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Abortion Rights, Morality, Legality, Conscientious Refusals, Model Policy, Duty to Refer


In 2008, one of us (JD) together with the former Dean of Law at the University of Ottawa (Sanda Rodgers), wrote a guest editorial for the Canadian Medical Association Journal on the topic of access to abortion in Canada. In the editorial, we argued, among other things, that "health care professionals who withhold a diagnosis, fail to provide appropriate referrals, delay access, misdirect women or provide punitive treatment are committing malpractice and risk lawsuits and disciplinary proceedings." In response to a series of letters to the editor written about our editorial, we wrote that, under the CMA Code of Ethics (Update 2004) and the CMA Induced Abortion policy (1988), "all physicians are under an obligation to refer"—that is, to make referrals for abortion—and "[the policy] does not allow a right of conscientious objection in relation to referrals."

The Executive Director of the CMA Office of Ethics (Jeff Blackmer) then weighed in, asserting that we were mistaken with respect to physicians' duty to refer. Several months later, the Co-Chairs of the Parliamentary Pro-Life Caucus wrote to our law deans and "ask[ed] that you take the necessary steps to ensure that your Faculty members -- who have tremendous power to influence the minds of our future lawyers and doctors -- not allow their own personal biases to impair their ability to accurately represent the law." The extreme reaction to the suggestion that physicians have a duty to refer when patients request abortion services planted the seed for the development of a model policy on conscientious objections for Colleges of Physicians and Surgeons.

Inspired in part by the above sequence of events, Carolyn McLeod brought together a team of academics from philosophy and law to reflect on the moral and legal dimensions of conscientious refusals in healthcare.

The meetings of this team provided rich soil within which to germinate the seed for a model policy. In this paper, we recount the stages that were involved in developing this policy and then present the policy itself in the hopes of encouraging its adoption by Colleges of Physicians and Surgeons across the country.

Publication Abbreviation

Health L Rev