By Nicholas Elbers
Catholic physicians in B.C. are sounding the alarm about a contentious piece of legislation that they fear has opened the door to ideological coercion and possible religious discrimination.
Since its controversial sprint through the B.C. legislature last November, Bill 36, the Health Professions and Occupations Act, has alarmed many British Columbians, in particular Catholics and Catholic doctors.
In broad strokes, Bill 36 represents the NDP government’s attempt to streamline existing regulatory colleges by reducing them to six from 15.
The bill was passed Nov. 24, but critics say proper consultation of the medical profession that will be affected by the bill was not carried out.
The regulatory colleges exist primarily to manage and regulate medical licensing for their professions’ members. They take complaints dealing with everything from malpractice to sexual assault and determine whether a member is fit to hold a licence.
On its surface the plan has support, but its changes to regulatory board composition have Catholic doctors and some secular organizations, including the B.C. Nurses Union, concerned.
Currently, the boards are majority-composed of members elected from the professions they oversee, with fewer than half of members appointed by the health minister.
Under the new legislation, all board members, as well as the superintendent responsible for board oversight, will be appointed by the health minister, with a requirement that 50 per cent of the board be composed of non-licensed public members.
The government justifies this shift away from physician-elected colleges on its website, where it says: “Currently, board members are elected by their profession. That is not in the best interest of patients as it creates a misunderstanding that elected members are beholden to those who elect them, even in partial.”
While there is broader concern amongst medical organizations in B.C. that the changes are poorly timed, given the widespread increase in waiting times for basic medical procedures and staffing shortages in the province.
Some critics also suggest the new requirements that colleges have 50 percent public membership will allow for ideological appointments by the government that would allow special interest groups to interfere with physicians’ ability to exercise their expertise.
Many Catholic doctors in particular are concerned about the impact that government intervention in the licensing system will have on doctor-patient relationships and conscience rights.
“The government now effectively gets to say what is good practice and what is not,” said Dr. Benjamin Turner, a surgeon in Lethbridge, Alta., who has patients from B.C. The new legislation lets the government “set practice standards,” he told The B.C. Catholic.
“So far as I’m concerned, that radically perverts the relationship between the doctor and the patient,” said Turner. “I was going to say between those and the state, but really, there shouldn’t be any relationship between the doctor, patient, and the state.”
The distinction Turner is making is an intricate one. Nowhere in the bill does it say colleges will be able to determine best practice. However Section 72 states that under the act, licensees “must act in accordance with,” among other things, “anti-discrimination measures.”
According to Section 15, anti-discrimination principals should “foster physically, culturally, socially, emotionally and spiritually safe practices” and prompt colleges to “adopt anti-racism approaches and tools to support these approaches.”
“The objectives of anti-discrimination measures” are to engage regularly “in processes to identify discriminatory practices, policies, programs, structures, values and attitudes that perpetuate discrimination or create conditions in which discrimination may occur,” the section reads.
What would constitute discriminatory practices is unclear, and doctors interviewed by The B.C. Catholic are concerned that when they asked their professional boards for clarification, they were essentially told not to worry about the bill’s contents.
In a world where abortion, contraception, and euthanasia are touted as human rights, doctors are feeling vulnerable given that the bill makes no mention of, or allowances for, conscience objection to various medical practices.
In effect, the bill will “criminalize any medical advice that is not sanctioned by the state or medical board,” said Dr. Theresa Szezepaniak, a Fraser Valley hospitalist physician who cares for patients in hospital.
Dr. Khai Phan, who practises family medicine in Burnaby, told The B.C. Catholic that while the medical and moral arguments against abortion, contraception, or gender reassignment surgery are strong, Catholic physicians have become outliers in the medical community for refusing to perform such procedures.
An example of their concerns is the College of Physicians of Ontario, which in 2016 said doctors must make “an effective referral” for medical assistance in dying (MAiD). “It effectively trumps conscientious objection,” said Phan. “We are very easy targets for this kind of legislation.”
The power of the boards lies primarily in their control of licensing, which Turner said has been effective up to this point.
“The hammer the colleges have had over us is our licences,” he said. “Every doctor in Canada lives in abject terror of getting a letter from their college.”
Responding to Heath Minster Adrian Dix’s statement that Bill 36 will increase transparency within the regulatory colleges, Turner emphasized that the colleges are effective in their current form. Disciplinary measures, including those for tardy responses to letters, are published for the public to see.
“Anyone familiar with the operation of the colleges knows that complaints are taken very seriously,” said Turner.
Bill 36 under growing backlash
The B.C. NDP government is facing growing and broad criticism and backlash over Bill 36, its new Health Professions and Occupations Act.
A recent campaign to recall Premier David Eby over Bill 36 failed to garner the required 16,000 signatures in Eby’s Vancouver-Point Gray electoral district. Rallies took place throughout the riding including outside Catholic churches such as St. Augustine’s and Our Lady of Perpetual Help.
The Justice Centre for Constitutional Freedoms has criticized the bill for giving “enormous unilateral power to the Health Minister” to impose health regulations on all health professionals as a condition of licensing. Those regulations would include compelling health practitioners “to be vaccinated against specified transmissible illnesses.”
The measure is squarely targeting B.C. health practitioners “who have opposed lockdowns and who have vocally and bravely raised an alarm about the safety and efficacy of the COVID shots,” said the Justice Centre. “If the purpose of Bill 36 was to silence unwanted opposition through cancelling their professional standing, it could hardly be concocted better.”
Now B.C. opposition parties are calling on Eby to bring Bill 36 back for debate, citing growing concerns by medical professionals across the province about lack of transparency and due legislative process.
The NDP passed the bill in November 2022 with the support of both Green Party MLAs. Nearly two thirds of the 200-page bill – more than 400 clauses – were left unread before the bill went to vote.
“The Official Opposition should have been given adequate time to ask questions about the bill, but the NDP closed the debate and – with the help of the Green Party – rammed through the legislation with over 400 clauses still left to examine,” said Shirley Bond, BC Liberal Shadow Minister for Health.
The B.C. Liberals brought forward a motion on March 9, that was rejected by the NDP, to reopen the bill for debate.
“The changes made to the structure of health care regulatory colleges in Bill 36 are some of the most significant in our province’s history, and they should not come into force before they have had a genuine chance to be discussed in the Legislature,” said Bond.
Despite their early support for the bill, the Greens in a Feb. 14 letter to Eby voiced concern that the forced closure of the bill stymied opportunity for “fulsome” debate, resulting in “gaping holes in the understanding of the legislation” for both the public and Members of the Legislative Assembly.
Among the party’s concerns is the bill untimely introduction while the health-care system experiences labour shortage induced strain.
The letter says the party will no longer support any bills that have forced closure, “no matter their merits.”
In February Independent Nechako Lakes MLA John Rustad introduced a petition in the legislature with more than 10,000 names asking the province to repeal Bill 36. Rustad, was acclaimed Conservative Party of B.C. leader in March.