Background: The concept of conscientious objection is well described; however, because of its nature, little is known about real experiences of nursing professionals who apply objections in their practice. Extended roles in nursing indicate that clinical and value-based dilemmas are becoming increasingly common. In addition, the migration trends of the nursing workforce have increased the need for the mutual understanding of culturally based assumptions on aspects of health care delivery. Aim: To present (a) the arguments for and against conscientious objection (...) in nursing practice, (b) a description of current regulations and practice regarding conscientious objection in nursing in Poland and the United Kingdom, and (c) to offer a balanced view regarding the application of conscientious objection in clinical nursing practice. Design: Discussion paper. Ethical considerations: Ethical guidelines has been followed at each stage of this study. Findings: Strong arguments exist both for and against conscientious objection in nursing which are underpinned by empirical research from across Europe. Arguments against conscientious objection relate less to it as a concept, but rather in regard to organisational aspects of its application and different mechanisms which could be introduced in order to reach the balance between professional and patient’s rights. Discussion and conclusion: Debate regarding conscientious objection is vivid, and there is consensus that the right to objection among nurses is an important, acknowledged part of nursing practice. Regulation in the United Kingdom is limited to reproductive health, while in Poland, there are no specific procedures to which nurses can apply an objection. The same obligations of those who express conscientious objection apply in both countries, including the requirement to share information with a line manager, the patient, documentation of the objection and necessity to indicate the possibility of receiving care from other nurses. Using Poland and the United Kingdom as case study countries, this article offers a balanced view regarding the application of conscientious objection in clinical nursing practice. (shrink)

Much has been written about the rights of health-care professionals to conscientiously object. Ironically, there has been no formal discussion as to whether clinical ethicists have the same right. Given that ethicists routinely deal with the same situations and questions that other health-care professionals find morally discomforting, the question as to whether they have the same right is a critical one. We conclude that ethicists should not have the same right to conscientious objection. The role of an ethicist is to (...) competently manage those situations and cases that cause moral discomfort and confusion. By conscientiously objecting, an ethicist would be failing to fulfil their primary function. The same cannot be said as forcefully about other professionals who object. Moreover, ethicists retain the right to conscientious objection to the joining of the discipline in the first place, and also retain the right to exit if they so choose. (shrink)

Some contributions to the current literature on conscience objection in healthcare posit the notion that the requirement to refer patients to a non-objecting provider is a morally questionable undertaking in need of explanation. The issue is that providing a referral renders those who conscientiously object to being involved in a particular intervention complicit in its provision. This essay seeks to engage with such claims and argues that referrals can be construed in terms of what Harman calls morally permissible moral mistakes. (...) I go on to suggest that one might frame the (in)actions of those who exercise the right of non-participation generated by the claim to conscientiously object in similar terms; they can also be considered morally permissible moral mistakes. Finally, and given that the arguments already advanced involve simultaneously looking at the same issue from competing ethical perspectives, I offer some brief remarks that support viewing conscientious objection as an ethicopolitical device. (shrink)

In an article published recently in this journal Daniel Hill argues that it is unacceptable that British law allows doctors to refuse to terminate non-emergency pregnancies but not to refuse to refer given that many doctors who are opposed to non-emergency abortion will be opposed also to any action that aids non-emergency abortion, including the action of referral. In this reply, I argue that Hill’s argument fails to describe properly the correct function of the law, which has never been about (...) ensuring people can exercise moral consistency in their behaviours. (shrink)