In support of CPSO’s commitment to bring equity, diversity and inclusion (EDI) to our policies, we have updated our human rights policy to provide guidance on how physicians can provide safe, inclusive, and accessible health services.

Overall, the Human Rights in the Provision of Health Services policy retains many of the core expectations found in its predecessor, the Professional Obligations and Human Rights policy.

One of the new expectations guide physician in responding to requests to receive care from physicians of a particular identity.

Dr. Karen Saperson, a member of the Policy Working Group, says it was important to address this issue because such requests cannot be rejected out of hand. "It may be clear that the request is not reasonable when the patient uses discriminatory or derogatory language,” but in most instances, she urges physicians to sensitively explore the request with the patient. There may be a valid reason why they wish a particular doctor.

For example, patients from racial or ethnic minority groups may request a physician of the same race or ethnicity based on a history of negative experiences with the health care system that resulted in mistrust. “Such requests can be considered reasonable and be accommodated if appropriate resources exist to meet patients’ requests,” says Dr. Saperson, a geriatric psychiatrist in Hamilton.

The literature is clear that a patient’s racial/ethnic/cultural background, sexual orientation, gender identity, socio-economic status and where they live can contribute significantly to disparate health care outcomes because of structures and systems of oppression, says Dr. Saroo Sharda, CPSO’s EDI Lead and Medical Advisor. Those belonging to racialized or marginalized groups are more likely to have difficulties accessing care because of systemic inequities in health care and beyond.

Incorporating the concepts of cultural humility, cultural safety, anti-oppression, and anti-racism into practice helps improve patient experience, health outcomes, and the quality of the physician-patient relationship, she says.

Four things to know about the updated policy:

• The policy supports physicians in taking steps to create and foster a safe, inclusive, and accessible environment, including by incorporating concepts of cultural humility, cultural safety, anti-racism, and anti- oppression into their practices.
• New expectations guide physicians in navigating requests by patients to receive care from physicians of a particular identity.
• The policy continues to strike an appropriate balance of the rights of physicians with conscientious or religious objections to the provision of certain health services and those of patients seeking to access those services by maintaining the effective referral provisions.
• New guidance advises physicians to consider the patient’s vulnerability and the urgency of their needs when deciding what steps to take when providing an effective referral.