Tag Archives: Alberta

The Conscience Chronicles

UPDATE: As this was being readied for posting, the Standing Committee on Private Bills and Private Members’ Public Bills voted to recommend that Bill 207 not move forward in its current form, meaning that the bill will not be proceeding to the floor. I have elected to post this anyway, given the possibility that the proposal might be resurrected and amended at a later date.

At a first casual glance, the stated premise of Alberta’s Bill 207, Conscience Rights (Health Care Providers) Protection Act, might sound reasonable: most people wouldn’t expect medical professionals who object to procedures like abortion to be required to perform them.

In practice, Alberta’s College of Physicians and Surgeons already allows medical professionals to opt out of medical procedures that they have a religious objection to (a status quo that is at times problematic), so long as they provide any referral or direction to comprehensive information needed, ensuring that their patient still receives care in a timely manner. Bill 207 removes the obligation to refer and / or ensure patient care — using the reasoning that providing a referral is sort of like participating in the procedure. Regardless of any urgency or medical appropriateness of care in any given situation, this change allows refusals to increase the time delay to accessing care (regardless of any urgency), put the burden of medical care back on the patient, and be a kind of barrier and discouragement, if not more. Indeed, it can be like making someone start over from scratch. Proponents of the bill say that because medical care is still available elsewhere, it isn’t really being denied, which is technically true… but the time, emotional and informational barriers cannot be discounted.

But while those advancing the bill claim it is only codifying that status quo in law, there are more things that Bill 207 does, many of which have received little attention by media.

The bill extends conscience rights to health care organizations, as well. While religious care organizations have already asserted conscience objections in many ways already, this codifies it in law. It also allows organizations to assert their conscience-based decisions over those of their facilities, staff and resources. By way of example, Covenant Health (Canada’s largest Catholic health care provider) owns 16 health care facilities throughout the province, including two major hospitals in Edmonton; its affiliate Covenant Care owns another seven assisted living and long-term care facilities. In some rural areas of Alberta, all or most facilities are religious-owned.

In short, this moves Alberta down a landscape in which anyone in the chain of service provision — from facility administration to lab technician and pharmacist — can create a roadblock to services, without consequence. This becomes even more concerning when one realizes the potential for administrative staff, clergy or even outside groups to apply pressure to doctors and clinics to deny services that they might not otherwise have initially had objections to.

In fact, by the text of the law, it is left entirely up to the health care provider or religious health care organization to determine if their conscientious beliefs would be infringed, and there really is no appeal process to see if there is some agreeable compromise. No record is kept, leaving no way to follow up to ascertain if the patient has ever received the care they needed or sought. Gathering statistics about patients denied care in order to inspect what consequences the law has had becomes impossible, as demonstrated elsewhere.

By the text of the law, if a regulatory body receives a complaint about denial of care having to do with conscience, the complaint must be discarded (there is a caveat that complaints or portions thereof that are not conscience-related are not discarded). They are not allowed to investigate or question the decision:

5(1)  On receiving a complaint in accordance with section 55(1) of the Health Professions Act, the subject matter of which is a health care provider’s decision not to provide a health care service based on their conscientious beliefs, the complaints director for the regulatory body that received the complaint must immediately

(a) dismiss the complaint, and

(b) provide notice of the dismissal to the complainant.

It also specifies that by law, “a health care provider’s decision to not provide a health care service based on their conscientious beliefs is not to be considered as unprofessional conduct,” and providers and / or organizations are immediately shielded from legal liability.

There is also an amendment to Section 7(1) of the Alberta Human Rights Act, to immediately shield any employee from termination or discrimination based on their conscientious beliefs. This amendment is not restricted in any way to the medical profession, and could conceivably provide a shield for harassment and abuse of one’s co-workers or customers because of one’s religious or conscientious beliefs.

The bill’s proponent, MLA Dan Williams, has promised a number of amendments to Bill 207, but in those proposed changes, none of these points is substantively changed. One of his proposals — to restore a duty to assist “if not providing the health care service would result in an imminent risk of death” — isn’t altogether reassuring about the thought that was put into the bill in the first place… but even with that change, there is no clarification on whether or how the legal shield and barriers to reporting and investigation might be changed in the event of a patient’s death (especially in cases in which it was not thought that there would be an “imminent risk”).

There are many hypothetical situations that one can suggest could arise as a result of this legislation. But this is not uncharted territory. It is very easy to look at places where “conscience” exemptions have been implemented or attempted — or where medical personnel or organizations have attempted to assert their conscience rights — and see how it has affected medical care for patients.

“I was nervous and excited about the consult for my first intrauterine device (IUD) at MedStar Georgetown University Hospital. After a brief conversation, Dr. Case (a pseudonym) asked me to get off the exam table and follow her to her office for a ‘chat.’ But in her office, when the door was safely shut, my excitement slowly started to fade. ‘Well, first things first, this is a Catholic hospital,’ she said in a mock whisper…”

Evann Normandin, writing at Rewire this past May, described what happened to her when hospital policy prevented her from getting an IUD. She left with a referral… and shaming. Although referrals don’t come with the added expense of multiple visits in Alberta, like south of the border, the expense of time and transportation remain, and can pale in comparison to the emotional cost of the refusal itself:

“… On my way out of the labyrinthian building, I scrunched up the unofficial paper in my hand. The ripped edges felt sharp against my skin. In the Uber ride home, after paying transportation to and from my apartment to a world-class hospital and forking over a $50 copay for unsolicited advice about my vagina, I cried…”

At Huffington Post, Ace Ratcliff described her fight with doctors over her need for a hysterectomy:

“My illness’ severity [hypermobile Ehlers-Danlos syndrome] led me to the conclusion early on that childbirth would irreparably damage my already broken body and would never be the right choice for me. My joints dislocate painfully and at random. I have difficulty swallowing food. I bruise like an overripe peach. I faint if I have to stand for too long. Wounds take much longer to heal on me than on a normal human.

“… Somehow, my personal autonomy, my health and my comfort didn’t rate high enough to outrank the desires of my future, then-nonexistent partner. And nothing I said could change my doctors’ minds [about a surgical hysterectomy], not the stories about my frequently dislocating hips, my mom’s complicated pregnancies or the increased rate of miscarriage and preterm labor for EDS patients…”

In another instance, the hospital’s policies would have allowed the removal of a dislodged IUD, but the doctor thought the policies wouldn’t, and refused care. The patient was sent home, limited in her options by her insurance company (not applicable in Alberta, but limits on options can occur because of other factors, such as rural accessibility), and she ultimately had to file suit:

“Her doctor confirmed the IUD was dislodged and had to be removed. But the doctor said she would be unable to remove the IUD, citing Catholic restrictions followed by Mercy Hospital and Medical Center and providers within its system.

“… It felt heartbreaking,” Jones told Rewire. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights…”

Something that Bill 207 does not address at all is any duty of physicians to discuss every option available to a patient. If referring is equated to participating in an objected-to procedure or medication, then one might tacitly assume that providing comprehensive information on that procedure or medication can be denied. Withholding medical information can have serious consequences:

“… a woman was traveling across the Midwest when she developed abdominal pain. She and her husband went to the nearest hospital, where she was diagnosed with a potentially fatal ectopic pregnancy. The doctors recommended immediate surgery to remove the fallopian tube containing the misplaced embryo, a procedure that would reduce by half her future chances of conceiving a child. They failed to mention that a simple injection of Methotrexate could solve the problem, leaving her fertility intact. (In fact, at a secular hospital she found on her smart phone, it subsequently did.) Why the omission? The Catholic hospital where she got diagnosed was subject to the “Ethical and Religious Directives” of the Catholic bishops, which state, “In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion…'”

In fact, denial of comprehensive information is a recurring issue when medical conscience exemptions are asserted.

Of course, some of these examples focus on the emotional impact, but that doesn’t mean that there aren’t serious physical consequences potentially at stake:

“After about 10 hours, the patient’s temperature soared to 102 or 103 degrees, Ralph recalled in an interview with Rewire in June, a few months after the incident. Ralph and her team gave the patient medication to induce labor. But Ralph could not administer mifepristone, which the American College of Obstetricians and Gynecologists (ACOG) considers part of the most effective drug regimen for such cases. The Catholic hospital didn’t carry the drug, which is commonly used for medication abortions—a failure Ralph believes was religiously motivated and needlessly prolonged her patient’s labor.

“… For more than 24 hours, the patient labored through painful contractions. She bled heavily, requiring at least one blood transfusion. Her lips and face lost their color. Finally, she delivered a fetus that had no hope of survival…”

The full extent of Bill 207’s reach isn’t understood either, until you realize that “medical provider” covers a wide range, as noted in an Edmonton Journal editorial:

“The list is long and includes emergency, primary and critical care paramedics; midwives, chiropractors, podiatrists, psychologists and psychiatrists; lab, respiratory, ultrasound and X-ray technologists; pharmacists, physiotherapists and physical therapists; opticians and optometrists; dieticians and nutritionists; anesthesiologists, surgeons, and social workers; audiologists, dental professionals and speech-language pathologists…”

The inclusion of pharmacists in that list raises the question about access to birth control, an issue that has already surfaced in Alberta and elsewhere in Canada:

“Joan Chand’oiseau of Calgary recently posted a photo on Facebook of a sign on her physician’s office door that read, ‘Please be informed that the physician on duty today will not prescribe the birth control pill…’”

It also raises questions about access to hormone therapy for trans patients, or the possibility of throwing in a bit of public humiliation for good measure:

“‘Sir, we canceled your prescription because we couldn’t figure out why a man would need female hormones,’ said the voice. ‘You’ll have to have your doctor call us to confirm this is correct because it doesn’t make any sense…'”

Indeed, trans health is just as likely to be impacted as reproductive health, and doesn’t even have to be about transition-related medical concerns. Trans people regularly report what they’ve nicknamed ‘Trans Broken Arm Syndrome‘ — that is, the refusal of care for basic health services just because they’re trans. And it does indeed happen in Canada:

“According to the College of Physicians and Surgeons of Saskatchewan’s charge of unprofessional conduct and the penalty presentation, the incident took place on Jan. 5, 2016, when Anderson saw a patient for “reasons related to bronchitis” — something completely unrelated to the patient’s transition to male from female.”According to the documents, the disciplinary hearing committee found it ‘probable’ that Anderson ‘launched into an unsolicited running commentary’ regarding transitioning. Anderson made statements ‘which were insensitive and unrelated to the reasons for which the patient requested your medical services,’ according to the charges against Anderson…”

It should also be asked what conscience protections might do to protect the still-persistent practices of reparative therapy in Alberta (albeit with coded language). But that aside, denial of basic care is something that all LGBTQ+ people have had to worry about, sometimes even with lethal effect in situations that didn’t initially seem to pose an “imminent risk”:

“Refusing to treat patients can be be deadly, as was the case in 1995, when Tyra Hunter, a transgender woman, lost her life after emergency medical technicians refused to assist her at the scene of a car accident. According to the Center for American Progress, had Hunter received care, her chances of surviving were 86 percent — she should have lived…”

Medical assistance in dying is another area in which medical access is an issue, and in this instance, access is even more seriously limited. It is estimated that the aforementioned Covenant Health (and affiliates) oversee up to 90% of the long-term care beds in parts of Alberta, and regardless of whether long-term care patients are healthy enough to be moved, doing so is sometimes necessary just have questions answered, because of facility policies:

“Covenant Health stated in May of 2016 that it has an ‘ethical and moral opposition to medical assistance in dying’ and that the organization’s ‘unequivocal position to not provide or explicitly refer’ must be recognized. Functionally, this means that any assessment of capacity, any answering of technical questions, and the act of assistance in dying itself would require a transfer away from a Covenant facility.

“… The case of Ian Shearer, an 84-year-old Calgary man living in Vancouver with palliative heart and kidney disease and severe chronic pain, brought attention to how transfers can do harm. Shearer was denied a request for medical assistance in dying from St. Paul’s Hospital, a Catholic facility near where he lived and where he’d been admitted for care. On the day he chose to die, his ambulance was delayed three hours and his medications were withheld to allow him to confirm consent. The ordeal, last August, was described by his daughter as ‘unnecessary… excruciating suffering…'”

Obviously, the out-of-province and out-of-country examples won’t exactly mirror what would happen in Alberta, because of circumstantial differences in things like medical coverage, but what this demonstrates is the extent to which individuals might be willing to abuse a conscience protection, and the twists of logic involved. From the firing of doctors for not adhering to an organization’s conscience policies, to the chilling effect on medical care caused by activism from anti-abortion groups against clinics just for hiring doctors who’ve performed abortions elsewhere in the past, to medical residents who openly vowed to give the wrong medications to specific groups of people, to some some truly backwards beliefs about medical interventions…

“Throughout the conference’s diverse and highly academic presentations, one discernible theme emerged, namely, that “brain death” has been invented to harvest viable organs from still-living people. Only when a person’s heart stops beating and their breathing ceases for a determinate amount of time can it be said that death has truly occurred…”

… the politics surrounding medical conscience exemptions raises a broad range of concerns.

It is likely that Alberta’s Bill 207 would not survive a legal challenge. Indeed, the same day that the bill was introduced in the Alberta Legislature, a similar policy was overturned in the U.S. Likewise, a ruling in Ontario last May affirmed patients’ rights to referrals when care is denied.

But getting there could be another long, legally costly process, with very real human collateral damage caused along the way.

Photo: Adobe Stock

(crossposted to rabble.ca)

The Alberta Advantage was Dependence

In the end, the “Alberta Advantage” was dependence.
And in retrospect, undoing that dependence on the oil industry — a mixture of real and perceived — needed to be the number one priority of the Notley NDP government. When Albertans (even to their own surprise) overthrew the 40-year Progressive Conservative dynasty in 2015, they were hungry for change, and they knew that change was both inevitable and urgent, given the realities of global climate change — something they had been increasingly experiencing (most notably when the third “one-in-a-hundred-year flood” in ten years ate High River and parts of downtown Calgary).
Instead, industry managed to keep the focus on oil development and pipelines, and sucked all of the rest of the political and economic air out of the room.
Of course, Alberta’s energy sector is well-versed in fostering and using the dependence on its jobs and products — whether manipulating gas prices, making punitive and excessive layoffs whenever an administration or policy it doesn’t like is in place, or dangling illusionary carrots, like job creation estimates that factor in a hundredfold of jobs that they imagine might be generated by their project (and which nobody ever follows up on to debunk). In reality, building a pipeline creates merely a small number of regionally-shifting jobs aimed at transporting the longer-term refining jobs out-of-country, but nobody really ever remarks on that, because of how overwhelmed with industry propaganda Albertans are, and their eagerness for what little crumbs industry is willing to toss their way.
Now, the rest of Canada might not be overly sympathetic to Alberta’s plight, right now, because the province has had a pretty good run, riding waves of oil prices over the past few decades to sustained prosperity, while labour markets elsewhere have dwindled, automated, and relocated to other countries. Consequently, Alberta may feel the coming change more acutely than the rest of Canada — but feel it everyone will.
Change is hard. It’s disruptive. And with the level of budgetary dependence on energy royalties and the perceived dependence (thanks to the hard work of neoliberal institutions like the Fraser, CAPP and corporate media) of everyone’s jobs on oil development, Alberta has had four years of reckoning that haven’t really done anything to assuage any of the associated fears that come with that change.
To be fair, that transition was never something that was going to be able to take place in a scant four years.
Additionally, the Notley NDP have tried to break some of that sense of dependence through diversification. It’s something that hasn’t been well-publicized, but it also needed to be more aggressively pursued. And diversification is only one step — job retraining and the economic support and optimism needed to get through it are more critical. Albertans looked to Rachel Notley to lead them into and through a transition, and somewhere along the way, industry convinced the government and the public alike that the transition was yet another pipeline.
Consequently, we find ourselves at a crossroads in which Albertans seem receptive to old, failed conservative policies of austerity and corporate giveaways, regardless of the ethical concerns with a guy who may have broken electoral laws in order to become party leader, and regardless of whether he has surrounded himself with lake-of-fire social conservatives and semi-open white nationalists. It’s why we’ve seen people who’ve never protested before come out to agitate for pipelines, and naively allowed themselves to get hijacked by and aligned with racist wingnuts who’d previously floundered on the fringe for decades. Despite the stereotype of the Albertan redneck, Albertans have always tended toward worrying about the money, and not caring about the social positions that have aligned themselves with it (which is, in a way, even worse).
But here’s the clincher: a pipeline isn’t going to slow or stop the one-in-a-hundred-year floods, or the summer seasons that might soon be renamed “Smoke,” or the fracking-triggered earthquakes. And electing a traditional oil crony is more likely to undo the first steps that Alberta has taken than to make those hard choices. Because the longer Alberta tries to forestall its transition, the more abrupt, disruptive, and devastating that eventual change is going to be.
(crossposted to rabble.ca)

Legislatively “Balancing” Human Rights

There is a simple, time-honoured rule about attempting to “balance” human rights classes in legislation so that it works out a particular way every time, and it goes like this:

You can’t.

That is a court’s role.  When two human rights classes are put into conflict in a way that creates hardships for both, a court becomes the arbiter, weighing the context of a given situation in order to determine which party has experienced the most undue hardship.

Legislating such a way that one party’s rights always supersedes the other creates a hierarchy of rights, and defeats the whole purpose of equal rights legislation.

Bill 10

That is what took place this week with Alberta’s Bill 10, which newly-crowned Premier Jim Prentice introduced to dump and replace Liberal MLA Laurie Blakeman’s Bill 202.

The latter bill sought to do three things:

  • Give students the right to form Gay-Straight Alliances (GSAs) when and if they wanted to;
  • Remove a section (s.11.1) of the Alberta Human Rights Act which called for parents to be notified and either evacuate their children or opt them into anything that taught tolerance of LGBT people (interesting trivia: Alberta is the only jurisdiction in the world that has a “parental rights” clause like this, and it took several years to implement because no one was sure how it could work); and
  • Add a mention of the Charter of Rights and Freedoms and the Alberta Human Rights Act to the Education Act.

Premier Prentice’s new Bill 10 does this:

  • Encourages school boards to allow GSAs;
  • Allow the students to sue the school boards if they don’t (presuming they can find enough legal help, information, support and funding to cover the legal expenses to do so, and ride out the years of delay tactics at boards’ disposal);
  • The bill also removes s.11.1 from the Alberta Human Rights Act, but makes changes to legislation which more or less negates the change, other than affecting the way complaints are addressed.

If at any point the Premier thought he had sliced through a Gordian Knot worthy of Alexander, he soon realized otherwise.  As the bill came up for Third Reading, several amendments were proposed by opposition MLAs, and Prentice is now said to also be considering some of his own.

There are two central conflicts within this debate, one that is discussed frequently during many debates on social issues, and another which has been barely remarked upon at all.

“LGBT Rights vs. Religious Freedom”

The first is the false equivalence between LGBT human rights and religious freedom.  The reason I call it a false equivalence is because what we’re really talking about is the complaint that the (“special,” as it’s sometimes called) right of lesbian, gay, bisexual and trans* people to have equal access to employment, housing, services and other forms of enfranchisement is trumping the (“perfectly ordinary everyday?”) right to deny LGBT people any or all of those things.  People retain the freedom to believe what they will, practice their faith, and speak their beliefs — all up to the point where doing so becomes harassing and disenfranchising to others.  In most of the situations that are framed as pitting LGBT rights against religious freedom, this sort of conflict can only be considered equally-matched if you believe that coexistence is a violation religious conscience.

But the “gay rights versus religious freedom” argument has been losing steam, partly because the public at large is starting to recognize it as a ruse, and partly because the cause of religious freedom opens the possibility that the proponents’ religion will be placed on an equal footing with other religions, such as Islam, Satanism, or even Atheism.  Hardline social conservatives like the American Family Association’s Bryan Fischer have spoken out about this within religious circles, and more are starting to follow.

Consider this candid rant by Scott Lively, the pastor who is widely credited with having inspired Uganda’s Anti-Homosexuality Act and Russia’s ban on “gay propaganda”:

“For about a year now I’ve been arguing against the use of “religious liberty” as a theme of Christian public advocacy. We retreated to that theme after SCOTUS Justice Hugo Black’s abandonment of the Bible’s authority in favor of a new “religious pluralism” standard in the 1940s-60s, starting with Everson v Board of Education (1947). That was the case that adopted Jefferson’s “separation of church and state” metaphor as a justification for declaring all religions to be equal with Christianity in America, and equally subservient to Secular Humanist authority…

“But God always provides a way of escape. (We’re only trapped if we accept the limitation of staying on their chessboard.) That narrow and difficult but God-honoring way is to stop arguing for “religious liberty” and resume our proclamation of the superiority of Christ and His Word over all opposing faiths (along with tolerance for people of other faiths — that‘s how it worked before Black). It’s goal must be nothing less than an official reaffirmation of the Bible as our legal and cultural foundation, which would require overturning Everson and its juridical progeny…”

It was never really about religious freedom.

“Parental Rights”

The other conflict that has been almost completely missed is the one between youth and parents.  The argument made for parental rights clauses is that parents should have (using the language of Bill 10) the right “to make informed decisions respecting the education of their children.”

No one was ever stopping parents from teaching their children what they believe and encouraging their kids to follow their lead.  What parental rights are actually about is the right to deny their children any information to the contrary.

And that only sounds like a good idea until you remember that the kids should have rights too.  But by enshrining parental rights in legislation, the Province of Alberta is essentially prioritizing the right of parents to deny their kids knowledge (and emotional support, if their kid happens to be gay or trans*) over the right of children and youth to know.  In some cases, it means that the attitudes of the narrowest-minded parents determine what everyone’s kids are allowed to know.

And when you say it for what it is, it doesn’t really sound like that brilliant a compromise.

On conscience-based medical exemptions

The College of Physicians and Surgeons of Ontario is currently reviewing its Human Rights Code policy on conscience-based exemptions for medical professionals, and their effect on access to medical services.

This review was sparked by a number of news reports of doctors in Ontario and Alberta refusing to prescribe birth control because of their religious beliefs. In some of those cases, patients were refused in clinics where there was only one doctor on duty.

Concurrently, south of the border, the United States Supreme Court ruled in favour of a corporation’s right to deny medical insurance to its employees when doing so would violate the owners’ religious beliefs — a case that was specifically about access to contraception. The Hobby Lobby case has been followed by several new attempts to widen the exemption, and calls to extend it to other sectors and in ways that would allow businesses to refuse service to LGBT people.

These events reflect a major shift in the way that conscience rights are being seen and applied in North America.  It is my hope that the experiences of trans* people in Alberta with conscience-based medical exemptions might provide some insights for those considering a conscience policy review in Ontario.

Alberta has had a policy for some time which allows a doctor to refuse to prescribe treatments that violate their religious beliefs in non-emergency situations. However, they are required to state that the refusal is because of their religious beliefs, and to provide a timely referral for patients to someone who will provide care, so that patients still receive service and experience a minimum of undue hardship (although to be fair, having to jump through referral hoops can be considered an undue hardship of itself, especially when one factors in the difficulties in scheduling time off from work and other real life concerns).  Ontario’s policy is similar, though not identical.

Alberta’s policy was created to protect medical professionals from having to participate in any situation that might lead to an abortion.  But in the past year, there has been an upsurge of discussion about the need for a religious or conscience-based exemption in every sector and every practice.  Access to birth control is one of the pivotal issues in play in that discussion, although it is not the only one.

As an advocate for transsexual and transgender people, I’ve needed to assist a great number of people over the years who’ve been denied medical services because they’re trans* under Alberta’s conscience exemption policy.  Sometimes people have even been denied services for things like urinary tract infections, routine checkups and cases of the flu.  To be fair, the conscience exemption is not the only factor: denials are sometimes made by doctors who say they’ve never been trained in trans* health — although this complaint is made not only in regard to trans-specific health concerns, nor does there appear to be a willingness to learn from many of those doing the refusing.

Most often, trans* people who are refused care are also not provided a referral to anyone else.  This exploits the public’s unfamiliarity with this part of the law, and that they’re entitled to a referral.  It is certainly not every medical professional who refuses to assist, but it occurs frequently enough that the trans* community has had to try to keep a list of “trans-friendly” doctors — a list that is constantly plagued by doctors no longer being able to accept new patients, or making changes in their practice or habits.  I’m always happy to add doctors to the list, with the only requirement be that they adhere to the WPATH Standards of Care (which is also the policy of Alberta Health Services).  Two years ago, someone obtained a copy of our records and stormed into the offices of several listed clinics in Calgary, raising a ruckus about doctors’ willingness to treat trans* patients, and this resulted in several requests to be removed from our list.

Although commentators sometimes note theoretical possibilities like a Jehovah’s Witness practitioner denying blood transfusions, I can say from experience that conscience policies already can and do result in people being denied access to the care they need… and are not always given “timely” alternatives.

I am sensitive to a person’s right to opt out of something because their conscience, and not just a religious-based conscience.  However, in practical experience, exemptions tend to be abused, and marginalized people pay the heaviest price.  If there is to be a conscience-based exception to medical care, a province also needs to have a much better way of coordinating timely and accessible care alternatives, and better enforce the responsibility to provide those alternatives.  In Alberta, this is difficult, since there is no centralized means of communicating with medical professionals and provide some forms of training after they’re already in the field, short of making laws — so strengthening things at a policy level proves difficult.

With the recent shift of thinking among the religious right toward making provinces “abortion-free” and denying access to previously uncontroversial things like birth control, this issue will worsen in coming years.  If there is to be a conscience-based exemption to medical care, provinces need to seek a solution to the policy quandaries this creates now.  For example, if a walk-in clinic’s only physician on duty  will not prescribe contraception, then it’s worth investigating what responsibility the clinic should have in providing a doctor who will, and in a manner that suits the patient’s needs, rather than the doctor’s.

Or what responsibility the province is taking upon itself by sanctioning health care exemptions.

(Crossposted to Rabble.ca)

MP’s trans predator fearmongering escalates.

On Friday, Sun News commentator Brian Lilley interviewed Rob Anders, the Member of Parliament who has drawn condemnation for conflating transsexual and transgender people with sexual predators in a petition he has been circulating on his website, and to at least one church in his riding. In “Children’s bathroom bill reaches Parliament Hill,” both doubled down on conflating trans people with sexual predators, and suggested that granting human rights inclusion will somehow enable and legally absolve predatory acts.  Anders claims there is “all sorts of examples of this going on.”  Which is news to anybody else.

Lilley introduced the interview by once again calling for the defunding and privatization of CBC, the network which first broke the Anders story, and which Lilley has tried to portray as ludicrous for taking note of the petition.  During this time, though, Lilley has also been taking note of a Toronto District School Board (TDSB) policy that accommodates trans kids.  Like fellow Sun News Network commentators Michael Coren and Faith Goldy, he’s made that all about washrooms.  While discussing the TDSB policy with Anders, they arrive at this exchange:

LILLEY: We are going and changing all kinds of things that… I agree with you, could put people at risk of being exposed to perverts to fix something that is, what, one percent of one percent of one percent of a subset of a subset?

ANDERS: Yeah.  You know, why would we lower peoples’ natural defenses of a man going into a woman’s bathroom in order to “accommodate” [scare quotes added because at this, Anders appears to grin mockingly or suggestively]  this very very small, you know, part of the population.  In order to expose all sorts of women and girls to this…?

At that point, Rob Anders relates a phone call that told an anecdotal story of a crossdressed peeping tom who allegedly peered over stalls in the Canterra building in downtown Calgary four years ago.  Searching various media online, there appears to be no corroboration that it even occurred, let alone that it happened as related.  The network sensationalistically underscores this story with staged photos that are supposed to be representative of trans people in restrooms, including one featuring a urinal covered in police tape, and another showing someone with a long wig and a dress standing at a urinal.  Or at least I’m assuming they’re staged, because it would be concerning if someone is snapping candids in washrooms.

At an earlier point in this interview, Brian Lilley also points to one of the men accused of chaining and abusing a Nova Scotia teen — the attacker was said to have occasionally dressed in womens’ clothing.

Most Canadians either don’t know someone who is transsexual or transgender, or else aren’t aware that an acquaintance is trans (and given my experience as a community advocate, I suspect it’s more often the latter).  For this reason, Anders and Lilley float these examples as being representative of all trans people, and as justification for excluding those entire characteristic classes from basic human rights protections.

LILLEY: “Then he’s free and clear.”

Enter Bill C-279, An Act to Amend the Canadian Human Rights Act and the Criminal Code (Gender Identity and Gender Expression), which is a human rights bill addressing employment, housing, access to services and discrimination.

The bill says nothing about washrooms, which Lilley briefly acknowledges before calling washrooms a side effect of the bill, and then continuing to focus on them at the expense of all else.  C-279 also wouldn’t change the fact that trans people have already been using washrooms appropriate to their gender identity for decades.  But it’s at this point that Lilley and Anders claim that the bill would somehow essentially absolve the people in their examples of any culpability for their actions.

ANDERS: “Then he’s free and clear, that’s right.”

Readers are invited to find any example in which rape, molestation and other illegal and inappropriate behaviours were suddenly excused because the perpetrator was a member of a class listed in human rights legislation.  As equal human beings, we are all still responsible for behaving ethically and respectfully toward our fellow human beings, and to face the legal consequences if we don’t.

We also don’t exclude entire groups of people from public washrooms (let alone human rights) on the off-chance that one of them might be a sexual predator.

When I wrote about the history of the “Bathroom Bill” meme, one thing I didn’t mention is how opponents of trans rights initiatives tended to conflate trans people with predators, and then when called on it, would habitually backtrack to say it wasn’t trans people they were worried about, but that they thought trans-inclusive legislation could provide cover for actual predators to commit acts of sexual predation.  And then they’d go on talking about “transgenders” with hairy legs and skirts stalking children and doing unmentionable things in washroom stalls, as a reason to block human rights legislation.

But with the way Lilley’s interview is presented, there’s visibly no effort at all to make any kind of distinction.

And all of this, of course, completely overlooks the dangers to safety of going the opposite direction and forcing transsexual women to use a men’s room.  Or whether women would be happy having trans men in theirs.

Which brings us to Brian Lilley’s bottom line:

LILLEY: “Why do we have all these groups mentioned to get special treatment in the Human Rights Act, in the Criminal Code?  I thought we believed in treat all people equally and fairly in this country.  And why don’t we just get rid of all this nonsense and say all people are equal above and beyond [sic] before the law?”

Overlooking the fact that you just referred to equality as “special treatment,” Mr. Lilley, it is most likely because there is ample evidence that there are clearly bigoted attitudes and beliefs about entire groups of people, conflating them with abhorrent actions and behaviours — even to the point of circulating petitions, making comments on the floor of the House of Commons, and reporting them on television as fact — in ways that make discrimination against those groups likely or even inevitable.

Sun Media’s Brian Lilley interviews Rob Anders

(Crossposted to Rabble.ca)

Rob Anders, the transsexual bogeyman, and the weird phenomenon of MPs petitioning their constituents.

Rob Anders is on a mission.  Hot on the heels of having to halfway apologize for alleging that NDP leader Thomas Mulcair drove former NDP leader Jack Layton to his grave, Anders is now sending at least one church (possibly more) a letter asking them to petition MPs to oppose Bill C-279, which would (in its current form) extend human rights protections to transsexual and transgender people.  You’d almost think he needs an easy deflection, and trans people are the punching bag du jour.

It must be important, too.  For a Member of Parliament who has gained a reputation for falling asleep during Question Period in the House of Commons, allegedly napping through presentations about homeless veterans, and about whom fellow MPs have stated that “It’s a regular occurrence… I sit across from him when we meet in Ottawa and I’ve seen his neighbours poke him awake sometimes,” this must be pretty urgent, attention-getting stuff. After all, he’s staying focused on this one.

In his original letter, he raises the alarm:

“That Bill C-279, also known as the “Bathroom Bill”, is a Private Members Bill sponsored by B.C. NDP MP Randall Garrison and its goal is to give transgendered men access to women’s public washroom facilities.

“And that it is the duty of the House of Commons to protect and safeguard our children from any exposure and harm that will come from giving a man access to women’s public washroom facilities.”

Ah, he wants to protect women.  Hence his vote in support of M-312, which hoped to make government an arbiter of what reproductive health decisions women are allowed to make.  How chivalrous.

The Calgary West MP has stirred up controversy before, sending Canadian troops a Christmas message which read, “when in doubt, pull the trigger.”  He also made international news when he called Nelson Mandela a terrorist.  In 2010, 19 members of Anders’ riding association quit citing interference from the Conservative Party, with another 5 of the 32-member board following in the days afterward.

I’ve written before about washroom panic, and the historic use of this non-existent epidemic (considering that we’ve used public restrooms for as long as we’ve existed, and not seen any statistically notable number of instances of predation) to oppose all basic human rights inclusion for trans people, and have to admit that Anders’ comments pale in comparison (probably only because of brevity) to the rant that Niagara West-Glanbrook MP Dean Allison delivered right on the floor of the House of Commons this past April:

I find this potentially legitimized access for men in girls’ bathrooms to be very disconcerting. As sexual predators are statistically almost always men, imagine the trauma that a young girl would face, going into a washroom or a change room at a public pool and finding a man there. It is unconscionable for any legislator, purposefully or just neglectfully, to place her in such a compromising position.

Still, Anders is careful to make his talking points look original, although they are really not that different from Allison’s, the panic letters previously sent from LifeSiteNews, rants by Charles McVety, or the letter sent by MP Maurice Vellacott to his fellow MPs when the predecessor of this bill, Bill C-389, trekked through the previous session of Parliament, forwarding comments from a “constituent” who turned out to be Jim Hughes of the Campaign Life Coalition.  Or the editorial written by MP Blake Richards in the Rocky View Weekly as C-389 proceeded to Third Reading.  That bill passed, but died awaiting ratification by the Senate, when the election was called.

Rise and shine, SunTV

Anders’ comments also come as Sun News Network commentators Michael Coren and Faith Goldy are reacting negatively to the Toronto District School Board’s introduction of a policy that will allow trans students to use washrooms that are appropriate to their gender identity — even the Toronto Sun implies that trans identity is whim by phrasing it as using “whichever washroom they wish.”  The TDSB ruling is in response to a 2011 ruling by the Ontario Human Rights Commission, and addresses accommodating trans kids (something badly needed), but like Anders, Coren and Goldy fixate on potty panic.  Transcribed by the Huffington Post:

“Goldy was quick to make the issue personal. ‘I cannot but help but bring this story back to my 5-year-old god-daughter and the fact that when she goes to the bathroom by herself who knows what kind of creepo is now fully permitted, he has the right now, to be standing in that bathroom and doing God knows what,’ the reporter said.”

“Who knows what” is probably peeing, and trans people value their privacy during that as much as any other Canadian, thank you very much.

Goldy, like Anders, deliberately misgenders female-identified trans people.  We know that Anders isn’t referring to anyone else when he is petitioning about “transgendered [sic] men” because the trans men I know would generally not be wanting to use the womens’ room anyway.  Granted, womens’ restrooms tend to be cleaner, but those beards might raise questions.

I’ve seen that kind of deliberate misgendering a lot, and typically the objective is to portray trans people as being deluded at best or else outright fraudulent.  But when this kind of intentional disrespect comes from politicians and media figures, it especially needs to be challenged.

“I’m petitioning you to petition me…”

Although Anders’ comments are obviously not new, it signals a growing trend when Conservative MPs start actively lobbying their constituents to lobby them for petition signatures.  This is reminiscent of Jason Kenney’s recent letter to congratulate himself on his efforts as a champion of LGBT human rights, and his previous petition to petition his constituents to petition him to thank him for petitioning them to thank him (or something) on his valiant initiative to deny health care to immigrants.  With Anders, Vellacott, Allison et al actively stirring up fears of an imaginary transsexual bogeymonster in order to defeat human rights legislation, it signals a disturbing trend among legislators — in these cases, Conservatives — by attempting to manipulate the public conversation and skew public input in a way that would appear to support their personal agendas.

Which brings me back to a point I’ve made before, and made often:

Human rights protections are necessary exactly because this irrational fear persists.  It’s necessary exactly because trans people still get conflated with sex predators and child predators, or labeled as “sick,” “perverse,” and “freaks.”  It’s necessary exactly because people become so clouded with assumptions and myths that they argue for our deliberate exclusion from human rights under the pretext that granting them would be “dangerous” or “scary.” It’s necessary exactly because this bias is so entrenched that people think nothing about broadcasting it openly as though fact.  It’s necessary exactly because this “ick factor” response is seen as justification for not allowing an entire group of people to share the same space, to terminate their employment or to evict them.  It’s necessary exactly because it is so pervasive that discrimination becomes not only likely but inevitable — especially if there is no explicit direction in law to the contrary on the matter.

And especially if that irrational meme is so prevalent that it’s being loudly and embarrassingly parroted by legislators.

The sponsor of Bill C-279, Randall Garrison, has responded to Anders’ petition, saying that “what’s most offensive about his petition is that he equates transgendered people with sex offenders and pedophiles.  This petition is obviously based on ignorance, misinformation and fear, but that’s unfortunately what we’ve come to expect from Mr. Anders.”

Rob Anders, however, has been not responding to requests for comment.  Maybe he’s nodding off, after all.

(Crossposted to Rabble.ca)