Opinion: Balance doctors’ freedom of speech with protecting Albertans

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This year marks the 106th anniversary of the armistice signed in a railway car in the Forest of Compiègne that marked the end of the First World War. As we do every Nov. 11, Canadians will pay tribute to those who made the ultimate sacrifice in service of our country.

Whether in Europe, Korea, Afghanistan, or elsewhere around the world, Canadians have always bravely stood up to tyranny and fought to advance the democratic ideals of freedom of assembly, freedom of religion, and, of course, freedom of speech. We honour their legacy by fighting to preserve these ideals at home.

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Free speech is the bedrock of a healthy democratic society, enabling the free flow of ideas and vigorous debate that support a well-informed public. This right is so critical that it’s enshrined in our Charter of Rights and Freedoms, which ensures Canadians can create and express their ideas, gather to discuss them, and communicate them widely to other people.

As with all rights, however, there is a delicate balancing act involved. You can’t willfully defame someone, for instance. Nor can you issue death threats or other calls to violence. Reasonable guardrails are necessary in a democratic society. The key, however, is that they must be justifiable and limited.

The same principle holds for professional codes of conduct. When speaking in their professional capacity, doctors, nurses, lawyers, engineers, and others hold positions of trust in society. They have devoted years of their life to a particular expertise, so they have knowledge that the vast majority do not.

The differences within professions can be significant. You wouldn’t approach a chemical engineer about a bridge. Nor would you go to a dermatologist for a heart condition. In the latter case, yes, both are doctors, but both have years of training beyond just medical school that equips them with specialized knowledge and experience the other doesn’t have.

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That’s why the code of ethics regulating doctors in Alberta directs them to be “cautious not to overstep the limits of their knowledge and skills.” After all, it’s impossible for a physician to have expertise in all areas of medicine. Making public comments about specialties they are not qualified to practise isn’t just dangerous but potentially deadly.

As it relates to personal beliefs and ideologies, however, the College of Physicians and Surgeons of Alberta (CPSA) has no interest in controlling the speech of its members. On the contrary, we encourage doctors to express their opinions and share their thoughts. What the CPSA does provide is sensible direction.

Our code of ethics doesn’t restrict physicians from providing opposing opinions; rather, it sets an expectation that they make it clear and self-declare that their opinion runs against the medical consensus when speaking publicly. We believe Albertans have a right to know the collective position physicians have taken based on their interpretation of the available evidence. What Albertans then do with that knowledge is up to them.

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Last month, Premier Danielle Smith announced the government would review professional regulatory bodies and introduce legislation next year to limit how they can oversee their members. In her remarks, she said, “What a doctor or lawyer believes or says about politics or religion is not a reflection of their competency to practise medicine or law.” If it doesn’t influence clinic care, CPSA wholeheartedly agrees.

As a regulator, current legislation says we’re obligated by provincial law to address each complaint brought forward by the public, even if it has no relation to their ability to practise medicine. CPSA doesn’t want to spend time dealing with complaints like these or others against physicians who express political or religious opinions outside their clinical responsibilities, but we currently don’t have a choice.

CPSA welcomes the opportunity to work with the provincial government to update the Health Professions Act. Having the freedom to dismiss complaints outside our direct mandate or those unrelated to clinical and patient care would allow us to spend more time on issues impacting the quality of care Albertans receive from our regulated members.

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The key will be finding language that protects physicians’ freedom of expression while maintaining their professional responsibility to protect the public. The right balance can be found, but it will take thoughtful conversations and hard work. The effort, however, will be worth it because protecting fundamental freedoms while advancing the health of Albertans is our duty.

Scott A. McLeod is the registrar and CEO of the College of Physicians and Surgeons of Alberta (CPSA).