Ontario forced referrals case - CMDS leader Larry Worthen responds

01 February 2018

It is a “no” for conscience protection for physicians in Ontario. On Jan. 31, the Ontario Divisional Court released its decision in Christian Medical and Dental Society (CMDS) v. College of Physicians and Surgeons of Ontario (CPSO).

The EFC joined with The Christian Legal Fellowship and the Assembly of Catholic Bishops of Ontario as intervenors in the case. In its decision, the court acknowledged that the CPSO policy infringes physicians’ freedom of religion by requiring them to take “positive action” to facilitate procedures such as euthanasia contrary to their beliefs. The court concluded that such an infringement is justifiable to the extent that it advances the CPSO’s goal of “ensuring access to health care services in Ontario, and, in particular, to the goal of ensuring equitable access to such medical services.”

Larry Worthen is executive director of the Christian Medical and Dental Society of Canada, an EFC affiliate organization. We spoke to him the day after the release of the decision to find out more about it.

Larry, what is your reaction to the decision?

LW: We were disappointed. The court acknowledged that our charter rights to freedom of religion were violated by the policy. They also acknowledged there was no concrete evidence that conscientious objection affected access. They also acknowledged that there were other jurisdictions that used less restrictive methods, and they acknowledged this was a serious matter for the applicants and the other doctors they represented.

We’re left wondering then why the requirement to offer an effective referral.

What do you think happened that swayed the Court in this direction?

LW: I think that that there were several affidavits the College put forward where people gave the opinion they thought this could affect access, but we provided others that said it wouldn’t. So, I think the court just agreed with the opinion of the CPSO.

What is left to do now?

LW: This weekend we’re commencing a two-month call for a conscience campaign in Ontario. We’re calling on people to write their MPPs and express their concern for lack of a conscience clause.

People can find it at That provides people with an opportunity to send a letter to the MPP and send a letter to the candidates for the upcoming provincial election. We’re also reviewing whether we have grounds for appeal.

Was this a case of balancing of rights where the right to freedom of religion lost out to other rights?

LW: Under section 1 of the Charter of Rights and Freedoms, any right in Canada can be limited. We felt in this case it was entirely possible both to provide access and protect conscience rights. Other provinces have struck the balance. Ontario is a little off and needs to be repositioned so doctors don’t have to change their specialties or leave the practice of medicine altogether.

The problem here is with euthanasia. There are very few specialties that would insulate you from getting a request for euthanasia, whether you’re a general practitioner, or a private care specialist, or an internal medicine specialist or someone who deals with cancer care. All of these specialties could be at risk of a compliant or discipline from the College of Physicians and Surgeons. We’re looking at people having to make decisions like closing their palliative care practice, and some doctors have left the province completely. That has already happened. We’ve had doctors retire early. It’s a complete change in the whole culture of the medical system. All of a sudden, doctors with conscientious objections are not welcome.

Are you hopeful at all this can still be reversed in Ontario?

LW: It’s just that it seems to me to be so unnecessary. I think that dialogue could work our way through this. We need a groundswell of support from people who support us in Ontario. If we can get that, I think we could convince the government and the College to sit down with us and find a way to grant access without negatively affecting conscience rights.

Editor’s note: See the official joint response from the EFC and CMDS and also a short video response by EFC President Bruce Clemenger at

Photo of Larry Worthen by Jessica Darmanin