Providers faced with a situation in which their professional integrity conflicts with the request/medical needs of a patient or family should begin by considering their biases and consult their supervisor(s) for guidance. Additionally, it may be helpful to bring pastoral care and/or the facility ethics committee into the conversation as appropriate to offer support and guidance to both patient and provider.

There is a reciprocal dynamic to this action item. In many cases, providers should inform the patient/family of their objection and educate as necessary to help them understand the relevance of the objection, though they are under no legal obligation to do so. Additionally, the patient/family should be given the opportunity to educate the provider as to any pertinent information including any religio-cultural beliefs or practices shaping the treatment they are requesting. This helps to decrease the likelihood of misunderstanding for either party, and ensures that everyone involved is able to make an informed decision.

When all other possibilities have been explored and exhausted, the patient/family must be respectfully informed that their request cannot be accommodated, and/or that the provider is not able to provide treatment. In some cases, the provider can then refer the patient to another provider. In facilities with ERD’s, providers are not able to provide formal referrals for procedures/treatments that violate the ERD’s. There are different interpretations of the extent of the limitations on referrals. Providers may be able to inform patients that such procedures are not prohibited at secular health care facilities.