Ensuring safe care spaces for all Albertans

College of Physicians and Surgeons of Alberta CPSA, Latest News Archive, Medical Matters, Messenger 10 Comments


Last month, I wrote about the concept of providing non-judgmental care to people suffering with chronic pain, but this really is just the tip of the iceberg. Over the past year, CPSA has addressed many complex issues. The subject of the matter is actually not that important, because whether we’re talking about opioid prescribing, chronic pain treatment, sexual abuse and sexual misconduct, LGBTQ2S+ care, medical assistance in dying, access to the abortion pill or conversion therapy, the position of CPSA is very similar. The medical profession expects all physicians to do what is in the best interest of the patient in a non-judgmental way and in accordance with the Code of Ethics and Professionalism and the Standards of Practice that are approved by CPSA Council.

When we see problems, it’s because physicians have deviated from those very basic principles. As I’ve said previously, all patients—no matter what their health concern is, their economic status, their religious affiliation, their sexual orientation, their beliefs about dying or their ethnic background—deserve access to non-judgmental care in a safe environment. They deserve to have a medical system and professionals working within that system who are accepting of them, understanding of their situation and provide them with the safest, highest quality care possible.

No one should ever feel taken advantage of or rejected because of their health needs.

Patients don’t come to us for care to make our lives difficult. They are unwell, vulnerable and in need of help. If an Albertan comes to a physician’s office for care, the last things they should be concerned about are their safety and whether they will be judged.

Physicians have the right to conscientiously object to providing procedures and forms of care to patients because of the physician’s own ethical concerns. For example, if a patient has a terminal illness and wants some control over their final days, they have the right to access the care they need from a physician who is willing to provide it. This is why we have a standard of practice on Conscientious Objection. But following this standard is different from being judgmental and selective in the patients you choose to care for.

I’m certainly not saying any of this is easy, and I’m also not saying that physicians should tolerate abusive behaviour or compromise their own ethical beliefs—physicians, just like patients, need to feel safe in healthcare environments.

The most recent version of the CMA Code of Ethics and Professionalism has been endorsed by the CPSA Council as the code we follow in Alberta. If all physicians followed this code, there would be far fewer dissatisfied patients and I would suggest many happier physicians.

I must reinforce that, in the vast majority of cases, Alberta physicians work very hard and provide excellent care while upholding the profession’s Code of Ethics. I’ve brought this up not because I think the profession is falling apart; in fact, it’s quite the opposite. I’ve seen many great physicians step up and take on very complex patients that are in need, and I receive letters on a regular basis commending the work of Alberta physicians. I bring this up because we don’t need to make things more complicated than they are. We don’t need to have policies for every situation—we need guiding principles that we can all align with as a profession, and I believe those already exist. We just need to remind ourselves of them every now and again.

As always, your comments are appreciated.

Scott

10
Leave a Reply

1000
5 Comment threads
5 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
6 Comment authors
  Subscribe  
newest oldest
Notify of
Mehreen Rashid

I agree 100%: “We don’t need to have policies for every situation—we need guiding principles that we can all align with as a profession, and I believe those already exist. We just need to remind ourselves of them every now and again.” Thank you.

Scott McLeod

Good morning Mehreen. Thank you for taking time to read the Messenger. Scott

Rafiq Ahmad Basharst

To Dr. Scott
I am totally agreed with your suggestions. Being an IMG physician and working as a Clinical assistant, I appreciate and thankful for your amazing guidance.
Rafiq Basharat

Scott McLeod

Thank you Rafiq. Scott

Matt

CPSA will be tried in court and loose, should they attempt to punish a regulated member for refusing to refer for/arrange/connect/instruct/guide/”offer timely access to” a procedure/treatment that the member is religiously opposed to. 2) This idea that a patient deserves care in a non-judgemental and safe environment is equally problematic. Of course, I agree with common courtesy, respect, and treating each other decently. However, “non-judgemental” and “safe” are incredibly subjective. Despite acting with courtesy, a patient may feel judged or safe (despite no intention for this on my part) if I don’t agree, for example, that it’s a safe and… Read more »

Scott McLeod

Hello Matt, Thank you for taking the time to comment and provide your perspective. You have raised concerns that are certainly not new and the Canadian Court system has been struggling with it for years. In fact, it has been in the courts in Ontario. I would refer you to the Court of Appeal for Ontario decision on the Christian Medical and Dental Society of Canada v. College of Physicians and Surgeons of Ontario. I found paragraph 48 of that document very interesting. It states that the Divisional Court said “physicians have no right to practice medicine, let alone a… Read more »

Matt

Thanks for your thoughts, Scott. Your voice certainly mirrors that of the CPSA as a whole, but not of the right-leaning province of Alberta. To quote your article: “As I’ve said previously, all patients—no matter what their health concern is, their economic status, their religious affiliation, their sexual orientation, their beliefs about dying or their ethnic background—deserve access to non-judgmental care in a safe environment.” The problem with your overall article to me, and to most Albertans is two-fold: 1) What if I am opposed to the “care” that a patient is seeking and refuse to participate in them seeking… Read more »

Norman Yee

Thanks for this thread, Scott. As you point out, as physicians, we are in service of our patients and community. The work is important, stimulating, engaging and frequently challenging. As a profession and as individual physicians, we need to rise to the occasions of safe and appropriate care to the best of our abilities. On those days where the challenge is too great, we may need a break or we may need help and support. These are available for the asking and we need to be self-aware enough to recognize this. Thanks for the reminder and the discussion. Cheers. Norm

Elisabeth Woolner

I agree with Norm. This issue is intimately connected with the issue of physician wellness (or lack thereof). I look forward to seeing the benefit of the new initiatives in this area (Well Doc Alberta, for example). I suspect that in at least some cases, when physicians are not fulfilling their obligations to patients, that they are also not well themselves.

Scott McLeod

Thanks Norm. Very well said. Scott