Moving Forward with a Clear Conscience: A Model Conscientious Objection Policy for Canadian Colleges of Physicians and Surgeons
Bibliographic record
Abstract
In 2008 one of us JD together with the former Dean of Law at the University of Ottawa Sanda Rodgers wrote a guest editorial for the Canadian Medical Association Journal on the topic of access to abortion in Canada In the editorial we argued among other things that health care professionals who withhold a diagnosis fail to provide appropriate referrals delay access misdirect women or provide punitive treatment are committing malpractice and risk lawsuits and disciplinary proceedings1 In response to a series of letters to the editor written about our editorial we wrote that under the CMA Code of Ethics Update 20042 and the CMA Induced Abortion policy 1988 all physicians are under an obligation to refer—that is to make referrals for abortion—and the policy does not allow a right of conscientious objection in relation to referralsbrbrThe Executive Director of the CMA Office of Ethics Jeff Blackmer then weighed in asserting that we were mistaken with respect to physicians duty to refer4 Several months later the CoChairs of the Parliamentary ProLife Caucus wrote to our law deans and asked that you take the necessary steps to ensure that your Faculty members who have tremendous power to influence the minds of our future lawyers and doctors not allow their own personal biases to impair their ability to accurately represent the law5 The extreme reaction to the suggestion that physicians have a duty to refer when patients request abortion services planted the seed for the development of a model policy on conscientious objections for Colleges of Physicians and SurgeonsbrbrInspired in part by the above sequence of events Carolyn McLeod brought together a team of academics from philosophy and law to reflect on the moral and legal dimensions of conscientious refusals in healthcarebrbrThe meetings of this team provided rich soil within which to germinate the seed for a model policy In this paper we recount the stages that were involved in developing this policy and then present the policy itself in the hopes of encouraging its adoption by Colleges of Physicians and Surgeons across the country
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.086 | 0.198 |
| Meta-epidemiology (narrow) | 0.001 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.058 | 0.046 |
| Scholarly communication | 0.025 | 0.014 |
| Open science | 0.010 | 0.022 |
| Research integrity | 0.063 | 0.058 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".