​​​It's understandable to feel uncertain when personal beliefs and values and professional responsibilities overlap. This page helps you recognize a conscientious objection (CO), understand your responsibilities, and plan ahead so client care remains safe and respectful.

​​Conscientious objection: What does it mean?

A conscientious objection is when a health-care professional refuses to provide a legal, client-requested medical service or treatment, based on their personal or religious beliefs or values, that falls within the scope and qualifications for their profession.

Important: A conscientious objection is different from refusing care based on a client's personal characteristics protected under human rights law (e.g., race, Indigenous identity, religion, sex, sexual orientation, gender identity or expression, disability, age). Refusing to provide care or services because of who the client is, is discrimination and not a conscientious objection.

Remember: A conscientious objection is always related to the action, not to the person. Respect, compassion, and safe care must continue.

​Case study: Jamie

Jamie's new job is in a practice setting where medical assistance in dying (MAiD) is provided. He reflects on whether MAiD aligns with his values and beliefs and feels uncertain about whether he wants to participate.

Natalie, a close friend and mentor, helps Jamie sort out his thoughts.

“Conscientious objection isn't about fear or dislike—it's about whether this action fits with your beliefs and values," Natalie explains.

Jamie asks himself:

• Does aiding in the provision of MAiD (directly or indirectly) align with my values, beliefs?
• What's driving my reaction right now—a values-based conviction, or fear, uncertainty, discomfort, bias, or moral distress? 

Jamie's decision

After reflection, Jamie decides MAiD conflicts with his personal values. He:

• Notifies his manager in writing.
• Creates a plan to avoid direct participation (e.g., starting an IV solely for MAiD).
• Arranges timely handover to a colleague to ensure client care continues safely.
• Provides respectful, routine nursing care not directly part of MAiD for the client receiving MAiD.

This way, Jamie stays true to his values while also meeting his professional duty to provide safe, respectful care.

​​​Your responsibilities if you have a conscientious objection

Nothing in the Criminal Code of Canada states that nurses must aid in the provision of MAiD. The Criminal Code generally sets out what actions are prohibited (and the conditions under which MAiD is not a criminal offence), rather than compelling health-care professionals to participate. Nurses with a conscientious objection must still take all reasonable steps to ensure the quality and continuity of care for clients are not compromised.

Prepar​​e ahead

• Tell your manager in writing as early as possible.
• Follow employer policies and BCCNM standards (e.g., Duty to Provide Care practice standard).
• Have a plan for handover if you cannot perform certain activities.

In th​e moment

• Do not abandon clients; see the Duty to Provide Care practice standard.
• Arrange safe transfer of care for MAiD-related activities.
• Document communication and handover steps clearly.
• Seek support (manager, ethics consult, cultural safety resources, EAP) if you have a CO. 

​​Quiz

A client on Ja​mie's unit has requested MAiD. Jamie has a conscientious objection. Which option best reflects his duty?

A. Provide care, but arrange handover for MAiD-related activities.

Correct. Jamie can still provide compassionate, routine care but must hand over any MAiD-specific tasks.

B. Refuse all involvement with the client.

Incorrect. Jamie still has a professional obligation to provide safe, respectful, and general nursing care.

C. Tell the client he does not agree with their choice.

Incorrect. Personal values must not be imposed on the client. Care must remain respectful and non-judgmental.

D. Avoid the unit whenever MAiD is being provided.

Incorrect. Indirect involvement may be unavoidable. Jamie's duty is to avoid direct participation, not to abandon the client or unit.

Jamie worries about indirect​ involvement, such as being on the unit when a client receives MAiD. What should he do?

A. Leave his job immediately.

Incorrect. Leaving a position is not required; planning for safe handover of direct tasks is the professional expectation.

B. Accept that some indirect involvement may be unavoidable.

Correct. Indirect involvement (such as working on the unit) may be unavoidable. The focus is on planning to avoid direct participation.

C. Refuse to work any shifts on the unit.

Incorrect. Nurses are still expected to fulfill their role in providing safe and respectful care, even in units where MAiD may occur.

D. Insist that no MAiD ever take place during his shift.

Incorrect. It is not appropriate or realistic to restrict client access to legally available care based on personal beliefs.

Which statement best describes your responsibili​​ties if you have a conscientious objection?

A. Quietly refuse without telling anyone.

Incorrect. Silent refusal can put clients at risk and is not acceptable.

B. Expect colleagues to cover for you without making formal arrangements.

Incorrect. It is your responsibility to plan ahead, notify your manager, and ensure safe transfer of care—not leave it to chance or assume others will step in.

C. Tell your manager in writing, arrange a safe handover, and document what you did.

Correct. Nurses must plan ahead, notify their manager, arrange safe transfer of care, and document clearly to ensure continuity and client safety.

D. Wait until a client situation arises before deciding what to do.

Incorrect. Waiting until the last moment risks disrupting client care. You should declare your conscientious objection in advance and have a plan in place.

 ​​Reflection questions

• Have you ever experienced a conflict between client care and your personal values?
• How do you decide if an action or practice fits with your personal beliefs and values?
• What support would help you maintain integrity and ensure client safety?
• If I needed to declare a conscientious objection tomorrow, what steps would I take and who would I talk to? 
  

​​​Need help or support?​

For further guidance on understanding and applying the standards of practice, contact our team by completing the Standards Support intake form.​