If you are a doctor with strongly held views about contraception and the sanctity of life, how should you treat a patient who comes to you requesting contraception or an abortion?

The Ontario College of Physicians and Surgeons recognizes that some physicians feel unable to personally prescribe contraceptives or perform abortions, but requires them to make a good faith referral:

Where physicians are unwilling to provide certain elements of care for reasons of conscience or religion, an effective referral to another health-care provider must be provided to the patient.

I was talking to a pediatrician who was outraged by this,and felt it required him to do something which was deeply offensive to him.He believes that all life is sacred and abortion is always the wrong thing to do. As a physician, his job is to “do no harm”, and he feels that ending a potential life must count as doing harm. He says that his objection to abortion is based, not on any religious belief, but on his interpretation of the medical evidence which leads him to think that the emotional aftermath of an abortion is always worse than carrying the baby to term. I do not think that this attitude could come from an unbiased reading of the literature, but he is sincere in this belief.

He argues that even providing a referral to a physician who is known to provide abortions is being complicit in the murder of an unborn child, and I can understand the logic of that viewpoint. The furthest he is prepared to go is to concede that there are facilities in Toronto which will provide abortions without a physician referral, but he personally would not do anything to help his teenage patients find one.

Other physicians have tried to get round the issue by posting notices:

A Calgary doctor working at a walk-in clinic who refused to prescribe contraception based on her personal beliefs posted a sign in the window informing patients “that the physician on duty today will not prescribe the birth control pill.” Women looking for the pill were instead provided with a list of other clinics willing to prescribe it.

Three family doctors in Ottawa were also refusing to provide artificial contraception in any form, including the “morning after pill.”

The Ontario college is warning doctors that posting a notice in an office announcing they will not offer certain treatments isn’t sufficient to “discharge your obligations” under the revised policy.

The Christian Medical and Dental Society of Canada is asking the Ontario Superior Court to overturn the policy:

The group’s 1,700 members have a variety of “conscience concerns” such as abortion, physician-assisted death, in vitro fertilization and contraception.

“Our members got into medicine because they were convinced that they could help people, that they could help heal them, that they could serve them and meet their needs,”.

I do not have a problem with a physician discussing the downside of contraception or an abortion with a patient, and in fact I think there is an ethical obligation to ensure the woman is aware of all of the options, and has thought through the pros and cons of each. It could reasonably be argued that there are too many abortions. But in some cases, such as a 15 year old who was raped, to pressure her to keep the child could be considered “cruel and unusual punishment”.

I agree with the College. Physicians do have an obligation to provide a good-faith referral to legal medical procedures and treatments, which may in future even include physician-assisted suicide, no matter what they personally believe. They are free, like any other citizens to campaign for changes to laws they feel are wrong, but we live in a secular country and religious beliefs should not impede patients’ access to medical care.