Dialogue Volume 11 Issue 1 2015 | Page 14

feature “The policy requires that physicians, who choose to limit the health services they provide on moral or religious grounds, do so in a manner that respects patient dignity, ensures access to care and protects patient safety.” chooses not to provide for reasons of conscience or religion. What is an ‘effective referral’? An ‘effective referral’ means a referral that is made in good faith with a view to supporting, not frustrating or impeding, access to care. The referral must be made to another health-care professional. This includes a physician, another health-care professional or an agency. The health-care professional must not share the physician’s conscience or religious objections and must be available and accessible to the patient. By ‘available and accessible’ the College means that the health-care professional must be in a location the patient can access, be operating and/or accepting patients at the time the referral is made. An effective referral must also be made in a timely manner to allow patients to access care. Patients must not be exposed to adverse clinical outcomes due to a delayed referral. Physicians will not be considered to have made an ‘effective referral’ if they: •  efer the patient to a physician, health-care profesR sional or agency who shares the physician’s own religious or conscience objections (e.g. a referral to an anti-abortion clinic, referral to a physician who refuses to prescribe the birth control pill); •  efer the patient to a physician, health-care profesR sional or agency that is not accessible or available to the patient: not in a location the patient can access, or not accepting patients, or not operating at the time of the referral (e.g. referral to a physician located in Northern Ontario when the patient lives in Toronto; referral to an Agency that is closed) •  elay making a referral where the delay results in the D patient being unable to access care or where the delay causes adverse clinical outcome(s). What if I put a notice up in my office that I don’t offer specific treatments or procedures for reasons of conscience or religion? Is that sufficient to comply with this policy? 14 No, merely posting a notice is not sufficient to discharge your obligations under the policy. Communicating with patients in these circumstances is essential. Communication must occur directly, in person so that physicians can convey information to the patient, and can also obtain critically important information from the patient in kind. Information from the patient is necessary in order to comply with the expectations in policy: the requirement to provide