A better approach to ethical objection by doctors

I've blogged before about the mystery of doctors who choose to practise in a certain field of medicine even though they morally object to an integral part of that field of medicine.  Surely they should have seen it coming that they'd be called upon to do the thing to which they morally object (in the case that inspired that blog post, prescribing contraception when working in a walk-in clinic) and surely they should have chosen a different field of medicine if they objected to this.

But with the eventual legalization of physician-assisted dying (as they seem to be calling it now) in the news, I see a situation where the doctors literally didn't sign up for this.  It's quite possible for someone to have become a doctor without having seen it coming that they could be called upon to deliberately end a life. 

So in the shower, I thought of a simple guideline that balances physicians' ethics, patients' rights, the "they should have seen it coming" factor, and the "they couldn't have seen it coming factor."

Doctors should be required to provide all procedures and services that were usual and customary in their field and their jurisdiction at the time when they begin practising.  However, doctors can be permitted to opt out of only those procedures or services introduced after they began practising. The time when they "began practising" can be defined as either the time when they began their medical training as a whole, when they began their training in that specialization, when they graduated, when they began (or completed) their internship or residency - whatever the medical profession considers the optimal point in time.

So if you became a general practitioner in 1951, you can opt out of prescribing birth control pills on moral grounds. If you became a general practitioner in 2015, you had fair warning that you'd be called upon to prescribe birth control pills, so if you'd find that prospect morally objectionable, you had plenty of time to plan your career in a different direction.

If you became a doctor in 2007, you can opt out of physician-assisted dying on moral grounds.  If you become a doctor in 2020, you'll have fair warning that you might be called upon to help people die in whatever specialties end up providing that service, so if you don't want to provide that service you can specialize in podiatry or obstetrics or something.

If a doctor changes specialization or changes jurisdictions, they're required to provide all the usual and customary procedures and services at the time of their transfer. The reasoning here is they have an opportunity to research what they're getting into and plan accordingly.

This will also make it easier for patients not to get stuck with doctors who won't provide the service they need.  Patients can simply look up the doctor in CPSO or their jurisdiction's equivalent, and see when they began practising.

This way, the proportion of doctors providing a potentially-controversial service or treatment will always increase and never decrease. The acceptance of services among doctors (and therefore their availability) should mirror the acceptance of services among society (and therefore demand).  After a transitional period, patients won't ever find themselves stuck with a doctor who is morally opposed to a usual and customary service or treatment in their field. But, at the same time, no doctor is required to provide any service or treatment that they didn't know they were getting into.