Friday, 6 February 2015

"Euthanizing God? Theism and conscientious objection to physician-assisted death"

From CMAJBlogs.com written by Ewan C Goligher and Stephen W Hwang,

Physicians and healthcare institutions committed to theistic belief systems therefore face an important challenge: is it reasonable to base conscientious objection to physician-assisted death upon belief in God? This question has become critical in light of recent proposals to curtail physician autonomy and conscience rights in Ontario by requiring physicians to make referrals for procedures in violation of their ethical commitments. We argue that it is eminently reasonable to base such objections on belief in God, because theism is a rationally defensible belief system that provides coherent grounds for upholding the ethical values central to this debate, namely human autonomy, well-being and the incalculable worth of human life. (Read the full article at: http://cmajblogs.com/euthanizing-god-theism-and-conscientious-objection-to-physician-assisted-death/#more-1459

Monday, 26 January 2015

#MDsHaveRights2

Join the conversation on Twitter. Use the hashtag, #MDsHaveRights2 to take about conscience protection in Canada. 


Monday, 12 January 2015

"Do you want a doctor with moral integrity?"

Our doctors maintain professionalrespectful and compassionate relationships with their patients. This includes accompanying patients as they make difficult choices, understanding fully that the final decision is always the patient’s. 

Our doctors simply ask that they be respected as professionals in return. 

Forcing doctors to violate their moral integrity is not only damaging to the doctor, but to the patient and to medical services as a whole. 

It will inevitably mean that many doctors will be forced to leave patient care, leaving Canadians with less access to the medical care they want and need.  

The choice is yours. Will you tell the College of Physicians and Surgeons of Ontario (CPSO) what you think about conscience rights?

The deadline for comments is: Feb 20, 2015  


The College of Physicians and Surgeons of Ontario (CPSO) have a draft policy that would demand that doctors participate in morally controversial procedures like birth control, abortion and even euthanasia (if it becomes legal). Participation means making referrals and actually performing these procedures when the regulator (CPSO) considers them to be “urgent or otherwise necessary to prevent imminent harm, suffering, and/or deterioration.” This as a very broad requirement and will be open to abuse. Doctors who cannot participate due to deeply held moral or religious commitments will be vulnerable to punishment from the regulator, even though their fundamental freedom of conscience and religion is guaranteed by the Canadian Charter of Rights and Freedoms.  This is a form of discrimination. 

If you are not already receiving CMDS updates and want to find out more about this issue:  

Thursday, 8 January 2015

Honesty in Medicine

-Jennifer Derwey

Would legislation that requires doctors to conceal information or conceal their professional and morally based opinions be in the best interest of the doctor patient relationship? Consider this from Dr. James F. Drane, Professor Emeritus, University of Edinboro Pennsylvania:

Not telling the truth in the doctor-patient relationship requires special attention because patients today, more than ever, experience serious harm if they are lied to. Not only is patient autonomy undermined but patients who are not told the truth about an intervention experience a loss of that all important trust which is required for healing. Honesty matters to patients. They need it because they are ill, vulnerable, and burdened with pressing questions which require truthful answers. 
Read the full paper here: http://www.uchile.cl/portal/investigacion/centro-interdisciplinario-de-estudios-en-bioetica/publicaciones/76983/honesty-in-medicine-should-doctors-tell-the-truth


Sunday, 14 December 2014

An opportunity to be heard

-Lester Liao

The recent policy draft of the CPSO that obligates physicians to refer for procedures they disagree with has given us an opportunity to voice or concerns. We cannot live under the illusion anymore that we face no persecution in Canada as Christians. We have to be bold and stand for what we believe and articulate it well. I urge you to make even a small feedback comment on the CPSO site at http://policyconsult.cpso.on.ca/?page_id=5165. Urge others to do this as well. Get in touch with your churches and the elders and get the whole body involved in this issue. Ask them to pray, and ask them to provide feedback. Be earnest and persevere in this.

We cannot go at this alone and we cannot do nothing anymore.

Lord willing this draft will be revised. Below you will find my own letter that I plan to send. I have put it here for your reference in case you find it helpful in articulating your own thoughts or care to pass it on to others.
Dear College of Physicians and Surgeons of Ontario,
I am a third year medical student in Ontario. Thank you for the work that has gone into drafting the latest policy on Professional Obligations and Human Rights. I recognize that this is a difficult task to be able to protect the rights of all. That being said, I would like to raise a few of my concerns. 
Firstly, I think it is important to define what religious beliefs are. Are religious beliefs those that are related to beliefs in a supernatural power or something else? We must clarify this because every single one of us has moral and religious beliefs. We all believe things about the meaning of life, what makes life valuable, and so on. These are not based on science but are metaphysical questions based on a worldview. We all espouse a worldview, whether it is theistic, deistic, agnostic, or atheistic, and all of our answers to these questions are based on these worldviews or religions. To exclude "religious" views based on some sort of worldview tradition would mean we must exclude how every one of us understands these life questions unanswerable by empirical science. This would prevent us from being people with thoughts, hopes, and any beliefs. In this sense we are all religious people. 
Additionally, every physician has a moral code based on a worldview that he/she then practices with. The decision to help a patient's health is in itself morally charged.  Why should a physician help? No scientific experiment obligates you to help someone - it only tells you what will likely happen if you for example give a certain drug. The decision to help is based on a moral belief that it is good to help others. Every physician has moral beliefs that necessarily play a massive part in his/her clinical practice. The current policy draft to exclude certain moral beliefs is problematic for three reasons: it fragments the humanity of the practitioner, it is logically and practically impossible to exclude moral beliefs from practice, and it presupposes that these moral beliefs are wrong without actually demonstrating so. I will tackle these in turn. 
Firstly, when we decide as a profession that we will force physicians to act against their moral beliefs, we are throwing moral integrity to the wind. We ask our physicians not to have moral integrity but to do what they are told, and it is extremely dangerous to force physicians to do something they believe to be wrong. This fragments who we are fundamentally as people with consciences. This means in essence saying we want slaves to perform our will, not free people working. This is a form of coercion and disregards the rights of the physician as an autonomous person him/herself. For the policy must take into account the humanity of both patient and doctor.
Secondly, we cannot ask physicians to be amoral because the decision to help people is itself moral, and the decision to be amoral is also itself a moral choice. In other words, any decision to be moral or amoral is impossible to exclude from practice logically because the decision is itself a moral one. Moral beliefs are also not a category that we can separate because they are at the heart of why we practice medicine and so we cannot exclude them practically. Do we ask a physician to leave their morals out of medicine, including their moral code to help people, be just, respect patients, and do no harm? No. This would be an absurd thing to do. This notion of keeping moral beliefs outside of practice is not coherent and is actually undesirable. This policy is imposing its beliefs on physicians, which goes against its very own moral stance to not promote one’s own religious/moral beliefs.   
This leads to the third point. If we begin to choose what moral beliefs can or cannot be excluded, we are in fact making moral judgments on whether those moral beliefs are correct or incorrect. To say that they must be excluded presupposes that these beliefs are wrong. We do not tell physicians to leave out their beliefs of helping people because they are believed to be right. If we exclude other beliefs, we automatically presuppose they are wrong. This policy as it stands already assumes these physicians are wrong but does not justify this position with reasons, and ironically it makes a moral conclusion it prohibits practitioners from making. Hence we cannot say that a physician is obligated to refer for a procedure he/she is unwilling to perform based on the grounds that his/her beliefs are simply "moral" or "religious."  
In a similar vein, the distinction between personal and clinical beliefs is unclear. Everyone that answers ethical questions in medicine draws from his/her worldview, which means ultimately these answers are personal for everyone. For example, whether you desire or do not desire to perform abortions is based on your moral outlook that it is either good or bad to do them, which is a personal matter based on worldview. Any decision made clinically is a personal matter. 
Once again I must express sincerely that I appreciate the work that has gone into this draft. This is a laborious process and I am grateful for the feedback process. However, I am afraid of the implications of what this means for physicians in Ontario and the province I hope to practice in. Are we moving to a place where we impose our beliefs on physicians to do things? Can we see ourselves in the future as a province stripping physicians of licenses because despite competently caring for thousands of patients they refuse to refer one based on non-malicious intent? And can we even justify these claims when all parties involved have arguments that are morally and religiously driven from worldviews?
Thank you for taking the time to read this and for carefully considering this letter.
Sincerely, 
Lester

Wednesday, 3 December 2014

What's in FOCUS?

FOCUS is CMDS Canada's publication covering topics that are important to the Christian medical and dental community. It's a great way to connect with colleagues, get the latest views and news on faith and practice, as well as find interesting and thought provoking essays and articles.

If you're not already subscribed, you can find past subscriptions here on our website or email our office to start your new subscription by mail.


Tuesday, 11 November 2014

Finding Light

-by Lester Liao

What does it mean to be light (Mt 5:14-16)? Undoubtedly there are many facets to this question, but Jesus does make clear that light is something that is seen and noticeable. It illuminates a house as a lamp put on a stand. Naturally as I considered Jesus’ words, I asked myself – am I shining?

There are many ways to be light in the medical setting. We can work well and glorify God (Col 3:23). We can influence our workplace with godly conduct and care for those who are sick. The list continues. But there is one aspect of light that I had previously given little thought before I hit the hospitals. Jesus addresses his disciples in the Sermon on the Mount (Mt 5:1-2). He says that they are the light of the world. In thinking about how to be bright, I overlooked that somewhere in the workplace there could already be light! And certainly several lights together shine brighter than any light alone.

When I began clerkship, I had my radar on. After a brief comment from one of my preceptors about a mission trip, I was prompted to ask. Turns out he is a Christian, and we shared some wonderful conversation afterwards. I gave him a copy of FOCUS and a book on worldviews. Over our continued time together, we also had the chance to sit down with a patient’s Christian mother and discuss the importance of her daughter’s spiritual health in her physical health. This physician encouraged me.

Over the following month and a half I encountered two more Christian physicians, both of whom I learned of by inquiring. Helpful words were exchanged. I also asked one of my preceptors that I learned did not perform abortions if he was Christian. He is not, but that conversation has prompted a yet-to-be-scheduled dinner over which we can talk about religion.

These are simply to point out that paying attention to where light shines is helpful. Often with the busyness I get caught up in the medicine and lose perspective. But I was surprised to learn that there are more brothers and sisters out there than I suspected, and forming relationships with them has been instrumental in helping me remember what I am doing in Christ. Especially in a time when faith is being pushed out of the public square, it is important to encourage one another. We were never intended to walk our lives of faith alone but to stir one another up to love and good works (Hb 10:24-25). And not surprisingly, other Christian physicians are particularly aware of the challenges we face, and the value of generational wisdom transmission cannot be overstated (Ti 2:1-6). Furthermore, as we begin to identify with one another in a public way, we can show how our faith positively impacts our practices and we can stand together when adversity comes (Ecc 4:12).

My hope is that we can find one another so that we can do life well as family. We can encourage each other to live well for Christ. We need one another. May God help us to come together and so be a brighter light in the medical world.