Faculty of Law, Joint Centre for Bioethics, University of Toronto, Toronto, Canada.
Int J Gynaecol Obstet. 2021 Dec;155(3):556-560. doi: 10.1002/ijgo.13979. Epub 2021 Oct 18.
Medical associations and leading courts reinforce the duty of physicians who conscientiously 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 procedures, 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.
医学协会和主要法院强化了医师的责任，如果医师出于良心拒绝对患者进行治疗指示，应将其转介给非反对者。当医生出于良心原因退出患者的治疗时，道德和法律义务要求保持护理的连续性。当患者要求例如避孕措施、绝育、堕胎、医学辅助生殖程序或性别重置时，这种转介义务可能会影响妇科医生。立法和主要法院，特别是英国最高法院和哥伦比亚宪法法院，以及专业协会，如安大略省医师和外科医生学院，已经澄清了转介义务。医生应该根据自己的职业道德和法律义务来调整自己的个人良心，优先考虑患者的选择，而不是个人反对。医生可以对他们认为不可接受的程序的“动手”行为提出反对，但不能以与其他护理提供者的行为共谋为由拒绝转介。
