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:

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