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.