Toronto health lawyer, Elyse Sunshine, says that physicians need to consider the Human Rights Code with respect to their practices. Elyse, what is the issue with this?
The issue is that physicians have always been required to comply with the Human Rights Code and to make decisions about seeing patients and treating patients in accordance with the tenants in that code. However, recently there have been some media cases where physicians have refused to provide particular treatments because it conflicted with their moral or ethical values.
I understand that the College’s [College of Physicians and Surgeons of Ontario] policy is up for review?
That’s right. It is a coincidence. Every College policy is slated for review, however it is rather timely given these media stories and those stories are having an impact in the feedback process that is going into the College policy review.
Without getting specific, what types of issues are arising in the stories?
Physicians are refusing to provide treatment such as birth control. They are posting, in one particular case for example, they did post a notice informing patients that they would not be providing this particular service. It did come to the College’s attention and it is being discussed quite openly as to whether this is appropriate practice or not.
Does that mean that doctors have to provide it [service]?
The short answer is no. As long as physicians act responsibly. Physicians cannot, for example, refuse to see a patient because of their religion, creed, sexual orientation and the like. However, with respect to treatment if the treatment is something that is within their expertise – again, physicians are not required to provide treatment that they do not feel experienced to provide – but if it is something within their expertise and it is something, however, that conflicts with their moral and/or ethical values, then if they handle it appropriately, such as by still informing patients about that option, advising them that it is not something that they provide in their practice and they assist by referring them to someone who could assist, then that would likely not be an issue for the College.
That is generally, what about particularly?
Particular treatments that tend to come up are things around birth control, abortion tend to be ones that health professionals sometimes get uncomfortable with or take issue with from an ethical perspective. Obviously this is case by case as to what a physician feels conflicts with their own values.
Do they have to tell their personal views?
They have to inform patients that it is not something they provide. They have to inform patients that it is a viable option. They are not allowed to minimize it or not say it’s an option because it conflicts with their values. They can explain that they do not provide that particular treatment. They have to assist them if it a treatment that would be appropriate and if the patient has an interest in it, and finding them alternate care.
What happens in small towns?
That is the million dollar question and is one of the reasons that the policy is being reviewed. From a practical perspective we are very lucky in the Toronto area that if a health provide does not want to do particular treatment there are lots of other options. But of course in small towns we may not have that. That is why people are looking at the policy that is why the College’s feedback process includes reaching out to all stakeholders including patients who may have something to say about that. It will be something that the College will have to grapple with when they are considering their new policy.
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