A Calgary physician who is refusing to prescribe birth control to patients at a walk-in clinic in the city’s southwest may not be fulfilling her obligation to patient health, say experts in medical ethics.

“I think this doctor may be, because of her religious attitudes, unable to meet an important range of patients’ health needs,” said Arthur Schafer, director of the Centre for Professional and Applied Ethics at the University of Manitoba, and a former head of the university’s biomedical ethics section.

Not prescribing birth control sends a message “maybe unintentionally, maybe quite intentionally,” that the doctor is unwilling to have important conversations about patients’ sexual and general health, he said.

On Friday, the Herald reported that Dr. Chantal Barry of Westglen Medical Centre does not prescribe birth control due to her personal beliefs. Rather, a sign at the clinic’s front desk informs patients “the physician on duty today will not prescribe the birth control pill” when Barry is on shift and clinic staff provide a list of other clinics where birth control is available. Westglen only has one doctor available for walk-in patients at any given time.

Barry declined a request for comment.

But Dr. Ian Mitchell, a bioethicist with the Conjoint Health Research Ethics Board at the University of Calgary, said Barry’s stance is “worrisome” and could have repercussions reaching far beyond causing inconvenience for patients seeking birth control.

“The first code of ethics is to put the interest of the patient ahead of yourself,” said Mitchell. Physicians should not be required to ignore their personal beliefs, he said, but nor should they allow them to interfere with patient care. While Barry should be commended for her honesty, Mitchell said her stance has the potential to do harm.

For example, women who are on birth control but are seeking medical care for another issue may feel they can’t disclose health issues or concerns related to sexual health or lifestyle for fear of judgment.

“It sets up a little barrier, it’s saying ‘some things, we’re not going to deal with.’”

Schafer echoed that sentiment, noting it is the responsibility of physicians to initiate conversations about sex and sexual health as an essential tenet of preventive medicine.

“In effect, this doctor is shutting down the possibility of discussion, dialogue and health counselling about sex,” he said. If you’re talking about teenagers or young men and women, that’s a big part of the preventive role of the physician.”

Both Mitchell and Schafer took issue with a response from the College of Physicians and Surgeons of Alberta, which seemed to downplay the impact Barry’s choice would have on patients. CPSA registrar Trevor Theman told the Herald doctors can refuse to provide medical services based on religious or personal belief as long as they ensure patients have timely access to those services by another practitioner. A delay in providing a birth control prescription is “not likely going to disadvantage a patient in a serious way,” he said, noting “in an ideal world” patients should look to their family physician for birth control.

But Mitchell said that presumes all patients have access to a family physician, when in fact one in five Calgarians, or 200,000 people, do not.