Medical body opposes Alberta conscience bill, but doctors back it

The head of the Alberta Medical Association is speaking out against a private member’s bill introduced last week that would protect the conscience rights of medical professionals.

Dr. Christine Molnar said she’s concerned Bill 207 may unintentionally limit a patient’s access to health services. However other physicians say they welcome the strengthening of their conscience rights.

Molnar wrote to Premier Jason Kenney, Health Minister Tyler Shandro, and Dan Williams, the United Conservative Party MLA for Peace River who introduced the bill, saying she had concerns about Bill 207, the Conscience Rights (Health Care Providers) Protection Act.

The bill would amend the Alberta Human Rights Act to include “conscientious beliefs,” meaning health practitioners — and organizations — can conscientiously decline a procedure without worry that they would be penalized or, at worst, lose their job.

In her Nov. 13 letter, Molnar said “the bill has generated attention and anxiety among physicians and patients. This is regrettable since it is avoidable. From our perspective, the bill is unnecessary.”

“The more serious issue is that the bill may have unintended consequences in limiting patient access to services,” Molnar added. “For physicians, the current state protects conscience rights, while also ensuring that patients are given information or referral to allow them to pursue access to the desired service. This arrangement has served Albertans well and should be maintained.”

“There are already protections in place for health care providers. Respecting physicians, the process currently in place under standards of the College of Physicians and Surgeons of Alberta is appropriate and effective. From this perspective at least, Bill 207 is redundant and potentially confusing.”

Currently, medical professionals who do not wish to provide services such as abortion or medical assistance in dying to refer patients to either a member or service that can, under the College of Physicians and Surgeons of Alberta standard of practice.

The CPSA said its standard of practice protects patients’ ability to access care while respecting physicians’ conscientious objection.

“If you compare Bill 207 and our standard of practice, you will observe there are differences,” Jessica McPhee, spokesman for the college, said in a statement. “CPSA will continue to provide feedback to the government review of the bill, ensuring they have the information required to make decisions in the best interest of Albertans.”

Williams was unavailable for comment Nov. 14, but made his case for the bill in an op-ed published in the Calgary Herald.

“Bill 207 does not restrict access to health-care services. Provision of services will continue on exactly as before. But my bill does provide clarity to health-care professionals in an evolving legal environment,” Williams wrote.

“Should that doctor be sanctioned or fired for exercising his or her conscience rights? I would say ‘no.’ Albertans should not have to surrender their constitutional rights in order to practise their chosen profession — especially not when there are viable alternatives to forcing providers to act against their conscience.”

Since the publication of Molnar’s letter, physicians have responded on the Alberta Medical Association website, most of them in favour of the further protection under Bill 207.

Freedom of consciousness (sic) is one of the indelible freedoms our forefathers fought hard for. It is a cornerstone of the western civilization. Regardless of one’s profession, religion, creed or breed, it is ours to protect and cherish,” wrote Dr. Maryana Apel, a physical rehabilitation specialist in Calgary.

In an interview, Apel said while patients’ rights and access to services absolutely need protection, Bill 207 strengthens the conscience rights protected under the Charter of Rights and Freedoms.

Currently, if a physician refused to provide a service, they could easily be targeted for complaint, says Apel: “The patient could complain to the CPSA and even if the complaint is frivolous or unsubstantiated, the review takes months and can cause significant stress for the physicians.”

Dr. Marthinius Strydom, an Edmonton family physician wrote: “I do not think the current system is as rosy as Dr. Molnar is attempting to suggest. The current system, in my opinion, in reality provides no autonomy to a patient (who realistically needs authorization of his/her choice) or physician (who is forced to be involved even though some might consider it minimal involvement.) The current system (Standard of Practice rules) is a forced involvement for those that disagree on moral principles.”
 One physician, identifying himself only as ‘Andrew,’ wrote “there is no evidence that Bill 207 will limit patients’ access to publicly funded services.”

However, another physician – commenting with the first name ‘Frederick’ – decried “making new laws that affected the doctors negatively,” adding he supporting Molnar’s stance on Bill 207.

“Your diplomatic letter is good but I think the AMA should take a much more aggressive stance towards this type of attitude from the government,” Frederick said.

Health Minister Tyler Shandro told reporters that he is in support of conscience rights, but he declined to confirm whether he would support the bill. He added it would not impact access to health care services.