Protection of Conscience Project
Protection of Conscience Project
www.consciencelaws.org
Service, not Servitude

Service, not Servitude

Canada

College of Physicians and Surgeons of Manitoba

Freedom of conscience and religion

Annotated Extracts and Links

Standards of Practice of Medicine
Conscience Based Objection
Updated to 2019 Dec 31
[Full Text]

12(1) A conscience-based objection is an objection to participate in a legally available medical treatment or procedure based on a member's personal values or beliefs.

12(2) A member must not promote his or her own values or beliefs when interacting with a patient.

12(3) On the grounds of a conscience-based objection, a member who receives a request about a medical treatment or procedure that a patient needs or wants may refuse to:

(a) Provide it;

(b) personally offer specific information about it; or

(c) refer the patient to another member who will provide it.

12(4) A member who refuses to refer a patient to another member or to personally offer specific information about a medical treatment or procedure on the grounds of a conscience-based objection must:

(a) clearly and promptly inform the patient that the member chooses not to provide a medical treatment or procedure on the grounds of a conscience-based objection;

(b) provide the patient with timely access to a resource1 that will provide accurate information about a medical treatment or procedure;

(c) continue to provide care unrelated to a medical treatment or procedure to the patient until that physician's services are no longer required or wanted by the patient or until another suitable member has assumed responsibility for the patient;

(d) make available the patient's chart and relevant information (i.e., diagnosis, pathology, treatment and consults) to the member(s) providing a medical treatment or procedure to the patient when authorized by the patient to do so; and

(e) document the interactions and steps taken by the member in the patient's medical record, including details of any refusal and any resource(s) to which the patient was provided access.

1.  Acceptable resources may include but are not limited to other physicians, health care providers, counsellors and publicly available resources which can be accessed without a referral and which provide reliable information about the available medical treatments or procedures.

Project Annotations

The policy is simple, clearly written and encompasses direct and indirect participation, while ensuring that patients have access to information needed for medical decision-making.  It can be applied consistently to all morally contested procedures, including euthanasia and assisted suicide. The expectation of co-operation in a patient-initiated transfer of care is the norm in jurisdictions outside Canada where euthanasia and assisted suicide have been legalized.

Standards of Practice of Medicine
Schedule M
Medical Assistance in Dying
Upated to 2019 Dec 31[Full Text]

I.    Minimum Requirements of All Physicians

A.   A physician must not promote his or her own values or beliefs about physician assisted death when interacting with a patient.

B.  On the grounds of a conscience-based objection3, a physician who receives a request about physician assisted death may refuse to:

a.  provide it; or

b.  personally offer specific information about it; or

c.  refer the patient to another physician who will provide it.

C.  A physician who refuses to refer a patient to another physician or to personally offer specific information about physician assisted death on the grounds of a conscience-based objection must:

a.  clearly and promptly inform the patient that the physician chooses not to provide MAID on the grounds of a conscience-based objection; and

b.  provide the patient with timely access to a resource4 that will provide accurate information about MAID; and

c.  continue to provide care unrelated to MAID to the patient until that physician's services are no longer required or wanted by the patient or until another suitable physician has assumed responsibility for the patient; and

d.  make available the patient's chart and relevant information (i.e., diagnosis, pathology,treatment and consults) to the physician(s) providing MAID to thepatient when authorized by the patient to do so; and

e.  document the interactions and steps taken by the physician in the patient's medical record, including details of any refusal and any resource(s) to which the patient was provided access.

D.    A member  who is not a physician and has a conscientious-based objection to MAID who receives a request for MAID, information  about MAID or a referral to a physician who will  provide MAID must advise the patient making the request that the member has a conscientious-based objection and must communicate the request to the member’s supervising physician in a timely fashion.

3.  See Section 12 of these standards of practice of medicine, where conscience-based objection is defined as an objection to participate in a legally available medical treatment or procedure based on a member's personal values or beliefs.

4.  Acceptable resources may include but are not limited to other physicians, health care providers, counsellors and publicly available resources which can be accessed without a referral and which provide reliable information about MAID.

Project Annotations

The policy is simple, clearly written and encompasses direct and indirect participation, while ensuring that patients have access to information needed for medical decision-making.  It is a specific application of the College's policy on conscientious objection (see above).   The expectation of co-operation in a patient-initiated transfer of care is the norm in jurisdictions outside Canada where euthanasia and assisted suicide have been legalized.