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Analyzing Whether Canadian Healthcare Workers Should Refuse to Work with Certain Patients by “Conscience Rights”


Fiala and Arthur ascertain that most of the health care practitioners such as nurses in Canada 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 practiced in the field of reproductive health care in medicine particularly when handling issues of contraception use and abortion.

Current laws in different States in Canada regarding conscientious objection in sexual health indicate that this area is frequently neglected and considered unworkable (Cameroon and Carpay 4). This continuous neglect has a tremendous impact on women’s rights and healthcare in overall. It is, therefore, imperative to discuss whether Canadian healthcare workers such as nurses need to be allowed to refuse to work with some patients owing to 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 vocational 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 nurses as they 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 nurses are tasked with the need to balance various priorities such as the 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 behaviors (Fiala & Arthur, 12).

Cameroon and Carpay add that Canada allows its nurses 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 nurses 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 nurses are compelled to provide support 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 nurse being pressurized by the government to carry out a punitive amputation, being compelled to perform Cardiopulmonary Resuscitation (CPR) and being compelled to accomplish the paperwork to so as to allow parents and family members to go and attend a cultural festival.

According to Fiala and Arthur, the nurse may also be asked to determine the gender of the fetus at 12 weeks to ascertain whether it is a male if not, the pregnancy is terminated as other patients request the nurse to assist them to conduct suicide (16). Additional scenarios include being questioned on the appropriateness of abortion on detection of a fetus suffering from cystic fibrosis and requesting for tubal ligation among young adults. These conditions are challenging and require the nurse to strongly rely on 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 depending on the 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 nurse is compelled to increase the efficiency of a health facility at the cost of patient care due to peer pressure (Cameroon and Carpay, 16). For instance, such situations can reduce the nurse’s capability of offering quality and excellent 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 nurse should not only base his refutation claims on his or her consent rights but individual moral and ethical beliefs. As such, the Canadian laws should provide the clinician the authority to refuse to examine the hymen of the young woman regardless of the apparent consent from the girl 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 nurse 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 nurses should have at all times stand to provide, quality reliable and truthful information. However, it is recommendable to institute a guiding and counseling 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 Tuberculosis 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 individual patients by 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 significant transformations regarding 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 health professional such as nurses are nationally challenged with the decision to either refuse delivery of service or not.

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

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