Project Annotations

In a 2001 bulletin, the Council noted  "that no physician is obligated to participate in a treatment or process to which they morally object" and sought feedback about appropriate guidelines for situations in which physicians have moral or ethical objections to a service or procedure wanted by a patient.  The statement above was issued the next year.

The identification of referral as a "preferred" but not a "required" practice is not necessarily problematic.  It prompts objecting physicians to consider, in each case, whether or not referral is a morally acceptable option, thus providing them with the opportunity to refine and better articulate their ethical reasoning.

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.