ACTION, RESPONSE, ENSURE for Professional Integrity Objections

Providers should begin by considering their individual beliefs and potential biases and consult their supervisor(s) for guidance. Additionally, it may be helpful to consult with pastoral care and/or the facility ethics committee 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 on any religio-cultural beliefs or practices shaping the treatment they are requesting. This helps to decrease the likelihood of misunderstanding for both parties, and ensures that everyone involved is able to make an informed decision.

After thoroughly completing the above actions, respectfully tell the patient/family that their request cannot be accommodated, and/or that the provider is not able to provide treatment.

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

Catholic facilities in the U.S. are subject to the Ethical and Religious Directives (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.

Transferring care to another provider is often initiated by the patient.

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. However, if the patient initiates a transfer of care, the provider may not interfere with this process.