Doctors who refuse to refer patients for services on religious and moral grounds — including abortions — could face discipline under a new policy adopted by their regulating body.

The measure protects patients’ right to access care and at the same time ensures that doctors meet their legal obligations under the Ontario Human Rights Code, Dr. Carol Leet, president of the Ontario College of Physicians and Surgeons, said in an interview on Monday.

Physicians who do not comply with the new policy could face repercussions ranging from a requirement to upgrade their education to revocation of their medical licences, depending on the seriousness of the situation, she said.

“There have been some complaints about access to care,” Leet said, explaining one of the reasons the college saw fit to update its previous human rights policy.

Media have reported that doctors at walk-in clinics in Ottawa and Calgary last year refused to prescribe birth control.

In addition to contraception and abortion, the new policy is also expected to affect the provision of vasectomies and blood transfusions.

The old policy stipulated that physicians did not have to provide services that conflicted with their personal values and beliefs, but it was non-specific about whether they should make referrals to other doctors, Leet explained.

Leet said the new policy, approved by the CPSO’s governing council last Friday, is “very explicit” that they must refer patients.

The college held a public consultation on the new policy and Leet could not confirm reports that the majority of 16,000 responses were opposed to it.

However, she acknowledged that there was a concerted lobby effort by organizations and individuals opposed to it to make their views known.

Leet said a more accurate measure of the public pulse was a poll conducted by the college last spring that found that the vast majority of 800 Ontarians surveyed were in favour of doctors referring patients.

Kerry Bowman, a bioethicist the University of Toronto Joint Centre for Bioethics, said that the issue of conscientious objection is ethically complex but that the CPSO “got it right” with its new policy.

“On the balance of it, patient health and well being is usually what we put out there as coming first in health care. And to that end, I think that is the right choice to make,” he said.

But he said there are some practitioners who perceive abortion referrals as moral collusion.

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“I think it is going to be really tough for them. I actually feel for them. They are trying to do what they think is right,” he said.

Bowman said he expects that the new policy will also oblige doctors to make referrals on assisted suicide.