Obligations for Services for Patients
Professional Standards Regarding Obligations for Services for Patients
Physicians have the right to limit the health services they provide for legitimate reasons of conscience, religion, or scope of practice. When exercising this right, physicians must not discriminate against patients. The rights of patients are paramount, and their interests must prevail.
This document provides instruction to physicians on how to meet their obligations to patients when limiting services to patients for reasons of conscience, religion, or scope of practice.
- General Expectations
- Human Rights, Discrimination, and Access to Care
- The Duty to Accommodate
c. make reasonable efforts to ensure patients receive care in their preferred language.
Interpretation and Language Services
Nova Scotia Health
- Instructions for Health Care Providers (HCPs) to Include Interpreters to a Zoom for Healthcare Appointment
- Nova Scotia Physicians Line – How to access an interpreter
- The world at your fingertips
- Interpreter On Wheels: New technology provides safe, quality care in any language at Nova Scotia regional hospitals.
- Limiting Health Services for Legitimate Reasons
The duty to refrain from discrimination does not prevent physicians from limiting the health services they provide for legitimate reasons (for instance, because the care is outside their clinical competence or contrary to their conscience or religious beliefs).
- Clinical Competence
The duty to refrain from discrimination does not prevent physicians from making decisions in the course of practicing medicine that are related to their own clinical competence. The College expects physicians will always practice in their own knowledge, skill and judgment.
b. inform patients as soon as reasonable where clinical competence may restrict the type of services or treatments provided, or the type of patients a physician is able to accept. Physicians must:
- Conscience or Religious Beliefs
The College recognizes that physicians have the right to limit the health services they provide for legitimate reasons of conscience or religion.
Discrimination is an act, decision, or communication that results in the unfair treatment of a person or group by either imposing a burden on them, or denying them a right, privilege, benefit or opportunity enjoyed by others. Discrimination may be direct and intentional; it may also be entirely unintentional, where rules, practices or procedures appear neutral but have the effect of disadvantaging certain groups of people.
Effective referral is taking positive action to ensure the patient is connected to a non-objecting, available, and accessible physician, other healthcare professional, or agency.
Freedom of Conscience: The concept of freedom of conscience and religion is rooted in the Canadian Charter of Rights and Freedoms. This concept is open to court interpretation in the context of a particular factual situation, so it does not lend itself to a static definition. Physicians who are uncertain whether their reason for limiting health services is properly based on this Charter right should obtain legal advice to understand the most recent court rulings on the point. At the time of creating this Standard, the case of Christian Medical and Dental Society of Canada v College of Physicians and Surgeons of Ontario provides relevant guidance.
Canadian Medical Association
- Professional Standards and Guidelines Regarding Accepting New Patients
- Professional Standards Regarding Referral and Consultation for Patients with a Family Physician
- Professional Standards and Guidelines Regarding Reducing the Size of a Medical Practice
- Professional Standards Regarding Transfer of Care
- Professional Standard Regarding Medical Assistance in Dying (MAiD)
Canadian Medical Protective Association
- Accepting new patients: The key to effective practice management
- The continuing evolution of medical assistance in dying
- Ending the doctor-patient relationship
- Treating transgender and non-binary individuals
- When patients make special requests, how should you respond?
The College has incorporated excerpts from the College of Physicians and Surgeons of Ontario’s Professional Obligations and Human Rights in the development of this standard.
First approved by the Council of the College of Physicians and Surgeons of Nova Scotia: May 27, 2022
Date of next review: 2025