Ontario doctors have now entered into their fourth year without a contract – unprecedented in Canada. Since 2015, the Ontario Liberal government has unilaterally cut over $2.5 Billion from the patient services physicians provide leading to ever growing specialist wait times, OR closures, ER gridlocks and one million patients in the province without a family doctor. To individual Ontario physicians, the stark reality is they struggle to make ends meet with funding that is 55% less than recommended by the OMA today. Furthermore, despite being an essential service, this government has denied physicians the right to binding arbitration and have instead created a toxic environment.
QUEENS PARK – POLITICS – Now the Ontario Liberal government is set to strip physicians of fundamental human rights with the anticipated passage of Bills 41 and 87 – an attack on physicians never seen before in the democratic world. Collectively, Bills 84 and 87 violate (see attached) six sections of the Canadian Charter of Rights and Freedoms (Sections 2, 7, 8, 11 12 and 15) and eight articles of the UN Declaration of Human Rights (Articles 1, 2, 3, 7, 11, 12, 18 and 23). Yesterday, Concerned Ontario Doctors and Doctors Ontario held a joint press conference at Queen’s Park to speak out against these serious human rights violations.
Bill 84, Medical Assistance in Dying (MAiD) legislation, violates physicians’ conscience rights protected under the Canadian Charter of Rights and Freedoms. It does not have to be this way. Access is more consistent if physician referral is removed from the equation. Every other jurisdiction in Canada and the world has managed to strike a balance between conscience rights of doctors and rights of patients to access a service: Ontario stands alone in denying physicians this human right. Currently 70-80% of Ontarians are being denied timely access to palliative care. How can Ontario ethically guarantee access to death within ten days while denying patients timely access to mental health resources and palliative care?
In 2015, the CPSO changed its human rights policy, stating that doctors have to refer to another provider for any service they are not willing to provide themselves. This is known as an effective referral. For conscientious objectors, this amounts to indirect participation. Every major religion, along with the Canadian, American, and Ontario Medical Associations have all said it is unnecessary. Every other jurisdiction in the world offering euthanasia has self-referral without impeding on conscience rights, including all the other provinces. A direct tele-health initiative will remove all barriers to patient access and will protect the conscience rights of physicians. Ontario stands alone in insisting doctors participate in making an effective referral if asked.
Beyond decreasing access to euthanasia, Bill 84 un-amended will effectively reduce access to other medical services. It is hard to fathom how coercing ethical doctors to quit practicing family medicine, palliative care, elderly care, or any other field of medicine is going to serve the public good.
Bill 87, the Protecting Patients Act, will make the stigma of mental health worse. 78% of Ontario’s doctors already report burnout; 86% citing the ongoing attacks and vilification of this government as a cause while struggling to keep the healthcare system afloat. Burnout very quickly leads down a road of depression, compassion fatigue, substance abuse and suicide. Most physicians suffer in silence while attempting to continue to provide care for their patients, until it becomes unbearable. Physician suicide rates were already twice that of the general population, the toxicity of this government’s treatment of physicians has sadly made it worse.
Bill 87 will grant the Ministry of Health unprecedented access to the personal and private health records of Ontario’s doctors. This will create barriers for physicians to open up about their own mental health challenges with their own family doctors. Bill 87 goes further in violating the human right of the presumption of innocence and physicians’ right to procedural fairness and natural justice. Once Bill 87 passes, CPSO will publish all patient complaints publicly on their website and have the ability to both temporarily and permanently revoke a physicians’ medical license before a committee hearing ever occurs and before any evidence is ever presented. The livelihood and public reputation of the physician, the physician’s family, as well as office staff can be forever tarnished without a hearing having ever occurred. This is grossly unjust and violates several sections of the Canadian Charter.
Bill 87 has created so much fear amongst physicians that many have already started to alter their practices and how they deliver patient care. Physicians are now being advised to hire chaperones in their practices to be present for all clinic visits, which most cannot afford to do. Doctors are fearful about putting themselves in harms way without having due process protections in place against baseless patient complaints. Many family doctors have stopped performing breast, prostate, pap and pelvic examinations and are now instead ordering ultrasounds instead. If Bill 87 passes, more and more physicians will take such measures to protect themselves against the violation of their Charter rights. This will lead to more fragmented care and longer wait-times for specialists and diagnostics while increasing healthcare costs in an already burdened system. And while Ontario doctors strongly support harsh penalties for criminals, it is wrong to create a kangaroo court out of CPSO to address the failings of our court system. It is wrong to punish and strip all 29,000 Ontario physicians of their human rights and freedoms to address a serious problem seen in less than 1% of college complaints.
“If the Wynne Government cannot respect and provide a humane and dignified working relationship with Ontario’s doctors, who is going to be left to care for the most vulnerable? This represents perhaps the gravest and most unconscionable example of this government’s poor leadership and incompetency,” stated Dr. Kulvinder Gill, President of Concerned Ontario Doctors. “The fact that they are now violating physicians’ human rights is a line that Ontario’s doctors will not allow to be crossed.”
Background: Concerned Ontario Doctors is a grassroots not-for-profit organization of physicians across Ontario advocating for a patient-centered, sustainable, accessible and quality healthcare system. They stand united in their belief that unilateral actions by any government will undermine their ability to deliver timely and quality patient care.