Thank you for working on a standard of excellence in the practice of conscientious objection As a retired physician I am gravely concerned about the proposed changes. When MAID was first proposed I was very concerned and a number of my colleagues and I physically went to the college to express our concern that as physicians we would be subject to making a “effective referral” when our conscience instructed us otherwise. Physicians who have taken the Hypocritic Oath, which states “above all to do no harm”, makes me wonder how becoming part of this decision is even legitimate What could be more harmful to the patient than to give a lethal injection resulting in death upon request? Am I to be complicit in this by making an “effective referral”? The answer is yes if I make the referral. There are many other options open to patients that do not require the physician Physician’s do have a conscience which is God given to help in making moral decisions Killing the conscience is harmful for not only the physician but society as well. How can I trust this physician? Will he be doubleminded and unstable in all that he does? I would prefer a physician as Robert Hauptman as stated so well that offers MAIL (Medical Assistance in Living) I agree with my collogue Richard Pidde in that we will be accountable for our actions. That was the basis of the Nuremburg trials where physicians claimed to be doing what they had been instructed to do by government. There is a higher order that we must take into account As the governing body for physicians please do not add the words “effective referral” and thus cause harm.