RE: Conscientious Objection - Policy Consultation

470 Weber St. N., Suite 202, Waterloo, ON, N2L 6J2 Ph. 519-208-9200 Fax 519-208-3600 www.christianlegalfellowship.org College of Physicians and Surgeons of Saskatchewan 500-321A-21st Street East Saskatoon, Saskatchewan S7K 0C1 Sent by e-mail to: communications@cps.sk.ca August 7, 2015 RE: Conscientious Objection - Policy Consultation The College of Physicians and Surgeons of Saskatchewan ( CPSS ) has invited feedback from the public concerning its draft policy on Conscientious Objection (the Policy ). The Policy addresses a physician s obligations when he/she has an ethical objection to providing a service requested or being considered by a patient. The Christian Legal Fellowship ( CLF ) provided a submission to the CPSS in its consultation of an earlier draft of the Policy in March 2015. CLF is pleased to note a number of improvements in the revised Policy, including some reworking of the referral requirement. However, CLF remains concerned with the vagueness of the Policy s wording, particularly in sections 5.2, 5.3 and 5.4, which could still potentially be interpreted as requiring a physician to provide a referral in a manner that violates his/her conscience. 1 A detailed analysis of the legal issues underlying these concerns is set out in CLF s March 6, 2015 submission. Rather than repeat these issues here, we enclose a copy of that submission as Appendix A and reiterate the concerns outlined in that submission with respect to the revised Policy, subject to the following comments. CLF appreciates that the CPSS is seeking to remove barriers to health care for patients, and to ensure that patients are treated with the utmost dignity and respect. Both are laudable objectives, and efforts to support them are to be applauded. At the same time, physicians are also deserving of the utmost dignity and respect, and like their patients, have a constitutional right to freedom of conscience and religion under the Charter of Rights and Freedoms ( the Charter ). They also have the right to engage in and carry on their profession without discrimination on the basis of their religion and/or creed under The Saskatchewan Human Rights Code. 2 CLF is concerned that the Policy, while improved, still fails to adequately protect these rights. In particular, the Policy seems to conflate the notion that physicians not act as barriers to health services with a requirement that physicians personally and actively facilitate such services. For example, while a physician with a conscientious objection should not prevent their patients from obtaining information or treatment, the physician should not, as a general rule, be required to personally NGO in Special Consultative Status with the Economic & Social Council of the United Nations BOARD OF DIRECTORS Robert Reynolds, President - Québec Joshua Tong, Secretary - Ontario Shayna Beeksma - Ontario Philip Fourie - Saskatchewan John Lockhart - Ontario Michael Menear, Vice President - Ontario Tim Sinnott, Treasurer - Ontario Shannon Davis - Alberta Jessie Legaree (Student) British Columbia Shawn Smith - British Columbia STAFF & VOLUNTEERS Derek B.M. Ross - Executive Director Calvin (Cal) Beresh - Director, Student Ministries Tim Stonhouse - Regional Director, West Rev. Reid Cooke - Chaplaincy Melissa Mucci Pineda - Office Administration Ellen Watson - Office Administration Shawn Knights - Student Ministry Support

and specifically arrange with another physician to provide that information or treatment to the patient on his/her behalf. At the very least, other accommodations, such as a third-party source of information (i.e. an agency) to whom patients could be directed, should be closely examined by the CPSS. In fact, a careful examination of accommodation options is legally required of the CPSS, for the reasons set out in CLF s March 2015 submission. CLF is also concerned with the new wording added to the end of section 5.4, which states that a physician must provide medical treatment where the patient s chosen medical treatment must be provided within a limited time to be effective and it is not reasonably possible to arrange for another physician or health care provider to provide that treatment. Certainly it is reasonable to expect a physician to take action in emergency situations where it is necessary to save a patient s life. However, it is difficult to contemplate a scenario where a doctor would refuse to do so, particularly on religious/conscientious grounds, and certainly this does not appear to be the case in the Province of Saskatchewan. The wording of section 5.4 is not limited to emergency or life-threatening situations, but is much broader and ambiguous, requiring physicians to provide patients with whatever medical treatment the patient chooses, even when there is no risk of harm! This is a particularly problematic provision in the Policy and should be removed in its entirety. Individual physicians do not bear the responsibility to facilitate whatever services or treatment their patients desire, and cannot be required to simply abandon any moral or religious beliefs which might prevent them from doing so. Whatever obligations the government may have in providing health care to its citizens, and its duty to remain neutral in doing so, rests with the state. Individual physicians must not be conflated with the state. Charter jurisprudence has consistently affirmed that doctors providing medical services are not government actors 3 and that the provision of a public service, even one as important as health care, does not per se qualify as a governmental function under the Charter. 4 Although physicians may provide a publicly funded service, they are not state officials or agents, 5 and they retain their rights as private citizens vis-à-vis the government (which includes the CPSS). This was underscored in the recent decision of the Supreme Court of Canada in Saguenay. In that case, the Court affirmed that the state has an obligation to preserve a neutral public space. In order to do so, however, the state must ensure that individuals within that space have true freedom to express and manifest their conscientiously held beliefs: [A] neutral public space does not mean the homogenization of private players in that space. Neutrality is required of institutions and the state, not individuals. On the contrary, a neutral public space free from coercion, pressure and judgment on the part of public authorities in matters of spirituality is intended to protect every person s freedom and dignity. The neutrality of the public space therefore helps preserve and promote the multicultural nature of Canadian society enshrined in s. 27 of the Canadian Charter. The rights and freedoms set out in the Quebec Charter and the Canadian Charter reflect the pursuit of an ideal: a free and democratic society. This pursuit requires the state to encourage everyone to participate freely in public life regardless of their beliefs. The state may not act in such a way as to create a preferential public space that favours certain religious groups and is hostile to others. It follows that the state may not, by expressing its own religious preference, promote the participation of believers to the exclusion of non-believers or vice-versa.

When all is said and done, the state s duty to protect every person s freedom of conscience and religion means that it may not use its powers in such a way as to promote the participation of certain believers or non-believers in public life to the detriment of others. 6 Physicians cannot and should not - be expected to abandon their ethical and moral convictions, by virtue of their career choice or the fact that they provide health care services to the public. However, physicians can and should - be required to behave in a manner that is respectful to the patient and the patient s beliefs, lifestyle, choices, and values. The two concepts are not mutually exclusive. The CPSS should recognize this and more clearly accommodate physicians who have a conscientious objection to active and personal involvement in specific referral arrangements. This would be consistent with - to paraphrase the Supreme Court - CPSS s duty to encourage every physician to participate freely in the medical profession regardless of their beliefs. This is a matter of ethical principle that strikes at the heart of what it means to be a medical professional. Few, if any, patients would want to be treated by physicians willing to compromise their ethical and conscientious convictions in order to keep their medical license and billing number. We note that the revised Policy clarifies that it does not apply to physician-assisted death, since that issue is currently in a state of development. However, in light of the inextricable connection between ethical judgments at the beginning and at the end of life, we respectfully request that this consultation be placed on hold until both concerns may be addressed at the same time. CLF would be pleased to provide further assistance in any way the CPSS believes would be appropriate. Thank you for your consideration of our submissions. Sincerely, Derek B.M. Ross, LL.B., LL.M. Executive Director CHRISTIAN LEGAL FELLOWSHIP / Alliance des chrétiens en droit www.christianlegalfellowship.org 1 These ambiguities, and some proposed clarifications, are highlighted in the joint submission of the CMDS, CFCPS, and CPL dated July 22, 2015. 2 The Saskatchewan Human Rights Code, SS 1979, c S-24.1, s. 17. 3 As the Supreme Court of Canada observed in R. v. Dersch, [1993] 3 S.C.R. 768: Participation in the emergency treatment of the accused did not in itself render the physicians agents of government for the purposes of s. 32 of the Canadian Charter of Rights and Freedoms, nor were they acting as agents of government. See also Eldridge v. British Columbia (Attorney General), [1997] 3 SCR 624 at para 43: the mere fact that an entity performs what may loosely be termed a public function, or the fact that a particular activity may be described as public in nature, will not be sufficient to bring it within the purview of government for the purposes of s. 32 of the Charter. 4 Stoffman v. Vancouver General Hospital, [1990] 3 S.C.R. 483 at p 485. 5 One exception to this rule is where physicians are clearly acting as agents for the state to facilitate police actions (such as taking a blood sample pursuant to a provision of the Criminal Code) however, courts have consistently held that where a physician is acting for medical purposes and not to facilitate police actions, the Charter does not apply: see R. v. McDougall at paras 88-89, 2013 SKQB 358; R v. Hart, 2014 SKPC 42 at paras 28-33. 6 Mouvement laïque québécois v. Saguenay (City), 2015 SCC 16 at paras 74-76 [emphasis added].

APPENDIX A : CLF SUBMISSION TO CPSS RE: CONSCIENTIOUS REFUSALS POLICY MARCH 6, 2015

1235 Fairview St., Suite 223, Burlington, ON, L7S 2K9 Ph. 905-332-0597 Fax 905-319-2940 www.christianlegalfellowship.org College of Physicians and Surgeons of Saskatchewan March 6, 2015 500-321A-21st Street East Saskatoon, Saskatchewan S7K 0C1 Sent by e-mail to: communications@cps.sk.ca RE: Conscientious Refusal - Policy Consultation The College of Physicians and Surgeons of Saskatchewan ( CPSS ) has invited feedback from its member physicians as well as the public at large concerning a new draft policy (the Policy ) that addresses a physician s obligations when he/she has an ethical objection to providing a service requested or being considered by a patient. The Christian Legal Fellowship ( CLF ) is a national charitable association that exists to strengthen the spiritual life of its members, and to encourage among Christians in the vocation of law the integration of faith with contemporary legal, moral, social and political issues. The CLF s membership consists of approximately 600 lawyers, law students, professors, and others who support its work. It has 14 chapters in cities across Canada and student chapters in most Canadian law schools. While having no direct denominational affiliation, CLF s members represent more than 30 Christian denominations working in association together. As an association of Christian legal professionals, CLF welcomes the opportunity to address the issues raised in this consultation process. The CLF has intervened in numerous legal cases at the Appellate and Supreme Court levels in matters pertaining to freedom of conscience and religion. The organization also engages in policy consultations relating to issues that impact, among other things, religious freedom and human rights. CLF is therefore knowledgeable and well-positioned to comment on CPSS s Policy. In reviewing the Policy, there are three broad areas of concern for CLF: (1) The Policy fails to recognize that physicians have constitutional rights to freedom of conscience and religion under the Charter of Rights and Freedoms ( the Charter ), as well NGO in Special Consultative Status with the Economic & Social Council of the United Nations BOARD OF DIRECTORS Robert Reynolds, President - Québec Josh Tong, Secretary - Ontario Shayna Beeksma - Ontario Philip Fourie - Saskatchewan John Lockhart - Ontario Michael Menear, Vice President - Ontario Tim Sinnott, Treasurer - Ontario Shannon Davis - Alberta Jessie Legaree (Student) British Columbia Shawn Smith - British Columbia STAFF & VOLUNTEERS Derek B.M. Ross - Executive Director Calvin (Cal) Beresh - Director, Student Ministries Tim Stonhouse - Regional Director, West Rev. Reid Cooke - Chaplaincy Janine Van Nus - Office Administrator & Media Designer Shawn Knights - Student Ministry Support

as the right to engage in and carry on their profession without discrimination on the basis of their religion and/or creed under The Saskatchewan Human Rights Code; (2) The Policy fails to recognize that the law protects physicians from engaging in activities that violate their religious, moral and conscientious beliefs, and such protection must be accommodated by CPSS; and (3) The Policy imposes duties on physicians and surgeons to provide services, including effective referrals, which may violate their sincerely held and Charter-protected religious and/or conscientious beliefs, without considering whether accommodation options or less intrusive means are available. An implicit assumption that seems to underlie the entire Policy is that a physician s moral or religious beliefs would negatively interfere with a patient s care. It seems to preclude the possibility that a physician s moral beliefs could be both relevant and beneficial to the patient s care. Physicians do not practice medicine in a moral or ethical vacuum. To the contrary, a physician s ethical framework does, and should, inform the care they recommend and provide, whether religiously motivated or not. Physicians should be encouraged to act in accordance with their conscience, not punished for it. A correct understanding of physicians freedom of conscience and religious beliefs, and what is required to fully protect them under the Policy, will be the subject matter of this submission. 1. Understanding Physicians Freedom of Conscience and Religion In its current form, the Policy emphasizes the need to protect a number of patients rights, but when it comes to physicians, it simply states that physicians freedom of conscience should be respected. This description fails to acknowledge the firmly-entrenched legal status of freedom of conscience and religion. In fact, conscience and religion, thought, belief, opinion and expression are protected as fundamental freedoms by the Charter. 1 The centrality of freedom of conscience to a free and democratic society was emphasized by Chief Justice Dickson in R. v. Big M Drug Mart Ltd.: [A]n emphasis on individual conscience and individual judgment also lies at the heart of our democratic political tradition. The ability of each citizen to make free and informed decisions is the absolute prerequisite for the legitimacy, acceptability, and efficacy of our system of self-government. It is because of the centrality of the rights associated with freedom of individual conscience both to basic beliefs about human worth and dignity and to a free and democratic political system that American jurisprudence has emphasized the primacy or "firstness" of the First Amendment. It is this same centrality that in my view underlies their designation in the Canadian Charter of Rights and Freedoms as "fundamental". They are the sine qua non of the political tradition underlying the Charter. 2 2

The concept of freedom of conscience forms the basis for almost every other right and freedom guaranteed in the Charter. Individuals, including physicians and surgeons, are afforded the right to choose their own religion or philosophy of life, as well as the right to choose with whom they will associate, how they will express themselves, and what occupation they will pursue. 3 As a regulatory body with legislatively-established authority over the medical profession, the CPSS is required to consider the impact of its decisions and policies on the Charter rights of its members, including freedom of conscience and freedom of religion. 4 Fully respecting physicians conscience and religious beliefs demands more than merely acknowledging they exist. Religious freedom must be jealously guarded 5 and is not accommodated if the consequence of its exercise is the denial of the right of full participation in society, 6 such as one s ability to maintain employment. The current Policy strongly suggests that physicians will risk a finding of professional misconduct should they refuse to engage in activities that violate their religious beliefs and conscience. Effectively denying employment on the basis of one s Charter-protected beliefs can only be characterized as more than a trivial or insubstantial infringement upon that freedom and thus constitutes a violation of that freedom. The Policy also precludes physicians from sharing their religious or moral beliefs with patients: physicians must not promote their own moral or religious beliefs when interacting with a patient. While this requirement may be appropriate in some circumstances, a blanket prohibition is problematic and a clear violation of freedom of religion and expression. Religion as a protected freedom is more than the right to privately think or believe certain ideas and principles. It is broadly defined and demands robust protection. Freedom of religion encompasses the right to entertain religious beliefs of one s own choosing, the right to declare religious belief openly and without fear of hindrance or reprisal, the right to manifest those beliefs by worship and practice, by teaching and dissemination. 7 It precludes forcing an individual to act in a way contrary to his or her beliefs or conscience and protects the right to share those beliefs with others. No exception may be created for physicians by virtue of their career choice or the fact that they provide health care services to the public. 2. CPSS Must Carefully Examine All Accommodation Options In addition to the rights guaranteed under the Charter, the Saskatchewan Human Rights Code (the Code ) protects the right of every person to freedom of conscience, opinion and belief and the right to freedom of religious association, teaching, practice and worship. 8 In addition, the Code protects the rights of physicians and surgeons to engage in and carry on their profession without discrimination on the basis of their religion and/or creed. 9 Even more specifically, the Code 3

guarantees that every person shall enjoy the right to membership, and all the benefits appertaining to membership, in any professional society or other occupational association without discrimination on the basis of a prohibited ground, including religion and creed. 10 The CPSS clearly falls within the Code s definition of an occupational association. 11 It is evident from these provisions that physicians beliefs and practices flowing from their religion and/or creed must be accommodated by their occupational association (i.e. the CPSS) to the point of undue hardship. Imposing sanctions or discipline on a physician who cannot perform, assist in, or refer a patient to services because they violate sincerely held beliefs based on religion and/or creed would therefore constitute prima facie discrimination under the Code. There may be cases where a physician s conscientious objection could conceivably create an interference for a patient which is not insubstantial. However, it should not simply be assumed that the physician must always perform a service in violation of his/her sincerely held beliefs in those rare instances. Nor should it be assumed that responsibility for accommodating a patient s requests rests with the individual physician. Rather, the CPSS is obligated to carefully examine whether both the patient s needs and the physician s religious beliefs can be accommodated. The obligation on the state rather than the individual service provider to carefully examine accommodation options was emphasized in the recent decision of Dichmont v. Newfoundland and Labrador (Government Services and Lands). 12 That case did not involve a physician, but rather a marriage commissioner who objected to performing certain marriage ceremonies that violated her sincerely held religious beliefs. Nevertheless, Dichmont is analogous to the issues at hand, as it deals with the accommodation of the religious beliefs of public service providers. Dichmont affirmed that the obligation on the government to provide non-discriminatory services to citizens...must be balanced with the religious rights of citizens [who] provide the services. That requires an examination of the various mechanisms for accommodating religious beliefs in that context. [emphasis added] (para. 96). In order to adequately address obligations under human rights legislation, state actors are expected to engage in a thorough consideration of the merits of systems that could accommodate both the concerns of members of the public who are seeking a specific service, and of service providers who hold contrary religious beliefs (para. 98). A thorough and careful consideration of the merits of various accommodation systems appears to be lacking in the context of the Policy. The CPSS could, for example, accommodate physicians by expressly permitting them to decline such non-emergency services, including specific referrals that violate the core of their sincerely held beliefs, at least to the point of undue hardship (which must be specifically assessed). Instead, the Policy requires physicians who are unable to provide certain health services due to their moral or religious beliefs to provide an effective referral to another health care provider, as an inevitable course of action. This is a particularly flawed and intolerable element of the Policy. 4

3. Compelling Physicians to Provide Services Such as Abortions or Referrals Would Violate the Charter For many physicians who have a conscientious objection to performing certain procedures, such as abortions, providing a referral is as much a violation of their religious and/or conscientious beliefs as performance of the act itself. Many would see such a referral as facilitating, supporting, or acquiescing in, the objectionable act. This is exacerbated by the fact that the Policy s definition of an effective referral requires the conscientious objector to take active steps to locate another health care provider who is willing and able to accept the patient and provide the service. The Policy does recognize that this obligation to refer may not apply where a physician has a lawful excuse, but this exception does not appear to encompass a physician s religious and/or conscientious beliefs (although it should, in light of the legal principles espoused in the Charter and Code discussed in Parts 1 and 2 above). The Policy gives no consideration to the extent to which the referral itself would constitute an infringement of a physician s freedom of conscience and/or religion, nor does it consider whether less intrusive options may be appropriate. For example, a more balanced approach can be found in the Canadian Medical Association s (CMA) policy on Induced Abortion, which provides the following accommodation for physicians religious and conscientious beliefs: A physician should not be compelled to participate in the termination of a pregnancy. A physician whose moral or religious beliefs prevent him or her from recommending or performing an abortion should inform the patient of this so that she may consult another physician. No discrimination should be directed against doctors who do not perform or assist at induced abortions. Respect for the right of personal decision in this area must be stressed, particularly for doctors training in obstetrics and gynecology, and anesthesia. 13 There does not appear to be any evidence that patients rights to life, liberty, and security of the person are currently being violated as a result of delays created by physicians conscientious objections in the Province of Saskatchewan. Nor does there appear to be any suggestion that the CMA s current model allowing a physician to inform a patient that his or her moral or religious beliefs prevent him or her from recommending or performing a procedure (so that another physician may be consulted) is unworkable. In the absence of any such evidence, CLF submits that the obligation to provide an effective referral as currently worded is inappropriate and falls short of the CPSS s accommodation requirements. 5

Also problematic is the wording of section 5.4 of the Policy, which states that if an effective referral is not possible without causing a delay that would jeopardize the patient s health or wellbeing, the physician must provide the service in violation of his/her deeply held religious and/or conscientious beliefs. Certainly it is reasonable to expect a physician to take action in emergency situations where it is necessary to save a patient s life. However, it is difficult to contemplate a scenario where a doctor would refuse to do so, particularly on religious/conscientious grounds, and certainly this does not appear to be the case in the Province of Saskatchewan. CLF is concerned that the wording of section 5.4 does not appear to be limited to emergency or life-threatening situations, but is much more open-ended and ambiguous. What is meant by the terms health and well-being? Who determines or defines the meaning of these terms? The CPSS? The treating physician? The patient? Since the time that the Policy was released for consultation, the Supreme Court of Canada handed down its decision in Carter v. Canada (Attorney General). 14 The Supreme Court struck down as unconstitutional Canada s Criminal Code provisions banning physician-assisted suicide, and gave Parliament one year to create a new regime. However, in so doing, the Supreme Court expressly recognized that a physician s decision to participate in assisted dying is a matter of conscience and, in some cases, of religious belief. The Court underscored that physicians Charter rights must be taken into account by legal authorities, including physicians colleges (para. 132). Many physicians have conscientious objections to ending human life. The concept of being compelled to end a patients life would for many have been unfathomable when they first embarked on their medical careers. However, under the Policy s current wording, physicians could be compelled to actively locate another health care provider who is willing and able to end their patient s life. Furthermore, section 5.4 of the Policy could be understood as requiring physicians to themselves aid in ending a patient s life if doing so could be interpreted as necessary to avoid jeopardiz[ing] the patient s well-being. In either case, CLF submits that such an outcome would run contrary to the protection expressed by the Supreme Court of Canada in Carter. In underlining physicians rights to freedom of religion and conscience in Carter, the Supreme Court referred to its earlier discussion of the topic in R. v. Morgentaler. 15 That case is well known for striking down Canada s existing law placing restrictions on abortion. Nothing in the Morgentaler decision, however, suggests that a physician should or even could be legally compelled to perform a procedure that violates his/her conscience. To the contrary, the reverse was the conclusion expressly reached in the reasons by Justice Beetz (Justice Estey concurring). Justice Beetz explained that one of the defects of the abortion law in question was that it granted exclusive authority to hospital boards to appoint therapeutic abortion committees to approve abortion procedures. Justice Beetz noted that some hospitals had chosen not to appoint such 6

committees on the basis of conscientious/religious beliefs, resulting in limited access to abortions in some regions. However, Justice Beetz did not indicate that these decisions were inappropriate or unacceptable under the law. Rather, he affirmed that such decisions were legally protected, stating: Given that the decision to appoint a committee is, in part, one of conscience and, in some cases, one which affects religious beliefs, a law cannot force a board to appoint a committee any more than it could force a physician to perform an abortion. The defect in the law is not that it does not force boards to appoint committees, but that it grants exclusive authority to those boards to make such appointments. [emphasis added] 16 The Supreme Court in Morgentaler did not force health care professionals to violate their beliefs. Instead, it struck down the existing law as unconstitutional for failing to grant authority to other individuals/institutions to appoint committees in place of those who conscientiously objected to so doing. It is critical to note that, in this discussion, the Supreme Court Justices explicitly affirmed that the law cannot force a physician to perform an abortion (as discussed above, this passage was recently cited with approval by the Supreme Court of Canada s unanimous decision in Carter). Consequently, any suggestion that the CPSS could or should compel physicians to violate their conscientious beliefs should be soundly rejected. There is a significant moral component to these complex issues, the resolution of which often rightly lies within one s conscience. In such instances, the law instructs that physicians must be afforded the right to align their practice with their conscience, and that right must be made clear in CPSS s policies. CLF submits that this necessitates, at minimum, the removal of (a) the current effective referral requirement, and (b) the open-ended wording in section 5.4 of the Policy. Conclusion In light of the Supreme Court of Canada decisions referenced herein and the compelling principles they espouse, CLF urges the CPSS to: (1) appropriately protect its members constitutionally guaranteed rights and freedoms by ensuring the Policy upholds physicians and surgeons sincerely held conscientious objections to providing certain services including referrals, and (2) carefully examine all accommodation options for physicians and surgeons religious and conscientious beliefs, where applicable. Doing otherwise would only impose one conscientiously-held view at the expense of another. To borrow from the Supreme Court of Canada s Justice Wilson (as she then was), denying freedom of conscience to physicians and surgeons in the Province of Saskatchewan would treat them as means to an end and deprive them of their essential humanity. 17 7

CLF would be pleased to provide further assistance in any way the CPSS believes would be appropriate. Please note the endorsements that follow. Thank you for your consideration of our submissions. Sincerely, Derek B.M. Ross, LL.B., LL.M. Executive Director CHRISTIAN LEGAL FELLOWSHIP / Alliance des chrétiens en droit www.christianlegalfellowship.org ENDORSED BY: 1. The Hon. George W. Baynton, Q.C., retired Justice Court of Queen s Bench for Saskatchewan 2. Philip Fourie, Lawyer, Prince Albert, SK 3. Thomas Schuck, Lawyer, Weyburn, SK 4. Dr. Noelene le Roux, General Practitioner, Prince Albert, SK 5. Kenneth Koprowski, Deputy Judge, Strathroy, ON 6. Joshua Tong, Lawyer, Toronto, ON 7. John S. Lockhart, Lawyer, Mississauga, ON 8. Shayna Beeksma, Lawyer, Burlington, ON 9. Michael Menear, Lawyer, London, ON 10. Robert E. Reynolds, lawyer, Montreal, QC 11. Timothy Sinnott, Lawyer, Kitchener, ON 12. Shawn Smith, Lawyer, White Rock, BC 13. Shannon Davis, Lawyer, Grand Prairie, AB 14. Jessie Legaree, JD Candidate 2015, University of Toronto 15. Grace Mackintosh, Lawyer, Oshawa, ON 16. Seventh-day Adventist Church in Canada 17. James Kitchen, Law Student, Fredericton, NB 18. Esther O. Abraham, Barrister and Solicitor, Mississauga, ON 19. Reid A. Wilkie, Lawyer, Medicine Hat, AB 20. Walter Thiessen, Lawyer, Winnipeg, MB 21. Christopher Hiebert, Law Student, London, ON 22. Richard M. Harding, Lawyer, Calgary, AB 23. Kenneth H. Volkenant, Lawyer, Surrey, BC 8

24. Joseph P. Hamon, B.A. LL.B. C.S. (Family Law) FMC Cert. CFM Family Law Mediator FMC Cert. CFM Collaborative Family Lawyer Cert. - Certified Specialist in Family Law by the Law Society of Upper Canada 25. L. Frank Molnar, Q.C., Lawyer, Calgary, AB 26. Marie-Louise Fast, Barrister & Solicitor, Richmond, BC 27. Charles Richard Allard, Barrister and Solicitor, Edmonton, AB 28. Paul D. Mack, B.A. (Sydney), LL.B. (Western), LL.M. (Osgoode), Lawyer, Oshawa, ON 29. Rev. Elias Munshya (LLB, MA., M.Div.), Student-at-Law, Calgary, AB 30. Donald L. Wilkinson, Lawyer, Kelowna, BC 31. Walter W. Kubitz, Q.C., Lawyer, Calgary, AB 32. Ruth A.M. Ross, B.A., LL.B., Barrister and Solicitor, London, ON 33. JoAnne E. Nadeau, LL.B., Ottawa, ON 34. Philip J. Dougan, Lawyer, Vancouver, BC 35. Dawson McKay, Articling Student, Kelowna, BC 36. Julie Ralhan, B.A., LL.B., LL.M., Barrister & Solicitor, Toronto, ON 37. I. Stanley Osobik (J.D.), Lawyer, Victoria, BC 38. Teresa Douma, B.A., LL.B., Lawyer, Ayr, ON 39. Geoffrey Trotter, Lawyer, Vancouver, BC 40. Derek A. Nowak, B.A., B.Ed., LL.B., Lawyer, Paradise, NL 41. Linda G. Yang, Articling Student, Vancouver, BC 42. Janine Van Nus, Citizen, Burlington, ON 43. Christopher Taucar, Lawyer, Bradford, ON 44. Karine Gratton, Lawyer, Ottawa, ON 45. Barry W. Bussey, Lawyer, Elmira, ON 46. Edward Choi, JD candidate (University of New Brunswick), LLM (Arb&DR), LLB, BBA, DipAcct, Fredericton, NB 47. Peter Trieu, Lawyer, Calgary, AB 48. Jonathan Ng, Lawyer, Toronto, ON 49. Deina Warren, Lawyer, Oakville ON 50. Lisa C. Wight, Lawyer, Plattsville, ON (Not Practising Law - Employed) 51. Kathleen Pinno, Law Student, Edmonton, AB 52. Chris Markou, Lawyer, Brampton, ON 53. Tyler Koverko, Lawyer, London, ON 54. J. Allen Howard, Barrister & Solicitor, Calgary, AB 55. Nancy Bergstrom, Lawyer, Red Deer, AB 56. Geoffrey F. Cauchi, LL.B., Lawyer, Mississauga, ON 57. Frank de Walle, Barrister and Solicitor, Lethbridge, AB 58. André Schutten, Hon. B.A., LL.B., LL.M., General Legal Counsel, ARPA Canada, Ottawa, ON 1 The Constitution Act, 1982, Schedule B to the Canada Act 1982 (U.K.), 1982, c. 11. 9

2 [1985] 1 S.C.R. 295 at 346. 3 See R. v. Morgentaler, [1988] 1 S.C.R. 30 at 166 per Wilson J. [ Morgentaler ]. 4 See Trinity Western University v. British Columbia College of Teachers, 2001 SCC 31 [ TWU ]. 5 Reference re Same-Sex Marriage, 2004 SCC 79 at para. 53. 6 TWU, supra note 4 at para. 35. 7 R. v. Big M Drug Mart [1985] 1 SCR 295 at 336-337. 8 Saskatchewan Human Rights Code, S.S. 1979, c. S-24.1, s. 4. 9 Ibid., s. 9. 10 Ibid., s. 17. 11 Ibid., s. 2(1)(k): an occupational association is defined to mean any organization, whether incorporated or otherwise, in which membership is a prerequisite to carrying on any trade, occupation or profession, but does not include a trade union or employers organization. 12 2015 CanLII 4857 (NL SCTD) [ Dichmont ]. 13 Accessed online on February 19, 2015: <http://policybase.cma.ca/dbtw-wpd/policypdf/pd88-06.pdf>. 14 2015 SCC 5 [ Carter ]. 15 Ibid. at para. 132. 16 Morgentaler, supra note 3 at 96. 17 Ibid. at 179. See also Sean Murphy, Postscript for the Journal of Obstetrics and Gynaecology Canada: Morgentaler vs. Professors Cook and Dickens, online: <http://www.consciencelaws.org/law/commentary/legal030-001.aspx>. 10