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Analysing Whether Canadian Health-care Workers Should Refuse to Work with Certain Patients on the Basis Of “Conscience Rights”


Fiala and Arthur ascertain that most of the most of the practitioners in Canada and other developed countries that refuse to offer healthcare services to some patients in some conditions tend to cite the conscience rights as the source of their defence (1). This issue proliferates into conscientious objection (CO) which is mainly practised in the field of reproductive healthcare in medicine particularly when handling issues of contraception use and abortion.

Current laws in different States in Canada regarding conscientious objection in reproductive health indicate that this area is frequently neglected and considered generally unworkable (Cameroon and Carpay 4). This continuous neglect has a tremendous impact on women’s rights and healthcare in overall. It is therefore imperative discuss whether Canadian healthcare workers such as nurses need to be allowed to refuse working with some patients depending on their conscience rights. ”

Critical Analysis

Fiala argues that the practice of modern medicine is continuously experiencing tremendous changes in Canada (6). Different institutions and individual professionals hold diverging views regarding what makes up acceptable and professional behavior. One of the most challenging responsibilities facing Canadian healthcare workers such as nurses is how to respond to the ethical and moral diversity within its membership. Conscience-based issues are becoming increasingly difficult for healthcare practitioners such as nurses and physicians try to intermingle with the increment of the rapidly emerging technologies (Fiala & Arthur 5; Cameroon & Carpay, 7).

Linane adds that these technological advancements are coupled with the changing prospects that are diversified to entail more than simple treatment of diseases and suffering alleviation (10). Modern physicians are tasked with the need to balance various priorities such as promotion of wellness, operating within the continuously evolving standards, and ensuring efficient and effective use of medical resources. Additional requirements include making viable decisions regarding individual’s quality of life, taking part in advocacy coupled with changing adverse patient behaviours (Fiala & Arthur, 12).

Cameroon and Carpay add that it should be understood that most of the developed countries allow their healthcare professional a substantial amount of conscientious objection through established codes of ethics or medical policies (11). These initiatives are often referred to as conscience clauses, refusal clauses or conscience rights. For instance, Canadian healthcare professionals have the option to opt out of administering   non-emergency care (Linane, 12). However, this right is deemed applicable only when the medical facility refers the patients to different people who can offer the appropriate help.

Linane ascertains that there are numerous conditions whereby the health worker is compelled to offer help despite the challenging nature of the situation and the protection one gains from conscience rights (13).  Such conditions can be considered dilemmas and include a physician being pressurized by the government to carry out a punitive amputation, being compelled to perform Cardiopulmonary Resuscitation (CPR) and being compelled to accomplish the paper work to so as to allow parents and family members to go and attend a cultural festival.

According to Fiala and Arthur, the physician may also be asked to determine the gender of the foetus at 12 weeks to ascertain whether it is a male, if not, the pregnancy is terminated as other patients request the doctor to assist them to conduct suicide (16). Additional scenarios include being questioned on the appropriateness of an abortion on detection of a foetus suffering from cystic fibrosis and requesting for tubal ligation among young adults. These conditions are challenging and require the physician to strongly rely his conscience rights when making his or her final decision (Cameroon & Carpay, 15).

Linane avers that the medical professional should always be given a chance to assess a patient recommended procedure before taking a decision to implement the decision (17). The government of Canada in collaboration with the country’s healthcare sector should allow their workers to reject working conditions such as that occurring when a physician is compelled to increase the efficiency of a healthcare facility at the cost of patient care due to peer pressure (Cameroon and Carpay, 16). For instance, such situations can reduce the physician’s capability of offering quality and optimum care for the senior patients suffering from severe conditions such as dementia.

According to Fiala and Arthur, this condition may be aggravated by unequivocal institutional economic constraints (18). Another scenario whereby the government should give healthcare professionals the mandate to decline offering treatment services where the parents of a given young lady order for a virginity certificate. In this case, the physician should not only base his refutation claims on his or her consent rights but on individual moral and ethical beliefs. As such, the Canadian laws should provide the clinician the authority to refuse examining the hymen of the young woman regardless of the clear consent from the young lady herself (Linane, 16).

Another condition whereby the government and the Canadian Law in general needs to increase the rights of the healthcare professionals in refusing to provide care is when the physician is compelled to distort the truth of a given medical diagnosis by the patient (Fiala & Arthur, 21). Despite the need to uphold ethical standards, the medical code of practice and respecting the patient’s informed consent, the physicians should at all times stand to provide, quality reliable and truthful information. However, it is recommendable to institute a guiding and counselling session with the patient and his or her next of kin as a strategy towards ensuring that his or her needs are well catered for (Linane, 20).

For instance, a patient suffering from a chronic disease such as cancer, diabetes and the communicable diseases such as Tuber culosis should always be handled with care (Cameroon and Carpay, 17). Additionally, the guardians and parents of such patients need to be educated on how to take good care of such individuals.  This assertion summarizes the fact that the healthcare professional’s decision to refuse to work with certain patients on the basis of his or her “Conscience Rights” depends on the type of the ethical dilemma being faced (Fiala and Arthur, 21)


Developed countries such as Canada are rapidly encountering tremendous transformations in terms of treatments available for different health conditions. Historically, some of these conditions require critical care and treatment which are predominantly known to create an ethical and moral dilemma for the professionals operating in the healthcare field. As a result, most of the healthcare professional such as doctors and nurses are nationally challenged with the decision to either refute delivery of service or not.

The most challenging issue in this case is the fact that refusing to work with patients in such challenging situations can not only compromise the health professional’s job but conscience. The most essential step to be taken, therefore, lies in the critical assessment of the situation at hand before deciding whether to refuse providing the treatment or to go ahead and administer the service.

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