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

Service, not Servitude


College of Physicians and Surgeons of British Columbia

Policies & statements relevant to freedom of conscience

Access to Medical Care Without Discrimination (2022)
Effective 2012 Nov | Revised 2022 May 06


Conscientious Objection to Providing Care

Registrants are not obliged to provide treatments or procedures to patients which are medically unnecessary or deemed inappropriate based on scientific evidence and their own clinical expertise. While registrants 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 or surgeons may be available to see them or suggesting that the patient visit an alternate health-care provider. Where needed, registrants must offer assistance and must not abandon the patient.

Registrants in these situations should not discuss in detail their personal beliefs if not directly relevant and should not pressure patients to disclose or justify their own beliefs. In all cases, registrants must practise within the confines of the legal system, and provide compassionate, non-judgmental care according to the CMA Code of Ethics and Professionalism.


Project Annotations

The words "without discrimination" added to the most recent iteration of the policy reflect concerns that the College advised the Project gave rise to the policy in 2012.

Under Conscientious Objection to Providing Care,"assistance" should not be understood to imply providing or facilitating a morally contested service, since that interpretation would render the policy self-contradictory.  In responding to questions from the Project in 2013, the College provided the following answers:

  • Q)  Is Access to Medical Care to be understood to require physicians to do what they believe to be immoral or unethical?
    • A)  No.
  • Q)  Does the College propose to take disciplinary action against physicians who refuse to do what they believe to be immoral or unethical?
    • A)  No, unless the College considers that in those specific circumstances the physician abandoned the patient without providing an appropriate level of medical care.