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

Service, not Servitude


College of Physicians and Surgeons of Prince Edward Island

Polices relevant to freedom of conscience

Conscientious Objection to Provision of Service (4 November, 2019)

The “Policy on Conscientious Objection to Provision of Service” has been developed by the College of Physicians and Surgeons of Prince Edward Island(the College) as a guidance document for physicians as to how to balance the ethical dilemmas that occur when one’s beliefs and ethics as a practicing physician conflict with the ethical beliefs of one’s patients. Communication is clearly vital in this situation. . .

Moral or Religious Beliefs Affecting Medical Care

1. A physician must communicate clearly and promptly about any treatments or procedures the physician chooses not to provide because of his or her moral or religious beliefs.

2. A physician must not withhold information about the existence of a procedure or treatment because providing that procedure or giving advice about it conflicts with their moral or religious beliefs.

3. A physician must not promote their own moral or religious beliefs when interacting with patients.

4. When moral or religious beliefs prevent a physician from providing or offering access to information about a legally available medical or surgical treatment or service, that physician should ensure that the patient who seeks such advice or medical care is offered timely access to another physician or resource that will provide accurate information about all available medical options.

While physicians 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 may be available to see them, or suggesting that the patient visit an alternate health-care provider. Where needed, physicians must offer assistance and must not abandon the patient.

Project Annotations

The policy avoids categorizing procedures or services as "medical" or "health care," which is itself often a point of contention in relation to morally contested services.  It recognizes a key distinction between providing information and providing or facilitating a morally contested service or procedure. 

The point 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.

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.  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.

The offer of "assistance" in certain circumstances should not be understood to imply facilitating a morally contested service by referral or other means, since some physicians refuse to do so because they believe that makes them complicit in the act that follows.  Further, the College applies the CMA Code of Ethics and Professionalism, which does not require referral by objecting physicians.


Canadian Medical Association and Referral for Morally Contested Procedures