Sign in office ends clash between MD's beliefs, patients' requests

An Ontario doctor who faced professional misconduct charges after refusing to prescribe birth control pills to unmarried women now posts a sign in his waiting room outlining his religious beliefs.

The move ends a confrontation between the College of Physicians and Surgeons of Ontario and Dr. Stephen Dawson, a born-again Christian from Barrie who had refused to prescribe the birth control pill to single women or sildenafil to single men because of his religious beliefs. In July 2001, 4 female patients lodged complaints with the college, and in February 2002 its Disciplinary Committee ruled that Dawson may have committed professional misconduct by failing to meet “the overall moral and professional standard of care.”

“It's not about his personal beliefs,” said spokesperson Kathryn Clarke, who added that the case and its unusual resolution are unique in college history. “It's the way in which those personal beliefs played out within the professional setting. It's not just the denial of services, but the way the situation was handled.”

Dawson, who does not approve of premarital sex, had allegedly been handing out photocopied letters to patients, which included excerpts from the Bible. One passage stated: “When you do not warn nor dissuade an unrighteous man from his evil ways, he will lose his soul for his iniquity, and his blood will be on your hands.”

The solution, as proposed by Dawson in August 2002, is to post a 186-word policy statement in his waiting room. It reads, in part: “As a Christian physician, the prescription of birth control pills to unmarried women is contrary to the dictates of my conscience and religion. Similarly, arranging for abortions and the prescription of Viagra to unmarried men is contrary to the dictates of my conscience and religion. … In accordance with my Christian beliefs and the Canadian Medical Association's Code of Ethics, I am setting out my policy so that you are informed in advance of my beliefs and practice.”

The agreement with the college also forbids Dawson from offering additional information about his religious beliefs unless patients request it. “The college had been concerned that he had not appropriately advised people in the past,” Clarke explained. “We simply wish to be assured that when he explains to his patients why he does not provide these services that he does so in a professional and respectful manner.”

Dr. John Williams, the CMA's director of ethics, said the CMA's current ethical guidelines require physicians to inform patients when their personal moral beliefs influence the medical recommendation they make, but they do not have to refer the patient to a clinician. “[They're] under no obligation to do something that they feel is wrong,” Williams said. — Brad Mackay, Toronto