Conscientious objection

Can doctors make a conscientious decision to refuse to provide certain treatment?

The GMC recognises that personal beliefs and cultural practices are central to the lives of doctors, and doctors have personal values that affect their practice. The GMC does not want to prevent doctors from practising in line with their beliefs and values, as long as doctors also follow the law and GMC guidance.

In this guidance, the GMC says doctors may practise in accordance with their beliefs, provided they:

  • act in line with relevant legislation (including Equality legislation).
  • do not treat patients unfairly.
  • do not deny patients access to appropriate medical treatment or services.
  • do not cause patients distress.

If any of these criteria cannot be met, doctors must provide effective patient care, advice or support, whatever their own personal beliefs.

If you are considering conscientious objection

In 'Good medical practice' (2024), the GMC says, "You must regularly reflect on your standards of practice and the care you provide considering how your life experience, culture and beliefs influence your interactions with others and may impact on the decisions you make and the care you provide."

It's important to be open with your employer and/or colleagues about a conscientious objection so that services can be planned without compromising patient care or over-burdening colleagues. Be aware that your contract might restrict your freedom to work with your conscience - this is a matter between you and your contracting body.

The GMC says you can choose to opt out of providing a particular procedure because of your personal beliefs and values, as long as this does not result in direct or indirect discrimination against, or harassment of, patients.

The guidance explains that, "This means you must not refuse to treat a particular patient or group of patients because of your personal beliefs or views about them. And you must not refuse to treat the health consequences of lifestyle choices to which you object because of your beliefs."

If you do have a conscientious objection to a particular procedure, 'Good medical practice' (2024) states in para 21 that, "you must make sure that the way you manage this doesn't act as a barrier to a patient's access to appropriate care to meet their needs."

Explaining to patients

If you wish to exercise a conscientious objection, you must do your best to make sure your patients are aware, in advance if possible. Patients have a right to information about their options, so if the option you do not provide may be clinically appropriate, according to GMC guidance ('Personal beliefs and medical practice', paragraph 12), you must:

  • tell the patient you do not provide it, being careful not to cause distress or imply judgement in the way you explain.
  • You must also tell them about their right to see another practitioner who does not hold the same objection and can advise them.
  • Make sure the patient has enough information to arrange to see another doctor who does not hold the same objection.

When you are explaining to patients, remember that you must not express your personal beliefs (including political, religious and moral beliefs) to patients in ways that exploit their vulnerability or could reasonably cause them distress. Whatever your own beliefs, "you must be respectful of the patient's dignity and views." ('Personal beliefs and medical practice', paragraph 16.)

Taking account of the patient's needs

Patient care must not be compromised by your conscientious objection and "you must not obstruct patients from accessing services or leave them with nowhere to turn" ('Personal beliefs and medical practice', paragraph 15).

Bear in mind that the patient may be in a position of vulnerability. As well as explaining your position, you will need to act promptly to make sure they are given the appropriate treatment or services. This means that, if it's not practical for the patient to arrange to see another doctor, you must make arrangements for them and take into account any reasonable adjustments they might need.

In an emergency ('Personal beliefs and medical practice', paragraph 13), "you must not refuse to provide treatment necessary to save the life of, or prevent serious deterioration in the health of, a person because the treatment conflicts with your personal beliefs."

Pregnancy termination

In England, Wales and Scotland, the right to refuse to participate in procedures relating to a pregnancy termination is protected by law.

However, you do not have the right to refuse to provide medical care to a patient who is awaiting or has undergone a termination of pregnancy.

If faced with a difficult decision, you may wish to talk through the issues with one of our medico-legal advisers. We can provide advice on ethical and medico-legal issues to help you be confident in any decision you make.

This page was correct at publication on 30/01/2024. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.