Ontario court rules doctors who oppose assisted death must refer patients

In the first Canadian test of conscience rights for doctors who oppose assisted death, an Ontario court has upheld regulations requiring the objectors to refer their patients to physicians willing to perform the procedure.

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.

But Ontario’s Divisional Court said the referral rule was a reasonable limit on doctors’ freedom of religion because it protects vulnerable patients from harm. And those patients, it said, have a constitutional right to equitable access to publicly funded health care.

 Without the policy of “effective referral,” equitable access would be “compromised or sacrificed, in a variety of circumstances, more often than not involving vulnerable members of our society at the time of requesting services,” Justice Herman Wilton-Siegel wrote in the 3-0 ruling on Wednesday.

The ruling 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.

 The preamble to the federal law on medical assistance in dying says doctors have a right to freedom of conscience and are not required to perform or assist in the provision of an assisted death. But Ontario’s regulations say doctors must provide an “effective referral.” The Supreme Court paved the way for assisted death by ruling three years ago that individuals suffering irremediably have a right to control their passage into death.


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