OP-ED: Jailing doctors won’t stop forced sterilization
"The law meant to protect patients could have a chilling effect on doctors."
Author: Susan Martinuk
Susan Martinuk is a Senior Fellow at the Frontier Centre for Public Policy. A Vancouver-based researcher and communications specialist, she has written more than 1,500 published columns, articles and reports on health care, bioethics and public policy. She is the author of Patients at Risk: Exposing Canada’s Healthcare Crisis and the forthcoming Patient Rights: Restoring Trust in Canada’s Healthcare System.
The forced sterilization of women in 21st-century Canada? Is that even possible?
Apparently, it is. According to a 2022 Senate report, Canada has a long history of using sterilization to reduce births in First Nations populations and other marginalized groups.
In June, the federal government responded to these findings by passing Bill S-228 to criminalize sterilization procedures done without consent. Physicians can now be charged with aggravated assault and face penalties of up to 14 years in prison if patients claim they didn’t give valid consent.
It may seem like a logical response to the problem. Except, it isn’t.
All it does is place a contentious legal covering over medical interactions between doctor and patient.
The Survivors Circle for Reproductive Justice claims as many as 12,000 to 15,000 people have been sterilized without consent since the 1890s; some as recently as 2025. (There is no way of knowing the accuracy of those figures or obtaining a breakdown of numbers by year). Class-action lawsuits claiming forced sterilization are already underway in certain provinces (B.C., Alberta, Saskatchewan and Quebec) and there is little doubt that more will follow.
Once the legal foundation is formally laid, patients will be running to law firms in the hope that money will ease their pain. The Saskatchewan suit of 50 women is seeking reparations of $7 million per case.
The Canadian Medical Association, which has publicly apologized to the Indigenous people for not meeting appropriate standards in their medical care, supports the bill (at least in public) as part of its reconciliation efforts. Understandably, however, obstetricians and gynecologists, the doctors who perform sterilization procedures, are concerned.
The Society of Obstetricians and Gynecologists of Canada (SOGC) has raised legitimate fears that consensual sterilizations could later be claimed as “forced.” Others could claim they were talked into the procedure or told it was medically necessary when it was not.
The SOGC believes the bill could have a “chilling effect” on its members as they respond to patients inquiring about such procedures. Actions taken during life-threatening emergency care are exempt from the law. Still, realistically, there is no guarantee of protection once legalities have even the slightest potential to override clinical judgment.
Consequently, the SOGC quite rightly states that Bill S-228 is not the answer.
Most notably, it fails to address the real problem—systemic racism. Jailing doctors is not going to change the cultural inequities that persist in health care.
How can we hold doctors and medical institutions accountable without criminalizing medical procedures?
Two words: Patient rights.
A better solution for all parties (patients, doctors and health-care institutions) is to consider this within a framework of patient rights based on standardized and agreed-upon principles that govern the interactions of health-care providers and patients.
For example, the principle of informed consent means doctors are accountable to provide all information to the patient, including risks, benefits and alternatives. Patient autonomy gives patients the right to be actively engaged in their own care, including shared decision-making. Patient rights hold both doctors and patients responsible for maintaining a non-discriminatory and respectful environment.
These rights (and others) should be acknowledged as key elements that underlie every health-care system and every doctor-patient relationship in Canada. Patients need to know them; doctors need to acknowledge them when interacting with patients.
When rights are violated, there should be an open and transparent system of accountability for health-care providers and institutions. It should be easy for patients to access and capable of dealing with complaints and medical errors in a timely fashion. That keeps the majority of medical concerns outside the courtroom.
Patient rights govern health care in many nations, but they remain largely unknown in Canada. Most provinces have a tacit statement about patient rights, but the rights vary considerably in terms of the language used, the degree of accountability and the effectiveness of their implementation. In some cases, they are almost impossible to access. Some have a legal basis, while others are merely suggestions for best practices. There are no standardized rights across Canada.
Forget the criminal charges. Deal with systemic racism. Reset the parameters of care in the doctor-patient relationship by creating a robust, standardized and national statement of patient rights. Develop local systems that hold doctors and institutions to account when errors arise, and rights are violated. Finally, and perhaps most importantly, make sure that both patients and doctors know the rules and what to do when they are broken.