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Correspondent: ATTORNEY GENERAL July 16, 2001 The Honourable Chris Axworthy
Dear Minister: I am writing to seek your assistance in a matter involving the College of Physicians and Surgeons of Saskatchewan. The problem in brief is that the College has repeatedly refused to answer a specific question concerning a subject that comes within the College's purview—namely, medical ethics. The question to which the College has not responded relates to infant male circumcision. I asked the College to clarify whether or not medical ethics permit physicians to operate on individuals who have no medical need for surgery and who are legally incapable of giving personal informed consent. I have asked the College this question on several occasions, most recently in a letter dated June 11, 2001. As you can see from the College's reply dated June 19th, my inquiry was ignored. I believe that by repeatedly sidestepping a simple question about an important aspect of medical ethics, the College is failing in its statutory obligation to serve and protect the public. Under Bylaw 44(1), pursuant to the Medical Profession Act, the College must enforce the Code of Ethics. I understand that under section 87 of the Medical Profession Act, the Minister of Justice may direct the College to provide "all information and particulars relating to the College that may be required or requested." Therefore I am requesting that you write to the College and ask them to respond in a reasonable fashion to my letter of June 11th. I enclose a copy of that letter, as well as the College's reply. I would be happy to provide you with copies of earlier correspondence with the College, should you wish to see it. I would appreciate receiving a copy of any letter you send to the College regarding this matter. Thank you for your assistance. Sincerely,
August 21, 2001 Dear Mr. Sawkey: Thank you for your letter of July 16, 2001, describing your concerns in regard to a medical ethics issue and the College of Physicians and Surgeons of Saskatchewan. In particular, you have requested that my office seek to have the College provide an answer to certain inquiries you have raised with them as reflected in the ongoing correspondence you have shared with me. The role of the Government of Saskatchewan with respect to professions is an important role that this government takes very seriously. That being said, an important aspect of such overall governance is to respect the professions' general autonomy and to ensure that the various professions are not interfered with in their day to day operations. Accordingly, I must decline to ask the Lieutenant Governor in Council to seek specific answers to questions you have raised. It is the government's view that such matters are best dealt with by the professions themselves as experts on these issues. Yours sincerely,
September 13, 2001 Dear Minister, Thank you for your letter of August 21, 2001. As you point out, the autonomy of the professions should in general be respected. Unfortunately, the College of Physicians and Surgeons has repeatedly refused to answer a specific question about medical ethics. I have exhausted all possible avenues open to me in terms of obtaining a satisfactory answer from the College. I am requesting your involvement as a last resort. As the professional body responsible for regulating the practice of medicine in Saskatchewan, the College of Physicians and Surgeons has a moral and statutory obligation to answer all reasonable questions related to medical practice. Specifically, the College should be able to comment on the ethics of a common medical procedure. Under the provisions of the Medical Profession Act, the College must enforce the Code of Ethics. I believe that by sidestepping a straightforward question about medical ethics, the College is failing in its obligation to protect the public. In such circumstances, section 87 of the Medical Profession Act gives the Minister of Justice the authority to intervene. The College of Physicians and Surgeons should be able to justify its stance on infant male circumcision, just as it should be able to justify its stance on any other medical procedure. Once again, therefore, I am requesting that you exercise your legislated authority vis-à-vis the College and ask them to respond to my letter of June 11th. Your assistance in this matter would be greatly appreciated. Sincerely,
October 29, 2001 Dear Mr. Sawkey: Thank you for your letter of September 13, 2001, requesting that I reconsider my response to you of August 21, 2001, respecting the medical ethics issue you have raised with the College of Physicians and Surgeons. I regret that I can only reiterate the comment in my previous letter that it is the government's view that such matters are best dealt with by the professionals themselves as the experts on these issues. Thank you for writing to me with respect to this matter. Yours truly,
November 21, 2001 Dear Minister, Thank you for your letter of October 29th, reiterating the government's view that the medical ethics issues I have raised are best resolved by the professionals themselves. Unfortunately, the medical profession seems unprepared to do its part. In a letter dated May 10, 2001, the Associate Registrar of the College of Physicians and Surgeons stated that I cannot therefore provide you with a corporate position for the College with respect to the two questions you have posed. I enclose a copy of that letter for your ease of reference. We seem to have reached an impasse. The College of Physicians and Surgeons will not state its position on two important questions, though these questions come within the College's purview; and the government will not direct the College to answer the questions, though the government has the legislated authority to do so. Could you perhaps suggest a way to break this deadlock and move forward? Sincerely,
February 21, 2002 Dear Mr. Sawkey: Thank you for your letter of November 21, 2001, respecting medical ethics issues. As I mentioned to you in my letters of August 21, 2001 and October 29, 2001, this is not an issue that I consider appropriate for the Minister of Justice to become involved in. You may wish to consider raising this issue with the Minister of Health, who is the Minister responsible for The Medical Profession Act. Thank you for writing to me on this issue. Yours truly,
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