A physician who is predisposed by faith or belief to make negative moral judgments about a patient is a bad doctor. The College of Physicians and Surgeons of Ontario appears to have recognized it has a problem on its hands with a system that has let doctors deny certain services – such as prescribing birth-control pills – because of their personal moral or religious objections.
The College has now unveiled a draft policy paper that attempts to reconcile the views of the doctors it regulates with the rights of patients to prompt, safe and effective treatment. The need for a new policy became clear when an Ottawa woman was turned away from a walk-in clinic last February after she attempted to get a refill on her birth-control medication – a rejection letter from one of the clinic's doctors cited his ethical and religious objections.
Any doctor offering services to the public in a walk-in clinic or a similar facility is going to hear and see things that may not meet his theological standards. But if that's a problem, it's up to the doctor to adapt professionally, rather than put the burden on patients. A pre-existing moral stance inhibits doctors from doing their job well, with the openness and attentiveness that is the hallmark of good medicine. We turn to physicians to resolve our most intimate problems with wisdom and compassion and fairness, not to be rejected because we don't fit a sacred model.
But the College has refused to come down harshly on doctors who let their religious views get in the way of their duty to provide care. Instead, medicine's conscientious objectors will be required to refer patients to doctors of greater moral flexibility, as if out of sight were the same thing as out of mind – "in a manner that respects patient dignity," according to the anodyne language of the College's draft paper.
But patient dignity is compromised the moment a physician confuses a religious judgment with a medical decision. No patient, particularly in a public health-care system, should be made to feel like a sinner and sent away. And no doctor who accepts funding in a secular, public system should be able to substitute personal belief for science.
The College's draft paper is a safe policy if the aim is to staunch controversy. But it is bad medicine.