Ontario Court decision forces doctors to refer patients to their death

By Alex Schadenberg, Executive Director, Euthanasia Prevention Coalition

Sean Fine, Justice Writer for the Globe and Mail, reported that Ontario’s Divisional Court ruled today that doctors in Ontario who oppose killing their patients, must provide an “effective referral” to a physician who is willing to kill their patient. The vote was 3-0.

Effective referral means a referral for the purpose of the act. Fine reported that Justice Herman Wilton-Siegal wrote that:

“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, wrote

the divisional court said that though the policy does limit doctors’ religious freedom, the breach is justified.

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Fine reported that Albertos Polizogopoulos, an Ottawa lawyer representing 4,700 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.

He added, according to Fine, that

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 faith doctors 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 medical assistance in dying on grounds of conscience.”

It comes as the faith-based medical community struggles to find a middle ground in the era of assisted dying, which has made it more difficult for some patients to obtain an assisted death in a timely manner. Some hospitals run by Catholic, Jewish or other religious groups have declined to offer assisted dying, transferring such patients to other facilities

Recently a Jewish care home in British Columbia accused a euthanasia doctor of sneaking-in and killing a resident.

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

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, 2017. 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 needs to be appealed.

Click here to view the decision.