Conscientious objection to abortion and euthanasia has emerged as an election issue in Canada's 2021 federal election - and politicians are refusing to defend it .
The pro-choice leader of the Conservatives, Erin O'Toole, has walked back from a promise in his party's platform to "protect the conscience rights of health-care professionals."
Does this mean that the Conservatives will defend the right not to refer patients for Medical Aid in Dying? O'Toole fudged an answer, but he was clearly not in favour.
The governing Liberal Prime Minister, Justin Trudeau, jumped on an opportunity to score points: "Pro-choice doesn't mean the freedom of doctors to choose. It means the freedom of women to choose. Leaders have to be unequivocal on that," he said last week.
The politicians' reluctance to support doctors who do not want to refer for abortion or euthanasia is mirrored in the reluctance of the professional associations to defend refusal to refer. The College of Physicians and Surgeons of Ontario requires doctors to provide an "effective referral" within a "timely manner" to another professional or agency, should they consciously object. "Physicians must not impede access to care for existing patients, or those seeking to become patients," reads the college's policy.
Quebec's Collège des médecins du Québec says that: "In Quebec, doctors cannot abandon patients or even ignore their request by invoking conscientious objections, particularly in matters of abortion or medical assistance in dying, without referring them to another colleague. It is an ethical obligation."
However, Colleges in Newfoundland and Labrador, Nova Scotia and Manitoba all explicitly say that professionals who refuse to provide service are not required to make a referral. They cite the Canadian Medical Association's Code of Ethics and Professionalism .
What's the end-game for this? One of Canada's leading bioethicists, Udo Schuklenk, believes that no doctor should have the right to conscientious objection.
Professor Udo Schuklenk, of Queens University and joint editor-in-chief of the journal Bioethics , once delivered a blistering attack on conscientious objection in medical practice in his blog :
The very idea that we ought to countenance conscientious objection in any profession is objectionable. Nobody forces anyone to become a professional. It is a voluntary choice. A conscientious objector in medicine is not dissimilar to a taxi driver who joins a taxi company that runs a fleet of mostly combustion engine cars and who objects on grounds of conscience to drive those cars due to environmental concerns.
Professor Schuklenk put forward two reasons. First, medicine is a service industry and "Patients are entitled to receive uniform service delivery from health care professionals. They ought not to be subjected to today's conscientious objection lottery." This is a particular concern in a country as vast as Canada, where doctors may be scarce in rural areas.
Second, he regarded appeals to conscientious objection as a fig leaf to give privileged protection to practicing Christians: "Conscience clauses today are by and large a concession of special rights to Christian health care professionals, at least in secular Western democracies."
This, sadly, is where Canada is headed: to a situation in which the very idea of conscientious objection has been abolished. That will eventually make doctors mere lackeys of the government. Are there any politicians in Canada who will speak up for the rights of conscience - or are they all as gutless as Erin O'Toole?