Protection of Conscience Project
Protection of Conscience Project
Service, not Servitude

Service, not Servitude


College of Physicians and Surgeons of New Brunswick

Policies & statements relevant to freedom of conscience

CMA Code of Ethics (2004) with CPSNB commentaries

Project Annotations

The CPSNB uses the 2004 version of the Canadian Medical Association Code of Ethics with comments added by the College Council to provide additional guidance.   Several provisions are relevant to physician freedom of conscience:

7. Resist any influence or interference that could undermine your professional integrity.

12.  Inform your patient when your personal values would influence the recommendation or practice of any medical procedure that the patient needs or wants.

  • CPSNB Comment: If the denial or delay of treatment has the potential to cause harm, the physician is obligated to expedite access to another physician if possible. In any case, the physician cannot obstruct such access.

    • Project note: The meaning of "harm" may be disputed in relation to morally contested services like euthanasia and abortion.

18.  Provide whatever appropriate assistance you can to any person with an urgent need for medical care.

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.

  • CPSNB Comment: The physician is obligated, as part of the process of informed consent, to provide the patient with whatever information will, from the patient's perspective, have a bearing on his/her medical care decision-making.

    • Project note:  In the Project's experience, this does not usually present a problem for objecting physicians.

23.  Make every reasonable effort to communicate with your patients in such a way that information exchanged is understood.

  • CPSNB Comment: Informed consent requires good communication.

22.  Recommend only those diagnostic and therapeutic services that you consider to be beneficial to your patient or to others. If a service is recommended for the benefit of others, as for example in matters of public health, inform your patient of this fact and proceed only with explicit informed consent or where required by law.

  • CPSNB Comment: Physicians have a duty to promote public health and to protect society, even when the procedures in question may not be intended for the direct benefit of the individual patient (e.g. certain vaccinations or diagnostic procedures such as serologic typing of some viral infections for the purpose of public health surveillance). Such procedures still require informed consent, unless required by law.