All Parties "Dropped the Ball" on Freedom of Conscience in Canada


OTTAWA, ON – When Parliament resumes sitting this fall, it should prioritize the protection of freedom of conscience. The call comes as think tank Cardus publishes a new report, Our Inner Guide: Protecting Freedom of Conscience. With Canada having adopted among the most liberal regimes for medical assistance in dying (MAiD) and some ethicists calling for medical schools to weed out future doctors based on their personal beliefs about MAiD, Cardus’s Rev. Dr. Andrew Bennett says Parliament needs to step in to pass a bill to protect medical professionals’ freedom of conscience.

“All the major political parties dropped the ball on freedom of conscience in the recent federal election campaign and the last Parliament,” says Bennett. “None of them was willing to stand up for robust protection of this fundamental freedom. We’ve seen regulatory bodies trample medical professionals’ freedom of conscience without consequence, courts unwilling to defend that freedom, and no province except Manitoba has been willing to legislate conscience protections. Parliament must act. It cannot create the potential for moral injury to doctors, nurses, and hospital chaplains through expanded MAiD and then walk away, outsourcing respect for the Charter of Rights and Freedoms to others.” 

Our Inner Guide: Protecting Freedom of Conscience outlines multiple issues regarding conscience in a contemporary Canadian context, including the thorny issue of effective referrals. While doctors are generally free not to participate directly in a procedure or service to which they morally object, they are often not free to refuse to facilitare that procedure or service through another doctor via a referral.

“Referrals are problematic for some health-care workers because, in their view, they amount to material cooperation—significant complicity—with immoral or unethical activity,” according to Our Inner Guide.

Questions and Answers

Why does Parliament need to protect something already in the Charter of Rights and Freedoms?

Parliament has a duty to stand up and defend freedom of conscience, especially when it has created laws that undermine or constrain this freedom. We have already seen regulatory bodies, like the College of Physicians and Surgeons of Ontario, actively curtailing doctors’ freedom of conscience and the courts loosely interpreting the constitutional protections this freedom affords. Parliament needs to step in instead of leaving it to others to create a hodgepodge of rules and regulations, which courts will have to sort out.

Won’t refusal to provide referrals deny patients their right to health care?

No. Given that the procedures or drugs that often attract conscientious objection are easily identifiable, one alternative to referrals is a public office to manage controversial procedures. For assisted suicide, Alberta created a “care coordination service” to facilitate access to this procedure. Another option, which appears to be not yet implemented in Canada, is to create an online database that can indicate which physicians are willing to perform particular procedures that attract conscientious objection.

But what about rural areas where an alternative doctor is not available? Shouldn’t rural doctors’ freedom of conscience give way to rural patients’ need for care?

Residents of remote communities often absorb costs associated with travelling elsewhere for procedures that are not available in their community, including open-heart surgery or chemotherapy. Neither health care in general nor specific procedures that are delivered through the healthcare system are freestanding Charter rights. Quality of access varies across provinces, and between urban and rural settings. If that reality is tolerated on account of funding constraints and geography, why refuse to tolerate it for the sake of a basic human right, like freedom of conscience?

When you say “robust protection” for freedom of conscience, what do you mean?

Passage of a bill that robustly protects freedom of conscience would specifically recognize the freedom of healthcare workers and the institutions that employ them to refuse any participation in a procedure or service they believe to be immoral or unethical. It would also specify that such a refusal would not result in any loss of a benefit, or leave conscientious objectors subject to sanctions of any kind. 

Our Inner Guide: Protecting Freedom of Conscience is freely available online.


Daniel Proussalidis
Cardus – Director of Communications


Cardus is a non-partisan think tank dedicated to clarifying and strengthening, through research and dialogue, the ways in which society's institutions can work together for the common good.