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Nurses' Experiences and Perspectives of Conscientious Objection in Practice: A Qualitative Systematic Review
Abdulrahman Alghathayan1,2, Zaneta Smith1, Morgan Smith1
1Adelaide Nursing School, Faculty of Health and Medical Sciences, the University of Adelaide, Adelaide, South Australia, Australia.
Aim:
To examine nursing experiences and perspectives regarding conscientious objection in healthcare practice.
Design:
Qualitative Systematic Review.
Methods:
The studies were identified, screened and appraised using the Joanna Briggs Institute (JBI) model and appraisal tools to assess the quality of the data and ensure rigorous evaluation.
Data Source:
Five databases, including PubMed, CINAHL, Emcare, Scopus and PsycINFO, were searched from September 2024 to December 2024 to identify existing qualitative studies on nurses' experiences and perspectives on conscientious objection.
Results:
15 studies from 1998 to 2024 were included in this review from 11 different countries. The synthesised findings identified five themes related to nurses' experiences and perspectives of conscientious objection: (1) Conflict with Moral, Ethics, Religious and Personal Beliefs and Values; (2) Conflicts with Policy and Law; (3) Work Expectations, Team Decisions and Dynamics; (4) Conflict over Care Dilemmas; (5) Forms of Conscientious Objection.
Conclusion:
Nurses from various clinical settings reported various perspectives on conscientious objection, identifying different clinical care experiences, personal ethical and religious conflicts, and ways in which they managed forms of conscientious objection in practice. The various conflicts may impact nurses by promoting burnout, stress and emotional exhaustion.
Implications For The Profession:
Understanding nurses' perspectives on conscientious objection allows clinical managers, stakeholders and policymakers to give nurses an opportunity to object conscientiously based on ethical and religious beliefs and create clear guidelines for ethical decision-making. Such guidelines allow nurses to conscientiously object while still maintaining professional standards and minimising adverse effects on the care provided to patients. Allowing conscientious objection has important implications for nursing practice, particularly in balancing professional responsibilities with personal and religious convictions.
Reporting Method:
This qualitative systematic review was reported in accordance with the PRISMA 2020 guidelines.
Trial Registration:
PROSPERO number: CRD42024599651.
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