth century, churches and civil society shouldered the bulk of the duty to care for the sick and dying. In many cases, this health care came at great personal cost. Governments were absent.

One ancient example is the Justinian Plague, during the dying days of the Roman Empire, when most citizens in Rome hid indoors to avoid catching the plague, leaving the sick and dying to fend for themselves. The exception was the Christians, who took it upon themselves to care for those infected by the plague to either help them recover or to comfort them during their last days. The Roman Emperor Julian, although an opponent to the Christian faith, nevertheless marvelled that they “care not only for their own poor but for ours as well; while those who belong to us look in vain for the help that we should render them.”

A more recent example is Mother Theresa, a devout Catholic from Macedonia who moved to India to minister to the sick and needy. Her compassion and mission to live out her faith in service to the sick have inspired countless others.

When it comes to health care, the primary role of governments has been to ensure that every person has the financial means to obtain health care, not to dictate how the sick are cared for. The main objective of Canadian health care policy, set out by the Canada Health Act, “is to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.” It accomplishes this objective by making the government the single payer for all medically necessary services. Governments should amplify rather than supplant religiously motivated efforts to care for the sick.

This was precisely why BC’s Denominational Health Care Facilities Association agreement was struck in 1995. Its purpose was to further the partnership between the provincial government (as the single payer for health care) and religious organizations (as one of many providers of health care) to care for the sick and dying. Scrapping the agreement or forcing religious institutions to violate their moral principles is equivalent to saying to the oldest player in health care, “Thank you for your service; now beat it.”

Which brings us to the second lesson from history. For thousands of years, health care practitioners have followed the Hippocratic oath. That oath includes the promise to use “regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course.” Patients could be confident that a physician was seeking to preserve their life and restore their health. Euthanasia was anathema.

This ethical standard was reflected in the Canadian Criminal Code, which outlawed euthanasia, assisted suicide, as well as counselling or encouraging someone to end their life. Euthanasia and assisted suicide were serious crimes.

Unfortunately, that changed when the Supreme Court and Parliament jointly legalized what they euphemistically called Medical Assistance in Dying. Over two thousand years of devotion to preserving the health of patients and doing no harm was thrown out the window.

Yes, euthanasia is now legal in Canada. That does not mean that every health care professional or institution, even if partially funded by the government, is obligated to provide euthanasia. Legal does not mean obligatory. There may be very good reasons why we don’t allow care aids to administer euthanasia and why not every small-town hospital in BC provides open heart surgery. By way of analogy, the legalization of marijuana does not mean that governments are obligated to provide everyone with the substance or force other institutions to provide it.

It is absurd that any institution should be criminally investigated, as Providence Health was, for not doing something that was a serious crime only 7 years ago, namely killing someone at her request.

Providence Health also has the constitution on its side. The Charter of Rights and Freedoms guarantees freedom of conscience and religion (which protects individual health care practitioners from being forced to provide euthanasia against their religious or conscientious convictions), but also freedom of association. Taken together, these freedoms protect a religious health care institution’s choice to refuse to engage in a practice for religious and moral reasons.

When Dr. George Carson, an obstetrician and gynecologist in Saskatchewan quoted in an article by Daphne Bramham, says that “conscientious objection for a building — particularly one supported by taxpayers — makes no sense,” he fundamentally mistakes what an association is. Providence Health isn’t a building. Providence Health is a collection of health care professionals and support staff who have freely associated together to serve a common cause: “inspired by the healing ministry of Jesus Christ, Providence Health Care is a Catholic health care community dedicated to meeting the physical, emotional, social and spiritual needs of those served through compassionate care, teaching and research.”

Providence Health operates 20 of 68 palliative care beds in the Coast Health region and is in the middle of constructing, in partnership with the provincial government, a new and expanded St. Paul’s Hospital. In a province that is in dire need of more palliative care beds (and more health care capacity in general), the Premier and the Health Minister shouldn’t be picking ideological battles with religious health care providers. Instead, to better serve its citizens, the government should be asking: how can we form more, new, and better partnerships with faith-based institutions to provide the services that British Columbians need?

So… could you spare five minutes of your time to send your MLA and Minister Dix a note, voicing your support for Providence Health’s right to operate according to their religious convictions?

Send an EasyMail

Ryan and Daniel are hard at work in the Ontario Legislature connecting with representatives to encourage them to protect doctors’ consciences.

Do You Want a Doctor with a Clear Conscience?

Consider the testimony of one Ontario doctor, who spoke to an Ontario legislative committee studying the issue of euthanasia. “I ignored my conscience, opting instead to follow the college policy and convincing myself that I had no choice … this was destructive to my very core. I felt like a shell of myself. Months later, I often still do. I came very close to leaving palliative care at the time, and every day I continue to question my ability to stay in this field.”[1]

This is one example of a doctor who has been directly impacted by Ontario’s policies for medical professionals who are asked to provide euthanasia. Others have brought up concerns that they may have to leave the province, retire early, or change specialties to avoid violating their conscience. Students in medical school also have concerns about what their medical career will look like due to the lack of protections for freedom of conscience.

As eligibility for euthanasia has expanded in recent years, an increasing number of doctors are concerned about how to care for patients who request it.

What’s the Big Deal?

Every doctor in Ontario is regulated by the College of Physicians and Surgeons of Ontario (CPSO). If there is any malpractice, the CPSO will deal with it. The CPSO also develops policies for how to address situations where a patient requests euthanasia.

In most cases, doctors are permitted to use their professional expertise and refuse ‘services’ that a patient requests if they believe it is not in the patient’s best interest. For example, a patient might request severe body modifications like a tongue splitting. Doctors may have different opinions on whether they should approve such a request, and they are permitted to refuse. However, if the ‘service’ requested is a more controversial and politicized one such as euthanasia, the doctor is not permitted to simply refuse. Instead, he must provide an effective referral. This means that he must connect the patient with a doctor who is willing to provide that procedure. While the patient’s doctor is not required to personally provide euthanasia, he is required to participate by helping the patient get what they want.

You have often heard ARPA Canada talking about freedom of conscience for medical professionals. This is also the focus of a policy report we published in 2021. While Ontario’s policy is among the worst in Canada, Manitoba is the only province that has explicitly protected freedom of conscience around euthanasia provision. This remains a controversial subject, which many in Canada’s legislatures are not ready to do anything about.

Why is this an issue?

With the recent expansions to euthanasia, activists are concerned about so-called ‘access to care.’ If a doctor in a remote, rural area of Canada is unwilling to provide euthanasia, the patient might not be able to access it easily or quickly through another doctor. Others are concerned that a doctor is passing moral judgment on a patient for requesting euthanasia, and this is deemed offensive. Ultimately, they say, a doctor must accommodate to provide the best possible experience for patients who need proper ‘care.’ They argue that we need to strike an appropriate balance between freedom of conscience and access to care, and many think that a policy requiring effective referrals, like the one in Ontario, does this adequately.

Federal and provincial governments seem to be worried about the backlash that may come from activists as a result of protecting conscience for doctors. And they don’t seem to have an effective defense. The contrast is too often set up as a choice between something that is good for doctors or something that is good for patients, and it becomes a battle between two sides. Instead, we need to realize that protecting freedom of conscience will be good for doctors and patients.

Why the Hesitancy?

With the recent expansions to euthanasia, activists are concerned about so-called ‘access to care.’ If a doctor in a remote, rural area of Canada is unwilling to provide euthanasia, the patient might not be able to access it as easily or as quickly. Others are concerned that a doctor is passing moral judgment on a patient for requesting euthanasia, and this is deemed offensive. Ultimately, they say, a doctor must accommodate to provide the best possible experience for patients who need proper ‘care.’ They argue that we need to strike an appropriate balance between freedom of conscience and access to care, and many think that a policy like the one in Ontario does this adequately. Federal and provincial governments seem to be worried about the backlash that may come as a result of protecting conscience. And they don’t seem to have an effective defense.

The contrast is too often set up as something that is good for doctors or good for patients, and it becomes a battle between two sides. Instead, we need to realize that the protection of freedom of conscience will be good for doctors and patients.

Good for Doctors and Patients

Let’s look at a brief story to illustrate this idea. Dr. Ignaz Semmelweis was a young doctor at a famous teaching hospital in Vienna in the 1840s. At the time, the hospital was experiencing high mortality rates in the maternity ward. When Dr. Semmelweis was placed in charge of one of the obstetrical wards, he realized that the women who died were usually the ones who had been examined by physicians and students who had recently come from autopsying the women who had died the day before. Dr. Semmelweis made a rule that anyone who had participated in autopsies must wash their hands before examining living patients. The mortality rate dropped significantly.

Later, Dr. Semmelweis made a rule that everyone must wash their hands after examining each patient, as he saw how disease seemed to spread from one patient to another. Although the mortality rate decreased further, his colleagues protested and ultimately his contract was not renewed.

Dr. Semmelweis obtained a new job in a hospital in Budapest and instituted the same policy surrounding washing hands. Mortality rates decreased, but he was again scorned by many of his colleagues. Despite the proof of decreased mortality rates, the medical establishment was unwilling to accept the importance of handwashing in medicine for many years.

When doctors are permitted to question medical practices (especially in controversial areas), healthcare improves. A doctor who has been trained to quiet his conscience and simply follow the crowd will not do what is best for his patient. The above example is obviously different from the issue of euthanasia, but presents a similar dilemma. Should a doctor disagree with established medical practice if he is convinced that the practice is harming patients? Or should he simply go with the flow and avoid controversy? When a doctor today is asked to provide euthanasia, he faces pressure to silence his conscience and kill his patient.

Another side of this are the healthcare shortages throughout Canada. The news lately has been full of stories of how we need to improve healthcare. In Ontario, for example, the government is seeking to decrease wait times for surgeries, and trying to attract more medical professionals to the province. What they don’t realize is that the current policy around conscience is pushing doctors out of the profession.

Conclusion

Patients suffer when doctors are afraid of speaking out about their concerns. Doctors suffer when they are forced to violate their conscience. We must advocate for a medical system that encourages dialogue between doctors and patients and allows doctors to practice in a way that is consistent with their beliefs.

Get Involved

Our challenge to you: meet with your MPP on this important issue.

We’d be happy to help. Click here to participate in this conscience campaign; share your email address, your riding/MPP and we’ll respond with some resources (including our new Conscience One-Pager) to help make sure you have what you need to make sure your meeting is as good as it can be.

[1] Legislative Assembly of Ontario, Standing Committee on Finance and Economic Affairs, “Medical Assistance in Dying Statute Law Amendment Act 2017” in Official Report of Debates (Hansard) 41st Parl., 2nd Sess., No F-17 (30 March 2017) at F-570, JBA. The Committee witness was Dr. Natalia Novosedlik.

To sign up, visit staging.arpacanada.ca/conscience

You’d be hard pressed to find a topic that has been discussed more in the last year than vaccine mandates. As we were heading into the summer of 2021, the federal and provincial governments were debating whether to enact vaccination requirements. Most provinces brought in a mandate of some sort by late summer/early fall. The federal government was the last jurisdiction to enact their mandatory vaccination policies, in the late fall.

Last summer, ARPA Canada took the position that Coercive Vaccine Mandates Are Bad Public Policy. In the months following these mandates we have witnessed what is arguably the most divisive time in our nation’s history. This was predicted in our article where we wrote: “Forcing citizens into decisions, particularly a decision that directly impacts what they put into their bodies, is likely to further anger and alienate those who were hesitant or outright resistant.” At this point, most mandates have been removed or, in the case of the federal government, suspended, but the fallout of these terrible policies will be felt for some time.

One response we’re seeing is attempts to pass legislation that would limit the federal government’s ability to enact these types of heavy-handed policies moving forward. On June 2nd, Conservative leadership candidate MP Pierre Poilievre tabled Bill C-278, The Prevention of Government Imposed Vaccination Mandates Act. The bill proposes changes to the Financial Administration, Aeronautics, Railway Safety and Canada Shipping Acts, as well as the Canada Labour Code. In his speech to introduce the bill, Poilievre said, “This bill would ban the government from imposing vaccine mandates as a condition of travel or employment. If the bill passes, the government would no longer be able to require federal workers to get vaccinated in order to keep their paycheques and jobs. It would also ban the federal government from requiring vaccines in order for people to travel. In other words, it would allow all Canadians, regardless of their personal medical decisions, to continue to work in the federal sector or travel on trains, planes and other federally regulated modes of transportation, regardless of whether they are vaccinated.”

On June 15, Niagara West MP Dean Allison introduced Bill C-285, the Medical Freedom Act. Allison introduced the bill with these words, “The bill would amend the Canadian Human Rights Act to add conscientious belief and medical history to the list of prohibited grounds of discrimination. The bill seeks to protect travelers from being banned because of their medical status. It would protect employees from reprisals by their employers because of a medical choice. The bill would also safeguard employees’ EI benefits in the event that they are let go because of a medical decision they made for themselves.”

Both bills, if passed, would make changes to the Canada Labour Code in an effort to add protections for Canadian workers specifically as it pertains to Covid-19 vaccinations. One significant difference between the two bills is that Bill C-278 only refers to Covid-19 vaccinations, whereas Bill C-285 is much broader in its addition of conscientious belief and medical history as protected grounds in the Human Rights Code.

It’s positive to see bills being brought forward in response to the divisive vaccinate mandates and proof of vaccination policies. The House of Commons has risen for its summer break, so these bills won’t be addressed any further until the fall. But stay tuned for grassroots activity on these bills in the fall. In the meantime, you can still get in touch with your own MP and encourage him or her to support these bills when the time comes.

Now that the dust has settled on the 2022 Ontario Election and now that we know who will be representing each riding in the 43rd Ontario Parliament, let’s take a look at some of the fall out.

Historic Election

The 2022 Ontario Election will go down in history for one very concerning reason: only 4.6 million out of a possible 10.7 million voters (or 43%) took the time to have their voices heard. Compared to the 2018 election, which had a 57% voter turnout, this is a marked drop. We can only speculate the reasons why so many stayed home on election day – was there Covid fatigue? Was it the growing cynicism toward voting and politics? Did most feel like none of the parties represented them or their values? Did people think that the election was a foregone conclusion? Regardless of the reason, while people in other parts of the world are quite literally dying to be able to vote, here in Ontario, more people declined their ballot than put an “x” on one.

And the winner is…

Doug Ford will remain Premier of Ontario with his PC Party taking 83 of a possible 124 seats in the legislature. That’s 7 more seats than they won in the 2018 election. The NDP lost nine seats and finished with 31, while the Liberal Party increased their seat count by one to a total of eight seats – still not enough to gain official party status (more on that later). The Greens and their leader Mike Schreiner held onto their single seat in Guelph. The last seat, and probably the most interesting story of the night, went to Independent Bobbi Ann Brady in Haldimand-Norfolk, in a riding that looked like a lock for the PC Party.

New Leadership

With the NDP losing nine seats and the Liberals failing to gain official party status, both Andrea Horwath (NDP) and Steven Del Duca (Liberal) announced that they would be stepping down as leaders of their prospective parties. In her concession speech, Ms. Horwath said that it was time (after leading the party through the last four elections and 13 years) to “pass the torch… to hand off the leadership of the NDP. It makes me sad, but it makes me happy because our team is so strong right now.” While the NDP did take a step back this election from the last and there is surely disappointment in the result, there is truth to the statement that the NDP is in some ways stronger than it’s ever been in Ontario. Traditionally, the NDP has been the third party in the Ontario Legislature, with the Liberals and PCs taking turns as government and official opposition. But the NDP formed the official opposition in both of the last two elections.

It’s hard to find silver linings from the Liberal Party’s perspective. The 2018 election saw the Liberals go from a majority government to a distant third place with only seven seats. That result brought about the resignation of Kathleen Wynne as leader of the party. Steven Del Duca took over that role in 2020 with the goal of rebuilding the party for the 2022 election. One challenge that Mr. Del Duca faced was getting himself back into the Ontario legislature. In 2018, he lost his seat in the riding of Vaughan-Woodbridge to PC candidate Michael Tibollo. The fact that he was not able to win this seat back on election day and that the party only gained one new seat were driving factors for his decision to step down as leader.

Official Party Status

To gain official party status in the Ontario legislature, a party needs to have at least 12 seats. The Liberals were not able to gain this official party status for the second consecutive election. What does that mean for them? To start, each official party is given funds based on the number of MPPs so that the party can hire office and research staff (in addition to the funds provided to each MPP).  The Liberals will continue to miss out on this. Additionally, when bills are debated, MPPs that are not from official parties have limited speaking opportunities (and are often excluded altogether). MPPs will essentially sit as independents and will only be able to debate bills if the speaker of the legislative assembly calls on them. This applies to Question Period as well. MPPs can submit requests to the speaker, but the speaker decides whether to call on them or not. These MPPs will still be able to make comments and ask questions on other members’ speeches, raise points of order, receive appointments to committees and present private members bills, but not having official party status certainly limits an MPP and their party.

Looking ahead

In the coming weeks, Premier Ford will be announcing his Cabinet. A few prominent Cabinet Ministers decided not to seek re-election, including Health Minister and Deputy Premier Christine Elliott. Additionally, the legislature will likely come back for at least a few days in order to swear in the MPPs and maybe even present an updated version of the budget. Look for the priorities of the government to be similar to promises made before and during the election campaign:

What would we like to see?

The morning after his victory, Premier Ford made one more promise to the people of Ontario. At a news conference he said, “We are going to make sure we keep every single promise.” We hope that promise includes promises made during the 2018 election. During that election, Premier Ford and the PC Party promised to protect the conscience rights of physicians as it pertains to assisted suicide and offering an effective referral. We’re hoping to engage the grassroots in the coming months to bring this issue front and centre in the Ontario legislature once again.

Additionally, prior to the election, we wrote about Why Family Law Should Be An Ontario Election Issue. In this article we outline four key issues we would like to see addressed as it pertains to the family here in Ontario:

  1. Address the fact that parentage in Ontario law is disconnected from any objective standard.
  2. Address the fact that the terms “mother” and “father” no longer exist in Ontario law.
  3. Address the fact that the law permits various arrangement by which multiple adults can sign an agreement to become legal parents of a child.
  4. Address the reality that Ontario law fails to connect children with their biological parents and instead bases parenting on ‘intent’.

What can you do right now?

First and foremost, remember to pray for our elected officials here in Ontario as they pick up their tasks once again. Pray that they would have clarity on how they ought to govern, that they would recognize where their authority comes from and seek to serve God in the roles that they have. Also, consider sending an email or letter to your MPP and the Premier. Congratulate them and tell them that you’re praying for them and why you’re praying for them.

May God bless Premier Ford, our MPPs, and the entire province of Ontario.

Colin, Daniel and Ryan discuss the results and the impact on the political landscape in Ontario.

Protection of Freedom of Conscience Act

Status: Bill C-230 is currently in 2nd reading in the House of Commons

Background: Bill C-230 is a private members bill introduced by MP Kelly Block on
February 4, 2022. The bill would amend the Criminal Code to make it an offence to
intimidate a health care professional, such as a medical practitioner, nurse
practitioner, or pharmacist, to compel them to participate in providing medical
assistance in dying (MAiD). It would also protect medical professionals from being
hired or fired based on their willingness to participate, directly or indirectly, in
providing MAiD.
Analysis: Freedom of conscience is a fundamental freedom protected under the
Charter of Rights and Freedoms. Bill C-230 recognizes that medical professionals
should be able to do their job based on their moral framework and conscientious
convictions. Currently, doctors can be forced to participate in MAiD through
effective referrals and there is no protection for those who believe they cannot
participate.

You can read more about this bill here.

On February 4, 2022, MP Kelly Block introduced the Protection of Freedom of Conscience Act. This private member’s bill will make it an offence to intimidate or dismiss from employment a medical professional who cannot in good conscience take part in providing medical assistance in dying.

Since Canada’s confederation, Canadian leaders have worked to promote tolerance of religion and conscience for all Canadians. They understood that Canadians have different moral perspectives and that making room for diversity is the best option for a unified country. By 1982, freedom of conscience was officially included in the Charter of Rights and Freedoms. In that light, it may seem that this bill would easily gain cross-party support.

However, that a bill like this is needed at all reflects the fact that we are seeing a worrying trend away from freedom of conscience in Canada. Conversations about conscience in healthcare often centre around whether we should prioritize the rights of doctors or prioritize patient wishes – and patient wishes often come out on top. But this question presents a false dilemma – freedom of conscience protects both doctors and patients and is critical for a good healthcare system. 

The ongoing expansion of medical assistance in dying (MAiD) has meant some doctors are being forced out of the profession by policies that do not permit freedom of conscience. Doctors are being pressured to provide what a patient requests, whether or not they think it is in the patient’s best interest and with little room for other professional, moral, or ethical considerations.

Many doctors believe they cannot participate in intentionally ending a patient’s life. Insisting that they do so is damaging to their professional and emotional wellbeing.

One doctor, testifying to an Ontario Legislative committee, relates the story of how she was directed to make an effective referral for assisted suicide: “I ignored my conscience, opting instead to follow the college policy and convincing myself that I had no choice … this was destructive to my very core. I felt like a shell of myself. Months later, I often still do. I came very close to leaving palliative care at the time, and every day I continue to question my ability to stay in this field.”

Canada already has a shortage of healthcare workers. This problem will only get worse if principled healthcare professionals are increasingly forced to leave or discouraged from entering the field in the first place. If we do not prioritize freedom of conscience, access to medical care will be further reduced as medical professionals are removed, move to another jurisdiction, retire early, or change careers.

Many patients want doctors who will help and treat them from a shared moral perspective. Patients may want the security of knowing their doctor will never recommend MAiD. Others may desire a doctor with a moral code that allows for MAiD. And most would surely prefer a principled doctor who provides their honest, ethical opinion, whether or not they agree with that opinion.

A heavy-handed approach to controversial medical and ethical issues is not helpful for either doctors or patients. It can cause specific groups of people to feel isolated, marginalized, and suspicious of the system in which they work, or which is supposed to help them navigate difficult medical choices. Penalizing physicians with conscientious objections to MAiD reduces the opportunity for many patients to receive their preferred care through a diverse healthcare system.

Conscience claims may on occasion cause inconvenience or hurt feelings. Inevitably, one person’s conscientious beliefs will explicitly or implicitly conflict with the beliefs of another person, no matter what the topic is. But our Canadian forefathers were right to recognize the value of unity in diversity for a stronger Canada.

Both doctors and patients should have the freedom to live and work in line with their moral and ethical principles. No one should be coerced to do what they believe is wrong.

Federal and provincial governments must ensure that doctors can continue to make ethical decisions that are both in line with their conscience and in the best interests of their patients, rather than forcing them to be identical in their thoughts, beliefs, and practices. The Protection of Freedom of Conscience Act will be good for both doctors and patients.