N.S. regulatory group, some Christian doctors clash over medical assistance in dying

A group of Christian doctors is fearful their position on medical assistance in dying will result in disciplinary action against them and lead to an exodus of like-minded doctors from Nova Scotia, but the province's physician regulator called their remarks incendiary.

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

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

The association's executive director, Larry Worthen, said 41 physicians 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, investigation and a disciplinary process that could result in the loss of their licence to practise in Nova Scotia," he said.

"Having a disciplinary action on their licence is a black mark on their record and can make it difficult to move to another province."

Worthen said 10 medical students at Dalhousie University have also said they will be unable to comply with the policy.

He said association members would not block access to MAID, but would advise patients to get 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 health-care provider who does not object to the service. Grant said there are more than 3,000 physicians in the province.

"I think we should be looking at their concerns through the lens of the patients that this will affect and the ability of those patients to access and be supported in their access to this difficult care," said Grant.

Dr. Amy Hendricks, an internal medicine doctor working in Antigonish, N.S., told the news conference she cannot refer a patient of hers to another doctor for reasons she described as "complex and personal."

"This policy says that if I will not provide that referral and send a letter asking one of my colleagues to kill my patients, that I am a bad doctor, that I need to be disciplined, that I may need my licence revoked and that I maybe shouldn't be practising," she said.

Grant called her words inflammatory.

"You're not sending off a requisition to have your patient killed," he said.

"What you're doing is asking another professional who is not in a position of conscientious objection to make an assessment of the patient's eligibility for medical assistance in dying."

Grant said MAID is just one area where physicians can find themselves in a conflict of conscience.

He said access to contraception, abortion, vaccination and blood transfusions are other areas where a physician's conscience can run counter to the wishes of their patients.

Grant said medicine was never about balancing rights, but promoting the best interests of the patient and keeping them at the centre of the health-care system. He pointed to a 2019 Court of Appeal of Ontario decision.

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 must give referrals for medical services that clash with their religious beliefs. The court ruled the doctors must give referrals in those circumstances.

Dr. Tim Holland, head of the bioethics department of Dalhousie University and a MAID provider, told CBC the language used in the news conference was not necessarily in the best interests of everyone involved.

Holland said the college wants what's in the best interest of patients.

"I've not known of any physicians who've left Nova Scotia specifically around the college policy around medical assistance in dying or abortion or gender-affirming care," he said.

A spokesperson for Nova Scotia Health said it's also unaware of any doctors leaving the province, or indicating they are unwilling to come to the province because of the college's policy.