The COVID-19 pandemic has reminded us of the critical importance of healthcare workers, and of the challenges and pressures that they face. And that is why I was very pleased that our 2021 Conservative platform contained a clear commitment to defend the conscience rights of healthcare workers and institutions. Our platform rightly noted that a lack of respect for conscience rights also drives people out of the healthcare profession and undermines patient access. Our plan was to simultaneously protect the conscience rights of healthcare professionals and institutions and encourage faith-based and other community organizations to expand their work in palliative and long-term care. This would have helped to improve the quality and availability of end-of-life care.
Simply put, conscience rights refer to the rights of individuals to choose not to be coerced into participating in things that go against their moral code. A vegetarian's right not to eat meat, a Quaker's right not to join the military, and a Catholic hospital's right not to participate in abortion or euthanasia. Conscience rights are not about attempting to deny something to someone else. Most vegetarians do not try to shut down farms or grocery stores. They just choose to personally opt out of things that violate their personal moral code. Conscience rights are protected in all of our key Canadian human rights documents, including the Charter of Rights and Freedoms.
The opponents of conscience rights have generally contended that allowing individuals to opt out of providing something means that others will not be able to access it. On the basis of this logic, opponents of conscience rights might also ask if we should permit the existence of vegetarian restaurants. What if we are talking about a rural community in which there is actually only one restaurant? What if someone shows up at a restaurant, unaware that it is vegetarian, and cannot get the food they are looking for? What if the prospective customer has a serious allergy to plant-based protein?
In reality, requiring people to provide certain services that go against their moral code is more likely to reduce access, not increase it. Those who find their moral code threatened will often shut down their operations entirely or shift to a different field. In a hypothetical world in which all restaurants are required to offer meat, those who are committed vegetarians are more likely to simply avoid the restaurant business. In a world where rural family physicians are required to provide services that violate their moral code, those with conscience concerns are more likely to opt for specific specialties and locations where their moral code will not be challenged. Simply put, there is no evidence suggesting that conscience protection hurts access or that violating conscience rights improves access. The opposite is more likely. So, the Conservative plan seeks to protect conscience rights while encouraging the greater participation of faith-based not-for-profits in end-of-life care who will no longer have to worry about being compelled to participate in euthanasia. These two things go together, protecting people's rights and increasing access.
The Conservative plan is also consistent with expert testimony, and what healthcare workers and their representatives are asking for. As Dr. Ann Collins of the Canadian Medical Association recently told a Parliamentary committee: "the CMA supports maintaining the balance between three equally legitimate considerations: respecting decisional autonomy for those eligible Canadians who are seeking access, protecting vulnerable persons through careful attention to safeguards and creating an environment in which practitioners are able to adhere to their moral commitments. The CMA equally supports conscientious objection and conscientious participation. Although in surveys we have not seen consensus among our physician members, this is one area in which there is a continued high level of support for CMA's position."
Finally, some of the national public conversation around this question has been greatly confused by the different uses of the term "referral". In a medical context, a "referral" is not simply a matter of providing directions or facilitating the patient-initiated transfer of care. Providing a formal effective referral is an endorsement of a particular course of care as being in the interests of the patient. Clearly a person who believes that a course of care is not good for their patient cannot provide a so-called "effective referral". Medical bodies can continue to find ways of protecting conscience rights that do not limit access to services. In virtually all cases of medical procedures which provoke a potential conscience objection, effective referral is not required anyway. Medical authorities in most provinces have established regimes that achieve access without requiring doctors with conscience objections to provide an effective referral.
In general, efforts have been made by some on the political left to stir up controversy in opposition to experts and where no controversy needs to exist. Leave people alone to live their lives according to their own moral code. Such a policy not only respects healthcare workers, but it is also more likely to improve patient access in general.