Welcome to the wild, wild north: conscientious objection policies governing Canada's medical, nursing, pharmacy, and dental professions

Bioethics. 2014 Jan;28(1):33-46. doi: 10.1111/bioe.12057. Epub 2013 Sep 30.


In Canada, as in many developed countries, healthcare conscientious objection is growing in visibility, if not in incidence. Yet the country's health professional policies on conscientious objection are in disarray. The article reports the results of a comprehensive review of policies relevant to conscientious objection for four Canadian health professions: medicine, nursing, pharmacy and dentistry. Where relevant policies exist in many Canadian provinces, there is much controversy and potential for confusion, due to policy inconsistencies and terminological vagueness. Meanwhile, in Canada's three most northerly territories with significant Aboriginal populations, whose already precarious health is influenced by funding and practitioner shortages, there are major policy gaps applicable to conscientious objection. In many parts of the country, as a result of health professionals' conscientious refusals, access to some legal health services - including but not limited to reproductive health services such as abortion - has been seriously impeded. Although policy reform on conscientious conflicts may be difficult, and may generate strenuous opposition from some professional groups, for the sake of both patients and providers, such policy change must become an urgent priority.

Keywords: conflict of interest; conscience; conscientious objection; conscientious refusal; moral conflict; moral values; religious belief.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Induced
  • Bioethical Issues*
  • Canada
  • Conscience*
  • Dissent and Disputes
  • Ethics, Clinical*
  • Female
  • Health Personnel / ethics*
  • Health Policy*
  • Health Services Accessibility*
  • Humans
  • Pregnancy
  • Refusal to Treat*