Canada
College of Physicians and Surgeons of Prince Edward Island
Polices relevant to freedom of conscience
Conscientious Objection to Provision of Service (4 November, 2019)
The “Policy on Conscientious Objection to Provision of Service” has been developed by the College of Physicians and Surgeons of Prince Edward Island(the College) as a guidance document for physicians as to how to balance the ethical dilemmas that occur when one’s beliefs and ethics as a practicing physician conflict with the ethical beliefs of one’s patients. Communication is clearly vital in this situation. . .
Moral or Religious Beliefs Affecting Medical Care
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.
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.
3. A physician must not promote their own moral or
religious beliefs when interacting with patients.
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 should
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.
While physicians may make a personal choice not to
provide a treatment or procedure based on their values
and beliefs, the College expects them to provide
patients with enough information and assistance to allow
them to make informed choices for themselves. This
includes advising patients that other physicians may be
available to see them, or suggesting that the patient
visit an alternate health-care provider. Where needed,
physicians must offer assistance and must not abandon
the patient.
Project Annotations
The policy avoids categorizing procedures or services as "medical" or "health care," which is itself often a point of contention in relation to morally contested services. It recognizes a key distinction
between providing information and providing or
facilitating a morally contested service or
procedure.
The point 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.
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. 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.
The offer of "assistance" in certain circumstances should not be understood to imply facilitating a morally contested service by referral or other means, since some physicians refuse to do so because they believe that makes them complicit in the act that follows. Further, the College applies the CMA Code of Ethics and Professionalism, which does not require referral by objecting physicians.
Related
Canadian Medical Association and Referral for Morally Contested Procedures