by Joyce Arthur.

Oral presentation at IWAC conference, Bangkok Thailand, IWAC conference, Feb 25, 2026

Highlights: In Canada, contraception and abortion care are medically necessary services, yet healthcare providers in Canada are allowed to refuse to provide care or referrals based on their personal beliefs. Regulations on the denial of care vary by province. Policies of professional colleges and associations are often vague, leading to confusion. There’s no monitoring or enforcement mechanisms. This qualitative study explored Canadians’ experiences with belief-based care denial of contraception and abortion and the consequences of this refusal in Alberta, New Brunswick, and Ontario. Denial experiences were based on age, marital status, and parity, as well as explicit religious beliefs of the provider or institution. Belief-based care denial is experienced as gatekeeping of necessary health services that extend beyond explicit “conscientious objection”. Policies permitting belief-based care denial can produce health inequities.

Key recommendations: Improve professional guidance and training by emphasizing patient-centered counseling and decision-making. Discourage denial of care, and encourage objectors to choose other fields. Require objectors to make a timely and effective referral. Establish clear and effective avenues for patients to report violations of professional standards related to care denial and its consequences. Enact professional discipline when care deniers obstruct care.

View presentation (PDF) Patients oppose and are harmed by belief-based denial of reproductive care