Calls for doctors to tell patients in advance if they object to providing abortions or IVF have been narrowly rejected.
Best practice guidance from the General Medical Council (GMC) says doctors should be open about treatments they will not provide.
But doctors at the British Medical Association's annual conference in Edinburgh voted by 50.6% to 49.4% against calls for them to "make every effort to inform patients in advance, for example through practice leaflets" which doctors will advise on issues like abortion and IVF.
Current guidance from the GMC says it expects doctors to be honest with patients in person and in leaflets, although it cannot compel them.
Dr Evan Harris, Liberal Democrat science spokesman, proposed a motion on the issue at the conference.
He said the right of doctors to conscientiously object to treating a patient was recognised in statute as relating to abortion, IVF and withholding life-supporting medical treatment from patients lacking capacity to make their own decisions. But this must not be allowed "to go off into other areas", he said.
There have been reports that some doctors do not want to offer emergency contraception or treat patients with alcohol disorders. Some do want to train in areas like abortion and sexually-transmitted infections, he said. A "pick and mix" NHS should not be allowed.
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