Preamble

The College of Physicians and Surgeons of Newfoundland and Labrador (the "College"), as well as the public, the medical profession and the government of Newfoundland and Labrador are concerned regarding the quality and accessibility of health care.

The College acknowledges the right of physicians to withdraw services under specific circumstances.

The College reaffirms that discontinuing required services to existing patients without arranging alternative services or providing reasonable notice is unacceptable and may constitute professional misconduct.

The College acknowledges it is obliged to communicate clearly to all parties what it expects from the medical profession in Newfoundland and Labrador during the time of withdrawal of services.

What does the College expect from physicians who wish to withdraw services?

The College expects individual physicians will adhere to their ethical obligations and avoid placing their patients at undue risk.

The College expects and is confident that physicians in Newfoundland and Labrador will act responsibly towards patients during a period of withdrawal of services.

The College expects and is confident that physicians in Newfoundland and Labrador will provide adequate emergency care and will ensure that patients are not abandoned.

The College expects that physicians will put in place a plan that will ensure patient access to emergency and other urgently required medical services in circumstances where groups of physicians decide to withdraw services at the same time. This includes access to physician services to assure renewal of prescriptions for medications which should be continued without any interruption in order to avoid patient harm.

The College expects that physicians choosing to withdraw services will inform patients of their decision and will make provision for patient access to emergency services.

The College expects that physicians will recognize the need for ongoing monitoring of their patients with potentially critical conditions which could deteriorate during a delay in treatment resulting from a withdrawal of services.

The College expects and is confident that physicians will make appropriate arrangements for the treatment of patients under their care who remain hospitalized or who are receiving or completing a course of treatment and who may come to harm if the course of treatment is not continued or completed.

What does the College expect from physician members of the College?

The College expects that physician members of the College will refrain from participating in withdrawing their services in order to avoid a potential conflict of interest.

What can the public expect from the College during a withdrawal of physician services?

The College will monitor the situation in Newfoundland and Labrador communities by communicating with the Newfoundland and Labrador Medical Association, physicians, and with regional health board medical directors and administrators in order to address concerns regarding patient access to medical care and to resolve difficulties where possible.

Should the College receive complaints arising from the withdrawal of services, the College will investigate these complaints utilizing the established investigative process of the College.

The College acknowledges the assistance of the College of Physicians and Surgeons of Saskatchewan and the College of Physicians and Surgeons of British Columbia in the preparation of this document.

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