Category: Nursing

The Nurse’s Appeal to Conscience

Ellen W Bemal, Patricia S Hoover

The Hastings Center Report
The Hastings Center Report

Abstract
A case is presented in which a registered nurse caring for a 63-year-old patient in severe pain from terminal cancer disagrees with the attending physician’s order of morphine for fear that it will hasten the patient’s death. The nurse finds herself on duty alone one night when the patient and her daughter request more morphine. Bernal and Hoover contend that, because the nurse apparently took no prior action to explore alternative courses of pain relief for the patient or to make other arrangements for care, her duty of care overrides her appeal to conscience in the immediate situation. Aroskar believes that the nurse in this situation must give the injection, find someone else who can, or contact the physician. She holds, however, that nurses should be allowed to refuse to carry out particular procedures based on an appeal to personal conscience if the decision is founded on accurate information, acceptance of consequences, and advance planning.

Bemal EW, Hoover PS. The Nurse’s Appeal to Conscience. Hastings Cent Rep. 1987;25-26. Available from:

(Editorial) A Nurse’s Conscience

Leah L Curtin

Nursing Management
Nursing Management

(This lengthy editorial was repeated verbatim in 1993. It includes the following)
Extract
“No nurse should be required to give any drug if (a) she is not competent to give it or (b) she has problems of conscience with regard to its administration. If, for these reasons, a nurse refuses to give a drug, another nurse may do so. The original nurse should receive inservice and/or counseling. If she still has conscientious objections, she should not be coerced. The patient’s right to have/refuse a drug should be protected by meticulous adherence to the principles and procedures of informed consent. However, his right to the drug is not greater than another human being’s (the nurse’s) obligation to practice with integrity. Therefore, if one nurse will not give the drug – the head nurse, coordinator or supervisor should give the drug.” If none of these nurses can, in conscience, administer the drug, then the physician who ordered it must give It himself or find another physician who will do it for him..

Curtin LL. (Editorial) A Nurse’s Conscience. Nurs Manag. 1983 Feb;14(2):7-8

(Editorial) Issues of Conscience

Thelma M Schorr

American Journal of Nursing
American Journal of Nursing

Extract
The reality of the situation is that since 1966, with the liberalization of abortion laws in a number of states, the number of abortion patients has been steadily increasing. This means that an increasing number of patients will seek care that most nurses have not been educated to render. . . . There are many nurses who see an abortion as an unconscionable act, and certainly they should never be placed in the position of having to nurse patients who have chosen to have their pregnancy terminated. Just as a patient’s freedom to choose must be respected, so must a nurse’s. But it is also that nurse’s responsibility to protect both the patient’s freedom and her own by refusing to work in a situation which she finds morally offensive.

Schorr TM. (Editorial) Issues of Conscience. Am J Nurs. 1972 Jan;72(1):61.