College of Physicians and Surgeons of Manitoba (Canada)
Freedom of conscience and religion
Annotated Extracts and Links
Conscience-Based Objection
17(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.
17(2) A member must not promote his or her own values or beliefs when
interacting with a patient.
17(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.
17(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.
Minimum Requirements of All Physicians
17(5) A physician must not promote his or her own values or
beliefs about physician assisted death when interacting with a patient.
17(6). 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.
17(7). 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 physician assisted death 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 physician assisted death; and
c. continue to provide care unrelated to
physician assisted death to the patient until thatphysician'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 physician assisted death 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 medicalrecord, including details of any
refusal and any resource(s) to which the patient wasprovided access.
3. See Section 17 of By-Law #11 - 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 physician assisted death.
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.