Michèle L. Hébert, PhD, OT

The term "effective referral" in this policy should be removed. Imposing such a practice will remove physicians' freedom to object and undermine the utterly personal nature of provider-patient decision-making. Physicians have a duty to inform and make health-centred recommendations that help patients determine their best interests. Conscientious objection involves ethical judgment and does not hinder the necessary, albeit occasionally contentious, exchanges between providers and patients. In cases involving fair end-of-life treatment, a policy update that prioritizes open, two-way communication over "effective referral" might be pertinent. A crisis in family medicine is present in Alberta, and to add "effective referral" will unfortunately give primary care physicians an additional reason to abandon their practice or transition away from general family medicine into more specialised areas. As a Canadian native who has been in Alberta for several years and whose family doctor relocated out of the province, I, like many others in Alberta, face the challenge of not having a culturally suitable primary care physician due to the family doctor shortage. Implementing this policy change will alienate certain cohorts of our society (a form of exclusion rather than inclusion), and this standard will discourage patients from coming forward and providers from pursuing medical practice in Alberta.

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