Alberta Bill to Protect Doctors’ Conscience Rights Draws Praise, Criticism

Medical staff perform a procedure on a medical mannequin at St. Michael's Hospital in Toronto on Aug. 13, 2019. A private members bill that would protect the conscience rights of medical professionals in Alberta has inspired both praise and controversy. (The Canadian Press/ Tijana Martin)

A private members bill that would protect the conscience rights of medical professionals in Alberta has inspired both praise and controversy. Bill 207, the Conscience Rights Protection Act, was introduced last week by United Conservative Party MLA Dan Williams and has passed first reading.

“Individuals shouldn’t have to choose between their most deeply held moral convictions on the one side and their job on the other,” Williams said in a press release announcing the bill. He noted that while the bill seeks to protect freedom of conscience, “it in no way limits access to health services in the province.”

The legislation states that no regulatory body can compel a health care provider “directly or indirectly, to perform a health care service that they determine would infringe their conscientious belief.” If a regulatory body received a complaint about a doctor not providing such a service, the body should “immediately dismiss the complaint.” Furthermore, doctors would be protected from any liability as a result of not providing the service.

That doesn’t sit well with opposition MLAs and some doctors who are concerned that patient access to abortion, euthanasia, or treatments for gender transitioning could be compromised.

NDP MLA Janis Irwin tweeted, “This bill is nothing but an attempt by the Uterus Control Party to attack reproductive rights and deny healthcare to LGBTQ2S+ folks. It’s shameful and we’ll fight it every step of the way.”

The bill passed first reading, with 36 UCP MLAs voting in favour and 15 NDP MLAs voting against.

Williams said the bill was inspired by a recent Ontario Court of Appeal decision that physicians must offer “an effective referral” to services they morally objected to, despite the constitutional right to freedom of conscience.

Nicole Scheidl, executive director for Canadian Physicians for Life, welcomes the legislation.

“Any doctor that objects to any kind of procedure just wants the right to be able to step aside,” she said in an interview. “They don’t want the right to get in the way of the person accessing the service. They just want the right to not have to provide the service or participate in it.”

Scheidl said referrals should be included in conscience protection for doctors because a referral “actually has a meaning in medicine. … You think this treatment is good for the patient and you’re supporting it and helping them get it. So conscientious objectors are saying, ‘We don’t want to do that. It’s the same to us as actually providing it.’”

NDP health critic David Shepherd disagrees. After the bill was introduced, he tweeted, “I’m deeply disturbed that any MLA would think it appropriate for a medical professional to refuse to even *refer* a patient in need to legal medical services they require – a particular threat for patients in rural & remote areas w/ much fewer practitioners.”

Scheidl said the reverse is true—that protection of conscience rights improves patient access, noting that forced referrals led to some Ontario doctors retiring early or getting licensed elsewhere.

“When you treat doctors like vending machines rather than professionals and you say, ‘You must do whatever is required of you without exercising professional judgment,’ … they will move somewhere else and practice where they’re respected and where they are supported.”

A 2018 report by the Council of Canadian Academies said that regarding conscience rights and access to medically assisted death, “safeguards for physicians have been implemented inconsistently across the country—and the rights of both parties deserve protection and support.”

The report also said that “if conscience-based refusals are not accommodated, people who value moral integrity might be discouraged from becoming health care practitioners. A fallout from this might be a reduction in the number of people who enter the health care field and a subsequent negative impact on access to health care.”

The 2015 Carter decision of the Supreme Court of Canada on euthanasia and assisted suicide called upon provincial legislatures to craft legislation to protect the conscience rights of medical care providers. A survey of doctors the same year found that 63 percent would object to providing “medical assistance in dying.”

“Many of them took the Hippocratic Oath which says they will not euthanize their patients,” Sheidl said. “So they have made a promise and that is part of their moral integrity. And now you’re telling them, ‘We don’t care what you believe, we want you to do something anyways.’

The press release announcing Williams’s bill included an endorsement from Dr. Thomas Bouchard of the Alberta Committee for Conscience. “The government allowing for patient access without forcing physicians to compromise themselves is the best solution,” he said.

After reviewing a legal opinion of the bill, former Supreme Court Justice John C. Major stated, “Bill 207 is valid legislation that embraces the Charter rather than breaches it.”