CANADA – Ontario’s top court rules that religious doctors must offer patients an ‘effective referral’ for assisted dying, abortion and birth control

Physicians who object on moral grounds to providing healthcare services such as assisted dying, abortion and birth control must offer their patients an “effective referral” to another doctor, Ontario’s highest court has ruled. In a unanimous decision released on 15 May, the Court of Appeal for Ontario reaffirmed a lower court’s conclusion that it was a reasonable limit on the religious freedom of doctors to require them to connect their patients with willing providers of these health services.

The case was Christian Medical and Dental Society of Canada et al. v. College of Physicians and Surgeons of Ontario. It delivers a victory for women’s reproductive rights, says the Women’s Legal, Education and Action Fund (LEAF). They wrote: “The Court’s ruling is an important contribution to the advancement of women’s and girls’ equality. It recognizes that enhancing access to reproductive health services is a valid and constitutional objective. It affirms that women’s right to autonomy over their deeply personal, individual health and life choices cannot be superseded by the personal views of health professionals. It confirms the importance of access to reproductive health services for women’s health and wellbeing, and signals that the Court will protect initiatives that safeguard women’s access to these services.”

LEAF argued in Court that access to reproductive health care lies at the heart of women’s reproductive choice, which is fundamental to women’s equality. The Court agreed that “due to historic inequalities in accessing the medical system, many women are dependent on physician approval to access reproductive services”. Since physicians act as gatekeepers to the system, an effective referral may be the only channel through which these women can access the care they need.

The Court further agreed that refusals by medical professionals to provide referrals has a disproportionate impact on women from marginalized backgrounds, noting that the effective referral policy is particularly important for women who are new immigrants, youth, Indigenous women, women in remote or rural communities, and people with limited economic means. Denying them a referral is tantamount to denying them access to the service altogether, with all the resulting harms including unwanted pregnancy, psychological stress, and increased risk of morbidity.
SOURCE: Globe and Mail, by Kelly Grant, 15 May 2019 ; LEAF, undated ; VISUAL: LEAF TWITTER Banner