Nurses’ use of conscientious objection and the implications for conscience

Aims To explore the meaning of conscience for nurses in the context of conscientious objection (CO) in clinical practice. Design Interpretive phenomenology was used to guide this study. Data sources Data were collected from 2016 ‐ 2017 through one‐on‐one interviews from eight nurses in Ontario. Iterative analysis was conducted consistent with interpretive phenomenology and resulted in thematic findings. Review methods Iterative, phased analysis using line‐by‐line and sentence highlighting identified key words and phrases. Cumulative summaries of narratives thematic analysis revealed how nurses made meaning of conscience in the context of making a CO. Results Conscience issues and CO are current, critical issues for nurses. For Canadian nurses this need has been recently heightened by the national legalization of euthanasia, known as Medical Assistance in Dying in Canada. Ethics education, awareness, and respect for nurses’ conscience are needed in Canada and across the profession to support nurses to address their issues of conscience in professional practice. Conclusion Ethical meaning emerges for nurses in their lived experiences of encountering serious ethical issues that they need to professionally address, by way of conscience‐based COs. Impact This is the first study to explore what conscience means to nurses, as shared by nurses themselves and in the context of CO. Nurse participants expressed that support from leadership, regulatory bodies, and policy for nurses’ conscience rights are indicated to address nurses’ conscience issues in practice settings. 目的 探讨临床实践中良知在护士良心反对中的意义。 设计 本研究以解释现象学为指导。 数据来源 数据收集自2016年至2017年间对安大略省8名护士一对一访谈。迭代分析与解释现象学一致开展,并得出专题研究的结果。 综述方法 使用逐行和句子进行迭代式阶段分析,突出显示已识别的关键词和短语。叙事主题分析的累计总结揭示了护士如何在生产良心反对的情况下让良知变得有意义。 结果 良心问题和良心反对是当前护士面临的重要问题。对加拿大护士来说,因为近期安乐死(在加拿大被称为临终医疗援助)在全国合法化,这一需要变得更为强烈。加拿大和全行业都需要对护士良知进行道德教育,并认识和尊重良知,从而支持护士在职业实践中解决其良知问题。 结论 护士在切身经历中遇到严重的伦理问题,需要通过基于良心反对的良知来专业地解决问题时,就产生了伦理意义。 影响 这是第一项探讨良知对于护士意义的研究,与护士自身的分享和良心反对的环境一致。参与访谈的护士表示,领导、监管机构和政策对护士良知权的支持表明实践环境中要解决护士的良知问题。