Joan Bryden

August 19, 2021



OTTAWA — Conservative Leader Erin O’Toole is promising to protect the right of health care professionals to refuse to provide or even refer patients for medical services to which they have moral or religious objections.

The promise to protect conscience rights — a measure championed by social conservatives who maintain doctors and nurses should not have to refer patients for services like abortion, medical assistance in dying or gender re-assignment surgery — is included in the Conservatives’ election platform.

The platform was released this week by O’Toole even as he tries to differentiate himself from his predecessor, Andrew Scheer, whose socially conservative views on abortion and LGBTQ rights arguably cost the Conservatives the 2019 election.

“The Conservative Party has not always been clear about its position on social issues,” O’Toole acknowledged in a speech Wednesday evening in Quebec, where suspicion of social conservatism runs high.

“I want to be very clear with you. I am pro-choice and I’ve always been pro-choice.”

But the platform’s promise to protect conscience rights reflects the circle O’Toole is attempting to square as he tries to broaden his party’s appeal without losing the support of social conservatives, who were crucial to his winning leadership bid and who make up a significant chunk of his caucus and his party’s base.

It states simply: “We will protect the conscience rights of health care professionals.”

It offers no details but appears to suggest the measure is needed to prevent doctors who have objections to medical assistance in dying from quitting the profession or leaving Canada, as some have threatened to do.

“The challenges of dealing with COVID-19 have reminded us of the vital importance of health care professions — the last thing Canada can afford to do is drive any of these professionals out of their profession,” the platform says. “We will also encourage faith-based and other community organizations to expand their provision of palliative and long-term care.”

However, social conservatives have been clear they see protection of conscience rights applying to a broad range of medical services, not just assisted dying.

During a 2019 Ontario court case, services to which various doctors’ groups and individual physicians said they would object included abortion, contraception, tubal ligations, vasectomies, infertility treatment, prescription of erectile dysfunction medication and gender re-assignment surgery, as well as assisted dying.

The case involved a constitutional challenge to the Ontario College of Physicians and Surgeons requirement that doctors who morally object to a service must provide patients with an “effective referral” to another doctor who does not have such qualms. The challenge was spearheaded by the Christian Medical and Dental Society of Canada, Canadian Physicians for Life and the Canadian Federation of Catholic Physicians Societies, who were joined by a number of individual doctors and intervener groups.

They argued that the college’s policy violated doctors’ right to freedom of conscience and religion, forcing them to be complicit in providing services they believe to be morally wrong. They lost the initial 2017 case but appealed. The Ontario Court of Appeal upheld the lower court ruling in 2019.

“It is impossible to conceive of more private, emotional or challenging issues for any patient,” Ontario’s chief justice, George Strathy, wrote in the unanimous appeal court ruling after enumerating all the services to which the appellants objected.

Allowing doctors to refuse to provide referrals for those services would stigmatize already vulnerable patients, leave them to navigate the complex health system on their own and restrict their access to medical services, he said.

“Given the importance of family physicians as ‘gatekeepers’ and ‘patient navigators’ in the health care system, there is compelling evidence that patients will suffer harm in the absence of an effective referral,” Strathy wrote.

In the case of assisted dying, abortion and emergency contraception, he said, “delay in accessing these procedures can prevent access to them altogether.”

Moreover, Strathy added: “One can reasonably anticipate that the loss of the personal support of a trusted physician would leave the patient with feelings of rejection, shame and stigma.”

Regardless of that ruling, O’Toole courted social conservatives in last year’s Conservative leadership race with a promise to protect “the conscience rights of all health care professionals whose beliefs, religious or otherwise, prevent them from carrying out or referring patients for services that violate their conscience.”

The platform promise is not as precise about protecting health care professionals’ right to refuse to make referrals. A party spokesman refused to “speculate” about the change in wording, saying only that “our platform language stands.”

The platform also promises that a Conservative government “will not support any legislation to regulate abortion.”

However, O’Toole has been clear that he won’t try to stop Conservative MPs from proposing their own private member’s bills to restrict abortion and can vote as they please on them. In June, a majority of his caucus supported such a bill to ban sex-selective abortions.

The platform also promises to outlaw conversion therapy, the discredited practice of forcing children or adults to undergo therapy aimed at altering their sexual orientation or gender identity.

Unlike a Liberal bill to ban the practice which over half the Conservative caucus voted against in June, the platform says the Tories would clarify that “non-coercive conversations” about a person’s sexual identity would not be criminalized, “giving comfort to parents and others” who counsel them.

The Liberal bill was passed by the House of Commons in June, after months of Conservative delaying tactics. The Senate did not have time to deal with it before adjourning for the summer and the bill died once the election was called.

c. CTV