In this issue: April 2015

• Revised Human Rights and Medical Marijuana policies get the green light
• You should trust your doctor not to judge you
• Transparency and Sexual Abuse Review Updates

Revised Human Rights and Medical Marijuana policies get the green light

Professional Obligations and Human Rights

On March 6, 2015, our governing Council approved the Professional Obligations and Human Rights policy to better protect patients and improve their access to health care.

The revised policy underwent two extensive consultations. It sets out physicians’ existing legal obligations under the Ontario Human Rights Code, and the College’s expectation that physicians will respect the fundamental rights of those who seek their medical services. The policy also sets out the College’s expectations for physicians who limit the health services they provide due to their personal values and beliefs.

A key feature of the revised policy is that it requires physicians to provide their patients with an effective referral to another health-care provider for those services the physician chooses not to provide for reasons of conscience or religion.

An effective referral means a referral that is made in good faith with a view to supporting, not frustrating or impeding, access to care.

"The referral requirement strikes an appropriate balance between patient and physician rights; reflects the expectations of the Ontario public,” said CPSO President Dr. Carol Leet.

“The policy protects patient rights by ensuring that patients are not prevented from accessing care that is clinically indicated and legally available because a physician objects to that care on moral or religious grounds, while also respecting physicians’ right to freedom of conscience and religion.”

We received more than 16,000 responses to our consultation, including from the Ontario Human Rights Commissioner who said it effectively strives to balance the rights of both patients and physicians.

The policy does not require physicians to perform procedures or provide treatments themselves to which they object on religious basis, except during a medical emergency.

If we receive a complaint that a physician has breached this policy, we will investigate.

In addition to the public consultation, we also sought the views of the Ontario public at large by commissioning a public opinion poll.  The results indicated that the vast majority of Ontarians believe that physicians, who object to providing certain elements of care on moral or religious grounds, should be required to identify another physician who will provide the treatment, and make and/or coordinate the referral. 

We reviewed all of the feedback we received carefully. Decisions about policies and policy revisions are made with the goal of ensuring the final policy is consistent with our mandate to protect and serve the public interest. We strongly believe that this policy strikes that balance.  

In late March, we were served with a Notice of Application from the Christian Medical and Dental Society, the Canadian Federation of Catholic Physicians and several Ontario physicians alleging that our Professional Obligations and Human Rights policy violates the Canadian Charter of Rights and Freedoms.

We intend to vigorously defend our policy.

The policy is available online, and is published with an article in this issue of Dialogue.

Marijuana for Medical Purposes

Council also approved the Marijuana for Medical Purposes policy, which sets out expectations for physicians who prescribe dried marijuana for medical purposes.

The policy was developed in light of new federal regulations that have significantly altered the legislative framework governing patient access to dried marijuana. Under these regulations, physicians have primary responsibility for the decision to authorize patient use of dried marijuana for medical purposes. Physicians enable patients to access a legal supply of dried marijuana by completing a medical document that functions like a conventional prescription.

In response to consultation feedback, key revisions were made to the policy. These include: adding references to provide physicians with the most current and reliable information on the medical use of dried marijuana; explicitly stating that physicians are not obligated to prescribe dried marijuana if they do not believe it is clinically appropriate for their patient; adding expectations for physicians who wish to prescribe dried marijuana to patients under the age of 25; and stating that physicians must discontinue prescribing if dried marijuana fails to meet the physician's therapeutic goals or the risks outweigh the benefits.

The policy is available online, and is published with an article in this issue of Dialogue.

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You should trust your doctor not to judge you

Embarrassment or shame is often a barrier to proper health care.  Think of how difficult it can be to talk about delicate issues like overactive bladders, sexual health and practices, hemorrhoids, addiction and mental health issues, or body parts that might be oozing, itching or bleeding. Most of the time, it’s not the condition itself that causes the discomfort, but the thought of discussing it out loud.

But it’s important to remember that health care professionals aren’t there to judge you, but to use their professional judgment and knowledge to help you.

Each of the 23 regulated health colleges in Ontario, including ours, set requirements for entering the professions, run quality programs, and hold health care professionals accountable for their conduct and practice.

Regulated health professionals have the education and experience to deal with any situation imaginable.  They should never make you feel ashamed or self-conscious, so don’t censor yourself.

Here are some ways to find the right courage and words:

• Research the issue, not necessarily to deal with it, but to realize that many others have faced it and you’re not alone.
• Practice what you want to say.  Hearing the words can ease your anxiety.
• Share your feelings.  Tell your health care professional you’re nervous.  He or she can speak with you in a sensitive way.
• Use your own words.  If the clinical terms make you uncomfortable, find another way to share the same information. 

Fear of information getting out is another reason why some people are reluctant to share particular details.  One Canadian survey found that four out of 10 people would keep information from their care provider, or seek care outside their community, due to privacy concerns.

But remember that regulated health care professionals, including doctors, are trained to respond with respect and professionalism, and are bound by confidentiality.

Part of their job is to put you at ease, no matter what you’re talking about. When you provide a full picture, your health care professional can make the best assessment possible and help ensure you get the care your need.

Got a question? Call our Public Advisory Service at 416-967-2603. We are here to help. 

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Transparency and Sexual Abuse
Review Updates

Transparency

In 2012, we began a multiphase initiative to review how we could make more physician-specific and process information available to the public on our website. The consultation  wrapped up on April 1, 2015. In response to a request from the Minister of Health, we sent the ministry a letter detailing our initiative and planned activity that is available in its entirety on our website. The Minister has not responded to our letter. In the current issue of Dialogue, there is an article that answers some of the frequent concerns we heard during the consultation of Phase 2 of the initiative.

Sexual Abuse Review

A task force was appointed to review of our governing legislation to ensure that existing legislative measures, designed to prevent and deal with the sexual abuse of patients by regulated health professionals, are appropriate and effective. Council has directed a review into our practices and processes relating to sexual abuse and an overview is provided in this issue of Dialogue.

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