Effective referral can mean a lot of things, depending on where you are.  The doctor refusing to provide the medical service should be responsible for paying the patient's cost to get to a doctor who will.  In the city that might be a bus ticket. In a small Northern Ontario town, that might be transportation to another town many kilometres away and possibly overnight accommodation in that town. 

We are talking here about medical procedures that are legal under the laws of Canada.  We are talking here about doctors deciding that their personal standard of what medical procedures ought to be provided should take precedence over the standard of what is legal.  If they wish to do that, it is they who should pay any resulting costs, not their patients.   I have to bear the cost resulting from my moral decisions.  It is morally wrong for me to require other people to bear the cost of my moral decisions..

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