Court upholds ruling that Ontario doctors must refer for services they oppose

An appeals court in Ontario has upheld a College of Physicians and Surgeons of Ontario requirement that doctors in the province must give referrals for medical services such as assisted dying and abortion that conflict with their moral or religious beliefs.

A 74-page ruling released May 15 by a three-judge panel of the Ontario Court of Appeal unanimously agreed with a 2018 divisional court decision that upheld the referral requirement. While the divisional court found the policy infringes upon doctors’ religious freedom, it said the benefits to the public outweigh the cost to physicians.

A group of five doctors and three professional organizations, including the Christian Medical and Dental Society (CMDS) and Canadian Physicians for Life, argued the ruling was unreasonable as it gave more weight to an assumed problem with access to health care as opposed to the real infringement on a doctors’ rights. 

The decision was met with disappointment by Nicole Scheidl, executive director of Canadian Physicians for Life.

“I’m disappointed but not particularly surprised given the way the courts have ruled on religious freedom in this country,” said Scheidl.

She said the appeals court refused to deal with conscientious objection “based solely on conscience,” instead basing it on religious grounds.

In its ruling, the court said “the issues raised in this proceeding present difficult choices for religious physicians who object to the policies, but they do have choices.” The CPSO policies “represent a compromise,” the court wrote.

“They strike a reasonable balance between patients’ interests and physicians’ Charter-protected religious freedom. They are reasonable limits prescribed by law that are demonstrably justified in a free and democratic society.”

“What they are saying here in this decision is that people with religious convictions are a barrier and impediment to access when in reality they’re the ones who have been out in the forefront, giving people access to health care who never had access before,” said Scheidl.

The divisional court said doctors can ask staff to provide a referral for services that run up against religious or conscience rights or they could choose to specialize in a type of medicine where they wouldn’t come up against such issues. That violated doctors’ religious freedom and conscience rights under the Charter of Rights and Freedoms, the CMDS argued.

The doctors and groups that launched the appeal said they will take a further look at the ruling and hold discussions on their next step, which could include an appeal of the ruling.