The inclusion of "timely" access to referral elsewhere is problematic, given our current broken system involves protracted referral to treatment times, that has to do with factors outside of the physician's control. This needs to be re-worded, I think. Conscientious objection is important to protect, as a physician who is in moral distress over pressure to comply will not function well and the patients in their care will also suffer. There should be room for conscientious objection in the currently evolving/complex issues of MAID and gender dysphoria/affirmation.