Conscientious Objection in Nursing

This assignment examines the complex issue of conscientious objection in nursing. It argues that conscientious objection, when practiced according to established ethical guidelines, is beneficial for patients by upholding moral standards and avoiding practices deemed ethically unacceptable. The paper delves into relevant codes of conduct, such as those set by the NMBA, and acknowledges the potential difficulties in distinguishing true conscientious objection from other motivations.

Running head: TRANSITION TO PROFESSIONAL NURSING 1
Transition to Professional Nursing
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Introduction
Conscientious objection has always been a debatable topic in the nursing profession
across the world. According to (Odell, Abhyankar, Malcom, & Rua, 2014), the conscientious
objection can be defined as the decline of a health provider to administer services to a patient,
simply because, the process would go against their ethical and moral standards. In the nursing
profession, it is often used by nurses to refuse to undertake some duties, procedures or practices
based on their conscience.
However, this practice has to be practiced within the guidelines and regulations set by
the healthcare governing bodies. In Australia, the registered nurses (RNs) work under the
guidance of the registered nurse (RN) practice. It is a professional undertaking that needs critical
thinking, comprehensive analysis and maintenance of constructive relationships. According to
(Australian Nursing& Midwifery Federation, 2015), conscientious objection is one of the rights
granted to the RNs in Australia. However, RNs are regulated healthcare technicians and exercise
their responsibility and accountability to the Nursing and Midwifery Board of Australia
(NMBA). Conscientious objection involves moments of critical decision-making, moral
integrity, and strict adherence to the professional code of conduct for the RNs. But they have to
undertake it within the stipulated national and core competency standards set by NMBA by
which their performance is assessed.
In the medical field, RNs are often faced with a wide range of morally controversial
health dilemmas. However, the nurses' right to refusal of what they deem "unacceptable" may
have limits. With the rights accorded to defend their moral, religious and ethical integrity, there

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is a level of refusal that cannot be allowed for a nursing professional in line with h/her duty
(Megan-Jane Johnstone, 2010), and these includes fear, personal preferences and prejudices.
Circumstances that May Lead to Nurses’ Refusal of Patient Care
Among many national professional competency standards set for the RNs by (Nursing
and Midwifery Board of Australia) Compliance with the common law and legislation is required
and this means that RNs must be aware among many other rules that their actions must
demonstrate legal implications of the nursing practice and legal implications of nursing
interventions. Additionally, in their fulfillment of the duty of care, RNs must recognize the
responsibility to prevent harm. Another crucial professional competency requires RNs to
recognize and respond to unsafe and unprofessional practice, which involves interventions that
prevent compromising of care and identifying behaviour that may deter optimal care. All these
outlined professional competency practices can provide valid basis for conscientious objection.
Generally, RNs are guided by morality and ethics. Understanding what is right or wrong is key to
correct decision-making. According to (Magelssen, 2012), having a strong conviction to morality
and religious beliefs that guide you into doing what is right and avoiding the wrongs, is a
beautiful and desirable character trait. Therefore, according to (Lachman, 2014) some of the
circumstances that may lead to nurse’s refusal of duty involve the following:
A Terrible Violation of Strongly Held Convictions
Some circumstances in medical field require tough measures to perform and this is what
the RNs are faced with frequently in their line of duties. When a RN has a strong belief that
taking part in some practices such as assisted suicide for a terminally ill patient is wrong, he/she

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will not take part in it. The RN will have to find alternatives including avoiding giving a killer
dosage to the patient and instead referring the patient for a palliative care.
Ending a patient’s life is a critical decision that very few would easily accept to
participate in. It is morally believed that every person has a right to live, and the nurse’s primary
objective is to save lives, hence, any practice that may involve ending the life of a patient rather
than saving it is a tough practice that many deem socially, ethically and morally unacceptable.
Plausible Rationale
These are circumstances embedded in ethical and religious beliefs of the nurse.
Sometimes it involves the secular morals that aid in reasoning and common sense that activities
such as ending a patient's life are not acceptable. However (Edwards, 2010), reiterates that even
though secular morality should be considered and practiced on the same level as any other
morality, it can be unpredictably wrong or disastrous. But as much as this may be a valid reason
to question the types of morality used to refuse participation, (Margaret A Burkhardt; Alvita K
Nathaniel, 2014) reaffirms that the source of moral values do not matter, but what matters is,
they are crucial to the identity of an individual. Integrity and morality are therefore good reasons
that may lead a nurse into declining to participate in certain duties.
Less Significant Treatments to Your Work
In certain circumstances, some hospices accept palliative sedation as a measure to relieve
the suffering of terminally ill patients. Therefore, as a nurse, it will not make much sense for you
to take up employment in such hospice because, palliative sedation is a controversial practice
that has always raised questions, and while some agree with it, others completely despise it. It is,

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therefore, reasonable for a nurse not take-up a patient care role in a hospice with palliative care
unit whereby such crude interventions are clearly inevitable.
The Relationship between Conscientious Objection and Nurses’ Ethics
Decisions made by the RNs not participate in patient care in most instances are derived
from the ethical point of view, as enshrined in NMBA’s professional and ethical principles. RNs
have the moral obligation to maintain very high levels of ethical practices. According to the
(Australian Nursing& Midwifery Federation, 2015), all the nurses regardless of their titles, have
a right to decline to participate in activities they strongly hold on religious, moral and ethical
grounds. But the federation further adds that, in the process of conscientious objection, the
nurses should ensure that they don’t compromise quality patient care and safety.
According to (Nursing World, 2010), the primary ethical responsibility nursing
professionals have is the respect for human dignity. This is the fundamental principle that guides
all the procedures and practices of the nursing profession. Conscientious objection arises as for
when a nurse is faced with a situation whereby he/she has to break the ethical standards, which is
always their conscience. It is understandable that practices such as aiding patient suicide go
against the respect for human dignity. Therefore, in this scenario, it is clearly shown that
instances of conscientious objection are a clear defense of ethical standards.
According to NMBA’s competency standards within ethical nursing framework, RNs
must accept patients regardless of their ethnic background, culture, gender, religion, age physical
or mental state and accept the rights of others, which include the right to life. Furthermore, the
RNs must always seek interventions on matters that involve moral conflict. The RN practice

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must understand the proximity of their patients' health problems, respect their rights and dignity
despite their problems and most importantly, that the dignity and worth of a patient are not taken
away by the nature of the health problem.
The Significance of Conscientious Objection
The toughest test RNs encounters is the dilemma of either performing the required tasks
or declining and maintaining moral integrity. However, in most instances when nurses are faced
with such situations, maintaining ethical integrity should not be an option. Conscientious
objection is beneficial to patients. It arises from situations which compromise the eligibility of
ethics, and RNs are allowed to practice it, as stipulated in NMBA’s competency standards 2.1,
“practices in accordance with the nursing profession’s code of ethics and conduct.” This is to
avoid tempering with integrity, which may lead to moral distress (American Nurses Association.,
2010).
Since the conscientious objection is based on individual’s commitment to stand for the
acceptable moral standards (Wicclair, 2011), then those morals can easily be presumably of good
faith. Avoiding practices such as ending patient's lives and cases such as abortion are in the best
interest of the patient because at the end of the day, only life—the value of nursing—is saved.
The conscientious objection serves the purpose of avoiding what is social, morally, religiously
and ethically wrong in the nursing profession.
Conclusively, conscientious objection is enshrined in integrity and what is morally
acceptable as set in NMBA’s professional and ethical standards. It should be practiced in the best
interest of the patients. Although in some instances, differentiating conscientious objection from
factors such as cowardice, personal opinion or dislike by the nurses is difficult (Jackie Crisp;

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Catherine Taylor; Clint Douglas; Geraldine Rebeiro, 2012); it still doesn't erode the valid reason
behind the practice. It is fueled by the refusal of the RNs not to perform some patient care
aspects, (Alexandra Robbins, 2016), but at it is a requirement through the ethical principles of
nursing that at no point should a nurse abandon the rights of a patient.

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Bibliography
Alexandra Robbins. (2016). The nurses : a year of secrets, drama, and miracles with the heroes
of the hospital. New York, NY: Workman Publishing Company, Inc.,.
American Nurses Association. (2010). Nursing's social policy statement : the essence of the
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Jackie Crisp; Catherine Taylor; Clint Douglas; Geraldine Rebeiro. (2012). Potter & Perry's
Fundamentals of Nursing - AUS Version. London : Elsevier Health Sciences APAC.
Lachman, L. D. (2014). Conscientious Objection in Nursing: Definition and Criteria for
Acceptance. Ethics, Law and Policy, 196-198.
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Nursing and Midwifery Board of Australia. (n.d.). National competency standards for the
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