Canada
College of Physicians and Surgeons of New Brunswick
Policies & statements relevant to freedom of conscience
Moral Factors and Medical Care
April, 2012: Amended June, 2017
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Moral Factors and Medical Care
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Les Facteurs Ethiques et les Soins Medicaux
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From time to time, physicians may be confronted with situations
where they may be requested to provide a treatment or procedure to
which they have an objection on moral or religious grounds. In that
regard, physicians should be guided by the Code of Ethics, which
advises as follows:
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Les médecins peuvent parfois recevoir des demandes d'un
traitement ou d'une intervention auxquels ils s'opposent en raison
de leurs convictions morales ou religieuses. Dans ce cas, les
médecins doivent s'appuyer sur le Code de déontologie qui recommande
ce qui suit :
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12. Inform your patient when your personal values would influence the
recommendation or practice of any medical procedure that the patient needs or
wants.
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12. Avertir le patient lorsque ses valeurs
personnelles influeraient sur la recommandation ou la pratique d'une
intervention médicale que le patient souhaite ou dont il a besoin.
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21. Provide your patients with the information
they need to make informed decisions about their medical care, and
answer their questions to the best of your ability.
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21. Fournir au patient les renseignements dont
il a besoin pour prendre des décisions éclairées concernant les
soins médicaux et répondre de son mieux à ses questions.
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Based on these principles, Council believes physicians should
respond to such situations as follows:
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En se fondant sur ces principes, le conseil estime que dans la
situation évoquée, les médecins doivent agir comme suit :
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(1) A physician must communicate clearly
and promptly about any treatments or procedures the physician
chooses not to provide because of his or her moral or religious
beliefs.
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(1) Un médecin doit faire connaître clairement
et promptement les traitements et les interventions qu'il choisit de
ne pas prodiguer en raison de ses convictions morales ou
religieuses.
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(2) A physician must not withhold information about the existence
of a procedure or treatment because providing that procedure or
giving advice about it conflicts with their moral or religious
beliefs.Project Annotation (i)
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(2) Un médecin ne peut pas refuser de donner
des renseignements sur l'existence d'une intervention ou d'un
traitement parce que le fait d'exécuter cette intervention ou de
donner des conseils s'y rapportant entre en conflit avec ses
convictions morales ou religieuses.
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(3) A physician must not promote their own moral or religious
beliefs when interacting with patients.
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(3) Un médecin ne doit pas promouvoir ses
propres convictions morales ou religieuses dans son interaction avec
les patients.
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(4) When moral or religious beliefs
prevent a physician from providing or offering access to information
about a legally available medical or surgical treatment or service,
that physician must ensure that the patient who seeks such advice or
medical care is offered timely access to another physician or
resource that will provide accurate information about all available
medical options.Project Annotation (ii)
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(4) Lorsque les convictions morales ou
religieuses d'un médecin l'empêchent de fournir des renseignements
ou les moyens d'en obtenir concernant un traitement ou un service
médical ou chirurgical permis par la loi, ce médecin doit s'assurer
que le patient qui demande ces conseils ou ces soins médicaux a
accès en temps opportun à un autre médecin ou à d'autres ressources
qui lui fourniront des renseignements exacts sur toutes les options
médicales disponibles.
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Project Annotations
This guideline was adopted in 2012, "based on
an inititiative" by the College of Physicians and Surgeons of Alberta. It recognizes a key distinction
between providing information and providing or
facilitating a morally contested service or
procedure.
i. Physicians are expected to provide information
necessary to satisfy the requirements of informed
medical decision making, such as prognosis, the
treatments or procedures available, benefits and
burdens of treatment, risks, etc. The point here is to balance the desire of a physician to avoid
complicity in a wrongful act with the importance of informed
decision-making by the patient, which requires that the patient have all
of the information relevant for the purpose of choosing a course of
treatment. It is necessary to respect both the freedom of conscience of
the physician and the freedom and right of the patient to make a fully
informed choice.
ii. Only if a
physician is unwilling to provide this information
is an offer of "timely access" to another physician
or resource required. The purpose of arranging
timely access in this situation is to ensure that
the patient has information needed for
decision-making. Offering timely access
may be achieved in various ways.