Doctors face the right to life decision against their own moral code.
Doctors who refuse to prescribe birth control pills have become the focus of a debate over physicians' rights to freedom of conscience when practising medicine.
An Alberta doctor has been in the media spotlight recently for posting a notice at the clinic where she works that she will not prescribe the pill and now faces a human rights complaint.
Earlier this year, three Ottawa doctors came under fire for similar reasons. The College of Physicians and Surgeons of Ontario (CPSO) is doing a public consultation on its guidelines that could be revamped to restrict doctors' rights to abstain from legal medical practices on religious or conscientious grounds.
For Dr. Howie Bright, past president of the Canadian Federation of Catholic Physicians' Societies (CFCPS), the attack on birth control is a "fairly discrete target" and is likely to "generate reaction."
It sounds weird, Bright said, that a modern doctor would not prescribe contraception.
The much larger threat he sees looming for doctors is euthanasia. When Quebec's new euthanasia law comes into effect it will force doctors to refer patients for euthanasia, even if they will be legally able to opt out of doing the killing themselves.
"The day they tell me I have to be complicit in killing my patients is the day I quit practising medicine," said Bright, a family physician in Chilliwack, B.C.
"When you start going through human rights commissions to constrain doctors, basically we have a coercive state," the physician warned. "Our society is big enough and broad enough we can tolerate each other. We don't need to be coercive towards each other."
In cases where the exercise of a religious belief is not life-threatening, there should be great care in "breaching such important and fundamental rights as freedom of conscience and freedom of religion," said bioethicist Margaret Somerville, the founding director of the McGill Centre for Medicine, Ethics and Law.
Though many Catholics ignore the Church's teaching on artificial birth control, "one of the reasons some doctors won't prescribe it is that sometimes they act as abortifacients – not just preventing conception but preventing the implantation of the embryo in the uterus," said Somerville.
Both Somerville and Bright pointed to strictly scientific, medical reasons why a doctor might refuse to prescribe the pill. Bright noted the World Health Organization has classified the birth control pill among the highest level of carcinogens. They also increase the risk of fatal blood clots, he said.
Somerville expressed concern over the way the debate which involves religious beliefs is being handled.
"What they are doing here is a strategy of label as religious and dismiss," she said. "They are arguing religious beliefs have no valid role in the public square or in the exercise of a public profession paid for by taxpayers' money."
This tactic, she said, was "clearly used" in the Quebec government's special "dying with dignity" legislative committee report that led to the euthanasia bill that was passed into law in June.
The report "dismissed religion" as something that "used to be important" but no longer has a role to play in the public square, Somerville said.
"If you want to get rid of views you don't like, label them religious and you can then assume you can automatically dismiss them," she said.
Somerville also blasted the argument that that since it is not illegal to have an abortion, or illegal to use contraception, "therefore doctors have to do it."
She noted that many people who object to religious views go on to claim tolerance as one of their maxims.
"They are tolerant until someone has a view they don't agree with," she said. Then their attitude is "we're going to force you to act the way we want."
Bright said he feels great empathy for the doctors involved. "I know how incredibly stressful this must be, to come into the public eye and be persecuted for your beliefs."
Some doctors are preparing to pay the price of losing their licences and their livelihoods rather than be coerced by the forces of political correctness to disobey their consciences, Bright said.
Bright guesses the majority of physicians who describe themselves as Catholic continue to prescribe oral contraception. For 14 years, he routinely prescribed birth control pills until he read Pope Paul VI's encyclical Humanae Vitae. Fertility is not a disease yet it is treated with potent medicine and even surgery, he said.