In response to feedback generated from physicians and others at Council’s request in a recent Bulletin, Council has approved the following comment:

One of the most difficult dilemmas in the patient/physician relationship occurs when the physician has a personal moral objection to a procedure or treatment that the patient may request or inquire about.  Such issues create a conflict between the recognized autonomy of a competent patient to make their own decisions regarding health care and the autonomy of physicians to practice according to their own knowledge, experience, and conscience. 

It is Council’s view that the autonomy of both patients and physicians can be respected, on the basis of physicians following the principles of good medical practice, the Code of Ethics, and College Regulations. 

To that end, it is a basic obligation under the Code of Ethics and College Regulations for physicians to advise patients when their personal morality would influence any recommendation or practice they may make regarding a patient.  In other words, it would be improper to refuse a patient’s request without stating such.  The basic requirement is that patients should be informed as to why a physician is declining to provide the service or treatment requested. 

Council also feels that, while it is not an obligation to do so, it is preferred practice for physicians who have such objections to refer the patient to another where such objections may not arise.  Nevertheless, if the physician feels even that is unacceptable, Council does view it as an acceptable alternative for the physician to provide information, upon the patient’s request, regarding resources which may be directly accessible to the patient. 

In any case, any discussions, should these issues arise, should be dealt with in a manner which is neither judgmental, nor intimidating.

Physicians are also reminded that other factors may have some influence here.  In addition to the Code of Ethics and College Regulations, the Human Rights Act prevents physicians discriminating in access to care based on a number of factors, including specifically “race, colour, religion, national origin, ancestry, place of origin, age, physical disability, mental disability, marital status, sexual orientation, or sex”. 

Finally, physicians are reminded that, should a complaint arise, any care offered will be judged according to accepted medical and scientific standards.


General Information

Address all correspondence to

Dr. Ed Schollenberg, Registrar
College of Physicians and Surgeons of New Brunswick
One Hampton Road, Suite 300
Rothesay, NB E2E 5K8 

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