By Greg Price
Many physicians across the province are rejoicing Bill 207 (conscience rights) dying on the table in the legislature at a committee hearing late last week at the Alberta Federal Building.
One of those physicians was Dr. Jill Demontigny with the Taber Clinic, who made the trip to Edmonton herself to see Bill 207 voted down, after writing several politicians with her objections to the proposed bill by Peace River MLA Dan Williams who introduced Bill 207 on Nov. 7. The all-party Standing Committee on Private Bills and Private Members’ Public Bills voted 8-2 to recommend not moving forward with the bill in the legislature.
“I wanted to be witness to it because I had a lot of misgivings about the bill,” said Demontigny, adding the committee heard from three different people on both pro and con for the bill before rendering their decision. “I was worried it was going to pass. Getting to be in the room and hearing from the stakeholders and the excellent questions and summary impressions from various members of the committee of why they are voting the way they voted. It was really very satisfying and a relief the bill didn’t pass. My impression of the two MLAs who voted yes on the bill, would have done so regardless of what anyone said. I don’t think there could have been any more compelling testimony with stakeholders on how flawed the bill was, and how it could have been so harmful.”
Even having a limit on stakeholder presenters and allowing the same amount of presenters for the bill as against, showed a flawed representation of viewpoints, according to Demontigny.
“It gave the impression that there were equal numbers of concerned members on both sides when we have really heard from hundreds of physicians across Alberta. We have heard from our professional medial organizations and our College of Physicians and Surgeons why this bill was unneeded and potentially very dangerous. We also heard from a bunch of other health care specialties and concerned members in general,” said Demontigny. “We are all patients at one time and everyone is at risk of having their health care rights infringed upon if this bill were to go through.”
The bill centered around conscience rights for health practitioners which would provide immunity from discipline for health providers who refuse to address patient needs that offend their conscience, including opting to decline to provide a referral.
Dr. Demontigny noted Bill 207 was too heavy handed in its extremism in that conscience rights are already protected to a degree under College of Physicians and Surgeons’ standards.
“If you take away the duty of effective referral, and you also remove any professional or legal accountability for physicians the minute they claim their failure to act or their actions were motivated by their beliefs or their cultural traditions, you remove any professional integrity,” said Demontigny. “For the profession of medicine, it would be incredibly harmful to remove the rights of doctors to complain about a doctor’s actions. Regardless of what the motivation is. It undermines the very foundation of which ethical health care is built on.”
The standing committee heard a testimonial from a doctor who was also a patient who was refused morning-after/emergency contraception. Also a patient from the Trans Equality Society of Alberta gave stories of being refused basic medical services.
“Their health care and other members of the society have been refused by providers who didn’t feel that their conscience would allow them to look at trans patients,” said Demontigny. “It’s called broken-arm syndrome. It’s basically everything you are dealing with in your health appointment, they bring it back to you being trans, and not to the fact that anyone can get a cold, depression or a broken arm. That’s failing to understand what the person is actually there for, and deliver on that care. Also, someone from medical assistance dying, related his story of how his mother had passed away from a long and painful terminal illness in a time before MAID (Medical Assistance In Dying) and how patients still in Covenant care facilities are still unable to get a consultation for MAID unless they are legally brought outside the facility.”
Dr. Demontigny found it odd that two doctors who spoke in favour of Bill 207 were not even from Alberta (Ontario) and the third was a doctor from Calgary and is the medical director of a private family doctor business. Being conscience objectors, none of them identified what it was that they objected to in medicine, according to Demontigny.
Dr. Demontigny noted that given the quick dismissal of the bill in its flawed wording, doctors have wondered out loud if the issue was really about conscience rights given there were already parametres in place to protect them.
Some have suggested Bill 207 was used as a trojan horse to bring the debate on abortion rights back into the spotlight while also undermining the health care system to try and move to more private options.
“It had many objectives. One of them I believe is undermining health care in order to make private health care seem more appealing to the public. Getting a physician that is already engaged in private-for-profit medicine is to me very telling. But it wasn’t identified at the time and I only found that out after I looked her up afterwards,” said Demontigny. “It was a targeted attempt to bring up abortion rights debate without naming and claiming that was the true objective. The bill wasn’t simply about physician conscience rights, it was also trying to bring conscience rights of institutions like Covenant care facilities over and above the rights of their individual employees and their patients. It was to re-open debate on what patients should have rights for in medicine on things that have already been decided. In case of abortions, we’ve had that right since 1988 in Canada. We’ve also had the right to medical-assistance in dying since 2016.”
The critical piece that is either ignored or deliberately misrepresented by proponents of Bill 207 that Demontigny noted were physicians don’t have a Charter right to being a health-care provider.
“It’s a profession we choose to take on and those professions individually have determined what is expected of us. While they allow some recognition that there are certain parts of the profession that might not be welcome or comfortable for the health-care provider, if you can’t even reconcile yourself to the fact that it is the patient’s body, it is the patient’s health that is at stake here, then the basic minimum of providing a referral or facing the complaints that that refusal should generate, that is part of the deal, that is part of the privilege of being in the profession,” said Demontigny. “No one is forced to be a doctor, or a nurse or a social worker in Alberta, but everyone is a patient. People need health care. Medicine has a certain set of expectations, and if you can’t meet those expectations, and if you don’t want to deal with the repercussions of not meeting them, medicine isn’t for you. There’s plenty of other things you can devote yourself to that might be more in line with your personal belief system.”
In the end, Dr. Demontigny added with Bill 207 now voted down, it has given her hope the process she used in exercising her right to democracy was effective.
“In this case in particular, writing to candidates by many people across the province really made a difference to the outcome with the standing committee. Online petitions can sometimes give us an idea of who is in favour and who is opposed, but it doesn’t carry much weight in parliamentary processes,” said Demontigny. “A number of different committee members did bring up how much correspondence they had received on this bill in determining their vote. It empowered me to continue writing on the things that matter to me and that are affecting my patients on a day-to-day basis. I can’t just go to work and do my job one patient at a time when the world around them is failing them to be healthy. You have to spend some time to fix the broken parts of the system.”