To make an "effective referral" to a procedure to which you are already a conscientious objector is to be forced to disregard your conscientious objection in the first place. I do not support forcing any physician to make an "effective referral" to any procedure to which they conscientiously object. It seems a relatively simple thing to provide patients with a list of physicians who will provide a given service and those who will not. The patient can then make a choice with which they are comfortable.