NS regulatory group, some Christian doctors clash over medical assistance in dying

A group of Christian doctors fear their stance on medically assisted suicide will lead to disciplinary action against them and an exodus of like-minded doctors from Nova Scotia. However, the provincial regulator of physicians has called their comments inflammatory.

The Dartmouth, N.S.-based Christian Medical and Dental Association of Canada held a press conference on Thursday to discuss the conscientious objection policy adopted in May by the College of Physicians and Surgeons of Nova Scotia.

The policy requires that physicians who are unable or unwilling to provide legally available treatment provide a good faith referral to another clinician.

According to Larry Worthen, executive director of the association, 41 doctors in the province have signed a letter saying they cannot comply with the new policy for moral and ethical reasons.

“These 41 physicians are at risk of a complaint, an investigation and disciplinary proceedings that could result in them losing their license to practice in Nova Scotia,” he said.

“If there is a disciplinary sanction on their driving record, it is a stain on their reputation and it can be difficult to move to another province.”

Worthen said ten medical students at Dalhousie University have also indicated they cannot comply with the policy.

He said the association’s members would not block access to MAID, but would advise patients to seek information and guidance through Nova Scotia Health.

Dr. Gus Grant, the college’s registrar and CEO, told CBC News the policy is clear. He said doctors who have a conscientious objection have a duty to refer the patient to another provider who does not object to the service. Grant said there are more than 3,000 doctors in the province.

“I think we need to look at their concerns from the perspective of the patients who are affected by this, and from the perspective of those patients’ ability to access and be supported in this difficult care,” Grant said.

Dr. Amy Hendricks, an internist in Antigonish, N.S., told the news conference that she cannot refer her patients to another doctor for reasons she describes as “complex and personal.”

“This policy means that if I don’t make that referral and send a letter asking one of my colleagues to kill my patients, I’m a bad doctor, I should be disciplined, my license may be revoked, and I may not be allowed to practice anymore,” she said.

Grant called her words inflammatory.

“You’re not going to request to have your patient killed, are you?” he said.

“What you are doing is asking another professional who has no conscientious objection to make an assessment of the patient’s suitability for medically assisted suicide.”

According to Grant, MAID is one of the areas where physicians can find themselves in a conflict of conscience.

He said access to contraception, abortion, vaccination and blood transfusions are also areas where a doctor’s conscience can conflict with the wishes of his patients.

Grant said medicine has never been about balancing rights, but about promoting the best interests of patients and putting them at the heart of the health care system. He pointed to a 2019 Ontario Court of Appeal ruling.

Five years ago, the Christian Medical and Dental Association of Canada was part of a group that took the College of Physicians and Surgeons of Ontario to court over whether doctors should provide referrals for medical services that conflict with their religious beliefs. The court ruled that doctors must provide referrals in those circumstances.

Dr. Tim Holland, chair of Dalhousie University’s bioethics department and a MAID provider, told CBC that the language used during the press conference was not necessarily in the best interests of everyone involved.

Holland said the board wants what is in the best interests of patients.

“I don’t know of any physician who has left Nova Scotia because of the university’s policies on medical assistance in suicide, abortion or gender affirming care,” he said.

A Nova Scotia Health spokesperson said there have been no reports of doctors leaving the province or indicating they do not want to come to the province because of the college’s policy.