Conscientious Objection

Professional Standards Regarding Conscientious Objection

Preamble

This document gives directions to physicians regarding conflicts of conscience which may arise from the physician’s belief structure or religion.

This document applies to all situations in which physicians are caring for patients, including, but not limited to, Medical Assistance in Dying (MAiD), immunization, reproductive care and gender affirming care.

Professional Standards

1. A physician must communicate promptly and respectfully about any treatments or procedures relevant to the patient’s condition that the physician is unable or unwilling to provide for reasons of conscience.
2. A physician must discuss all available treatment options with the patient and must not withhold information regarding a procedure or treatment relevant to the patient’s condition, even if providing such information conflicts with the physician’s conscience. 
3. A physician must not promote their own moral or religious beliefs to patients.
4. When a physician is unable or unwilling to provide a legally available surgical or medical treatment for reasons of conscience, the physician must make an effective referral.
5. With the consent of the patient, a physician must provide all relevant and available health records to the clinician receiving the effective referral.
6. After making an effective referral, the physician must continue to provide care to the patient until this care is no longer required or wanted, or until another suitable physician has assumed responsibility for the patient, or until after the patient has been given reasonable notice that you intend to terminate the relationship.
7. In medically emergent situations, physicians must provide whatever medical care is necessary for the patient, notwithstanding any issues of conscience.

Definitions

Effective Referral means a referral made in good faith to a non-objecting, available, and accessible physician, healthcare professional, or agency or service that oversees the delivery of the care being sought.

Conflict of Conscience describes a circumstance where a healthcare professional objects to care practices or treatments that conflict with their personal, ethical and or religious beliefs.

Resources

College of Physicians and Surgeons of Nova Scotia

• Professional Standard Regarding Medical Assistance in Dying (MAID)
• Professional Standard and Guidelines for Ending the Physician-Patient Relationship

Canadian Legal Information Institute Ontario Court of Appeal

• Christian Medical and Dental Society of Canada v. College of Physicians and Surgeons of Ontario, 2019 ONCA 393 effective referral

The New BioEthics Journal

• Conscientious Objection: Understanding the Right of Conscience in Health and Healthcare Practice

Canadian Medical Association

• CMA Code of Ethics and Professionalism

Acknowledgements

The development of this College standard was informed by the College of Physicians and Surgeons of Alberta’s Conscientious Objection standard of practice.

Document History

Approved by the Council of the College of Physicians and Surgeons of Nova Scotia: May 24, 2024

Date of next review: 2027