Updated: Aug 31, 2022
I admit that the title of this column seems clickbait-y. But it is among the serious questions being asked in the wake of the recent decision by the Ontario Divisional Court in the case Christian Medical and Dental Society et al v. College of Physicians and Surgeons of Ontario.
The Christian Medical and Dental Society, along with a number of other groups, pushed back against the College of Physicians and Surgeons of Ontario for requiring physicians who would not participate in an assisted death to refer patients to physicians who were willing to comply. The Court concluded that while, yes, the rights of objecting physicians were being compromised, the greater good of patients’ rights to obtain a legal remedy outweighed the conscience rights of those physicians.
The John Paul II Academy for Human Life and the Family makes the Roman Catholic position on the matter starkly clear:
“Seeking to impose on a doctor the duty to perform abortions or euthanasia (or, alternatively, to leave the medical profession or a given hospital), or to impose on him the duty to refer a woman to an abortionist, is gravely sinful and a direct violation of his inalienable human dignity and freedom of conscience.”
“The same also applies to the case where a pro-life physician is claimed to be obliged to refer a patient (who requests physician-assisted suicide or euthanasia) to a colleague who would perform such acts. Not only is the pro-life physician not obliged to refer a patient to a colleague who would perform intrinsically wrong acts, he is also absolutely morally forbidden to do so.”
One grim conclusion to be drawn from this line of ethical reasoning therefore would be that a Christian person would have to withdraw from the practice of medicine in Ontario, or avoid the profession in the first place, on pain of committing a serious moral transgression.
But is this the only Christian possibility?
I feel badly for physicians being asked to refer in the case of assisted death, an issue about which I have strong negative convictions myself. And I wish the court had come to a different decision since, so far as I know, nothing prevents a patient wanting an assisted death from finding on his or her own another physician willing to perform one.
Still, the conscience-stricken physicians are not (yet!) being forced to participate in assisted deaths, a requirement which I would agree would compel one to withdraw from the profession in that jurisdiction. Instead, to refer someone to a willing physician when that someone is within their legal rights to pursue assisted death is a compromise I think Christian medical professionals should be prepared to make.
This moral challenge is, after all, not new to physicians in Canada. Physicians have long referred patients to plastic surgeons for procedures they wish he or she didn’t want, especially recognizing that surgery always poses significant risks to the health of the patient. Others have routinely referred patients for second opinions when they are sure those patients need surgery immediately and they are afraid the next MD might take a more conservative, and life-threatening, route.
Such referrals already pose conscience problems for physicians. But those MDs generally accept such compromises as facts of life for the practice of medicine in the contemporary Canadian context. Such compromises do not indicate mere moral weakness, but they are instead an unavoidable, if regrettable, part of what it means to grant each other liberty to do other than what we think is best.
Again, I am against the legalization of assisted suicide and for several reasons. But I sympathize with many who desire it, and I recognize their legal right to it. And, unlike the parallel with abortion, there is no one else who is directly suffering as a result of such patients’ decisions. (I do recognize that other people are involved—that’s part of why I’m against assisted death. But the distinction is still valid: No one else is dying here.)
Should Christians stop training to become physicians, and should Christian MDs quit? I don’t see why.
We are all enmeshed in a world of deeply compromised systems. No educator, no health care professional, no politician, no police officer, no civil servant, no retailer, no transporter—none of us get to enjoy a job that doesn’t implicate us in some sort of systemic evil. There is waste, and abuse, and fraud, and oppression on every hand.
Does that mean we should become indifferent to evil? Heavens, no. But it does mean we must stare clear-eyedly at the way the world actually is and decide how we are, in the name of Christ, going to make the most shalom in each situation.
The Divisional Court decision is disappointing, and it might be overturned on appeal. But for now, Christian MDs should keep on healing, and Christian medical students should keep on studying.
The wholesale withdrawal of Christians from our medical system would be catastrophic for everyone, while the presence of Christians practicing medicine well, testifying to their values when they can, and graciously acknowledging the awful liberty God grants to others to do the wrong thing can only improve the common good.
Tempting as it is to throw up one’s hands and leave, we are obliged instead to stay at our posts, as salt and light, and work toward a better day when such issues will fade away. And with the advances being made in palliative care, that day may come soon.