Conscientious objection and duty to refer






Bernard M. Dickens


Medical associations and leading courts reinforce the duty of physicians who con- scientiously object to participating in treatment indicated for their patients to refer them to non-objecting practitioners. Ethical and legal duties require continuity of care when physicians withdraw from patients’ treatment on grounds of conscience. The duty to refer might affect gynecologists when their patients request for example, contraceptive means, sterilization, abortion, medically assisted reproductive proce- dures, or gender reassignment. Legislation and leading law courts, notably the UK Supreme Court and Constitutional Court of Colombia, and professional associations such as the College of Physicians and Surgeons of Ontario, have clarified the duty to refer. Physicians are expected to cater their individual conscience to their professional ethical and legal duties, favoring their patients’ choices over their personal objections. Physicians can object to “hands-on” conduct of procedures they find objectionable, but cannot deny referral on grounds of complicity in what other care providers do.