I am writing to respond to the request for feedback on, and to express my concerns with regards to the proposed CPSA Standard of Practice for Conscientious Objection. In the preamble, the Standard states that “These expectations accommodate the rights of objecting physicians to the greatest extent possible, while ensuring that patients’ access to healthcare is not impeded”. However, the subsequent text contains some contradictions and lack of clarity which invalidate this dual principle. The area of concern in the policy is 1.e. and 1.f. To begin, Section 1.e. states that a member must ensure timely access to: “i. a regulated member who is willing to provide the medical treatment, service or information; or ii. a resource that will provide accurate information about all available medical options;” There is a lack of clarity here as to what exactly qualifies as “a resource”, especially as the following section requires “an effective referral plan”, about which I will provide more feedback later. For greater clarity, and consistency with the MAID Standard of Practice, which states the information for the Care Coordination Service must be provided to requesting patients, this policy should be updated to explicitly state the requirement detailed in Section 1.e.ii. is satisfied by the provision of information regarding the MAID Care Coordination Service. This is in keeping with the Policy of the College of Physicians and Surgeons of Manitoba, and would best balance rights of conscientious objectors with the rights of patients. I am also concerned by the inclusion of the phrase “effective referral” in section 1.f. of this Standard. As commonly understood, this phrase indicates “Taking positive action to ensure the patient is connected to a non-objecting, available, and accessible physician, other health-care professional, or agency” (from the College of Physicians and Surgeons of Ontario” Policy on Human Rights In the Provision of Health Services). At least on some readings, this requirement would not be satisfied by providing information about the Care Coordination Service. This is of concern to many Conscientious Objectors, who cannot in good conscience actively implicate themselves in intentionally causing the death of another human being. Therefore, I request that the phrase “effective referral” be removed from the policy. I’d like to conclude by stating that Conscientious Objectors should not be seen as “a problem constituency”. Instead, please try and understand that their conscientious objection is driven by a reverence and deep regard for human life, and an unwillingness to participate in practices that they view as degrading it. While this unwillingness means that they will not participate in the provision of some few services, the opportunity to retain these employees should not be missed: the same deep regard for humanity that drives conscientious objection also motivates these colleagues to go above and beyond in providing superb, caring and gentle health care to their patients. Even if there is disagreement on specific practices, this kind of devotion to humanity will only enrich the teams and places where they work. So please see this as an opportunity for fruitful coexistence, rather than just a “problem to be solved”. Sincerely, Karol Boschung