He’s not sure how he feels and realizes he needs to sort it out. Does he have a conscientious objection to medical assistance in dying? What
is a conscientious objection? He wonders where to start.
Natalie, a close friend and mentor, helps Jamie sort out his thoughts. She explains conscientious objection as feeling that an action, practice or policy is contrary to the kind of person you want to be and the kind of society and community you want to foster.
“Conscientious objection is driven by moral concerns that are based on your world view—your basic beliefs and values,” she explains. “These may be personal, ethical or religious.”
She explains that conscientious objection is not based on fear, prejudice, bias, convenience or distaste but rather on a conflict with one’s basic beliefs and values. Natalie encourages Jamie to reflect on medical assistance in dying and determine whether it is compatible with his beliefs and values.
He reflects on the following questions:
After much thought, Jamie determines that medical assistance in dying goes against his basic values and beliefs. He wonders how he can conscientiously object in a way that respects his values and beliefs—while still meeting his professional and legal obligation to provide clients with safe, competent and ethical care.
Jamie wants to avoid participating in an action that goes against his basic beliefs and values. He wonders however, what is appropriate to avoid and what is unavoidable.
He knows he can take steps to avoid immediate and direct involvement in medical assistance in dying, such as starting the IV or providing information about medical assistance in dying to the client. But avoiding all indirect involvement—such as working on the ward where clients may request and receive a medically assisted death—may be not be possible without serious consequences such as leaving his job.
Jamie understands his objection is to the action and not the person(s) requesting or performing the action. He decides to make sure there is a plan outlining how he will avoid being in a situation with direct involvement, and how, if necessary, he will hand over care for the activities for which he will not perform. This will ensure continuity of care for the client. In this way, he will demonstrate respect for the person or persons, care for them, and transfer care to others when needed—but will not participate in or support the action.
Nothing in the
Criminal Code compels nurses to aid in the provision of medical assistance in dying. However, nurses with a conscientious objection must take all reasonable steps to ensure that the quality and continuity of care for clients are not compromised.
Jamie needs to make his manager aware, in writing, of his conscientious objection. He should also have a plan in place, well before a client would require care. Should an unexpected situation arise, Jamie will involve his supervisor and other team members as appropriate to safely hand over the care of the client.
You’ll find more information and guidance in the
Duty to Provide Care practice standard, and
Medical Assistance in Dying resource centre and