Conscience Protection Fact Sheet

  • Supreme Court of Canadahas struck down the criminal prohibition against physician-assisted death (PAD).
  • Ontario College of Physicians and Surgeons (CPSO) passed a policy that forces doctors to refer for, and in some cases perform, procedures despite the doctor’s moral convictions. Doctors have challenged this in court.
  • Quebec will soon implement PAD. Physicians must refer if they cannot participate in euthanasia of patients.

We are concerned that physician conscience rights are at risk. Conscience rights are ONLY protected when: 1. There is no duty to perform the procedure 2. There is no duty to make any type of referral 3. There is no discrimination if (i) and/or (ii) are not done.

Many physicians cannot refer for euthanasia for reasons of conscience or religious belief. They want to maintain the physician patient relationship, and continue to care for the patient, but ask to step aside when the patient chooses this procedure.

  • The Supreme Court of Canada has said that participation in euthanasia is a matter of conscience protected by the Charter of Rights and Freedoms. (Carter,para. 132)
  • The CMA Code of Ethics requires doctors to explain to their patients when their personal values might interfere with providing a service or referral. (s.12) We are also responsible to promote ethical access to health care resources in society in general. However, a physician is not obliged to provide for every patient request.
  • The Code states that physicians are required to neither participate in nor support practices that violate basic human rights (s.9). Requiring physicians to act against conscience violates basic human rights.
  • The CMA Policy on Abortion does not require performance, or referral, and prohibits discrimination. The physician’s duty is to continue to care for our patients’ other needs.
  • The CMA passed a motion at General Council in 2014 that “supports the right of all physicians, within the bounds of existing legislation, to follow their conscience when deciding whether to provide medical aid in dying.”This motion protects members who are unable to refer for reasons of conscience.
  • No country or jurisdiction that has legislated euthanasia,except Quebec,has forcedphysicians to refer for euthanasia.
  • The Hippocratic Oath preserves conscience rights on these issues.

Self-referral is the solution

  • Self-referral by the patient, their family or their substitute decision maker to a central intake service in each region would provide quick access without morally implicating the physician in the patient’s choice. This has been practiced successfully in cases of abortion. Access is not a problem for patients. The original physician would then be available to provide all other care until care is finally transferred.
  • Public opinion polls indicate that more people support self-referral when the moral convictions of the doctor will not allow them to participate in a controversial procedure.

The importance of conscience protection for patient care

  • Physicians are professionals and must retain the ability to freely act in their patient’s best interests. The best way to protect the public, the patient and the role of the physician is to safeguard physicians' conscience rights so they can practice with moral integrity. If freedom of conscience is not respected for one procedure, it will soon be eliminated for all procedures.

We call upon the following organizations to protect conscience rights in the following ways:

  • Canadian Medical Associationmust not change the Code of Ethics (para. 12) and must support freedom of conscience by not advocating the requirement that physicians refer for, or perform, euthanasia or assisted suicide.
  • ProvincialColleges of Physicians and Surgeonsmust write policies that respect conscience rights of physicians, neither requiring them to refer for, or perform procedures that go against their well formed and reasonably held moral convictions.
  • The Canadian Medical Protective Associationmust defend a physician if a College attempts to discipline them for acting on his or her moral convictions in this way.

The following organizations are working together on this issue. Canadian Physicians for Life, Canadian Federation of Catholic Physicians’ Societies, Christian Medical and Dental Society of Canada. For more information see: