ACTION, RESPOND, ENSURE for Personal Conscience Objections

Ideally, inform your supervisor about your conscience objections as soon as you know that you have them. Knowing about conscience objections makes it possible to schedule staff appropriately to care for all patients.

Ensure that you clearly understand the patient’s/family’s request. If the request conflicts with your personal conscience, first inform your supervisor of your objection.

Once you inform your supervisor, inform the patient/family of all the treatment options available to them. It is best to do this without promoting one course of treatment over another, especially when your objection is guided by religious/moral beliefs rather than professional ethics. 

Consult with the facility ethics committee and, if appropriate, the pastoral care team. They can serve as sources of guidance and support for the provider as well as the patient.

Respectfully communicate to the patient and/or family that you are not able to provide the medical care that they are seeking, or that their request cannot be accommodated.

If you are comfortable, it may be appropriate to disclose to the patient/family that your refusal is based on a conscience objection, though you are not legally obligated to make such a disclosure.

If you are willing and able, refer the patient to another provider, as this supports continuity of care.

Catholic health care facilities in the U.S. are subject to Ethical and Religious Directive (ERDs), which prevent providers from giving referrals for procedures/treatments that violate the ERDs. There are different interpretations of the extent of the limitations on referrals. For example, providers may be able to inform patients that such procedures are not prohibited at secular health care facilities without issuing a referral to a specific facility or provider. Consult your employer’s policies to determine what information you can provide to patients regarding procedures that violate the ERDs.

If you are willing and able, consider facilitating a transfer of care to a provider without a conscience objection, as this supports continuity of care.

While it is appropriate to transfer care to another willing, qualified provider, providers exercising their right to conscientiously refuse a particular treatment or procedure are not legally obligated to initiate a transfer of care. If a patient initiates a transfer of care, a provider may not interfere with this process.