An ethical issue: nurses’ conscientious objection regarding induced abortion in South Korea

Abstract

Background The Constitutional Court of South Korea declared that an abortion ban was unconstitutional on April 11, 2019. The National Health Care System will provide abortion care across the country as a formal medical service. Conscientious objection is an issue raised during the construction of legal reforms. Methods One hundred sixty-seven perioperative nurses responded to the survey questionnaire. Nurses’ perception about conscientious objection, support of legislation regarding conscientious objection, and intention to object were measured. Logistic regression was used to explore the factors associated with support of the legislation and the intention to conscientiously object. Results Only 28.8% of the responding nurses were aware of health care professionals’ conscientious objection. The majority (68.7%) felt that patients’ rights should be prioritized over health care professionals’ conscientious objection. On the other hand, 45.8% supported the legislation on conscientious objection to abortion, and 42.5% indicated a willingness to refuse to participate in an abortion case if conscientious objection was permitted. Religion, awareness of conscientious objection, and prioritizing of nurses’ right to conscientious objection were significantly associated with supporting the legislation. Moreover, religion and prioritizing nurses' rights were significantly associated with the intention to conscientiously object. Conclusions This study provides information necessary for further discussion of nurses’ conscientious objection. Nursing leaders, researchers, and educators should appeal to nurses and involve them in making policies that balance a women's right to non-discrimination and to receiving appropriate care with nurses' rights to maintain their moral integrity without compromising their professional obligation.

Clarifying the concept of conscience in nurses’ ethical performance in Iran: a concept analysis study

“…In the context of evaluating nursing performance, conscience is a base of ethical actions and decisions as well as ethical nursing care ( 22 , 23 ). In the nursing field, conscience provides a warning signal, higher sensitivity in actions, and an ethical guide in fulfilling patients’ needs ( 18 , 24 , 25 ). Disregarding conscience can lead to troubled conscience and stress of conscience in nurses’ professional life ( 8 , 26 , 27 ).…”

Nurses' attitudes toward, perceptions of, and experiences with conscientious objection

“…29,30,47 The right to act in line with one's religious and moral values should be limited when it comes to healthcare professionals protecting patient rights. 48 Ko et al 12 reported that most nurses were of the opinion that patients' rights took precedence over healthcare professionals' right to CO. They also found that half of the nurses believed that CO should be legal and that they would not participate in abortion procedures if it was legal.…”

“…Supporters of CO also maintain that freedom is a fundamental prerequisite for providing good healthcare provided that CO is limited. 12,13 Opponents assert that healthcare professionals are supposed to use their knowledge and skills to treat and care for their patients and should never prioritize their values and beliefs over those of their patients. 13 They have also raised concerns that CO may place a burden on patients and other colleagues, reduce the quality of health services and care, disproportionately affect those living in rural areas, and result in discrimination and abuse.…”

“…13 They have also raised concerns that CO may place a burden on patients and other colleagues, reduce the quality of health services and care, disproportionately affect those living in rural areas, and result in discrimination and abuse. [12][13][14] Research shows that nurses would like to exercise their right to CO in different situations, such as administering a futile treatment that causes nothing but suffering, providing technologically assisted treatment for brain-dead patients, managing a neonate's pain during medical procedures, and taking part in procedures like abortion, sterilization, assisted reproduction, family planning, euthanasia, and organ harvesting. 13,[15][16][17] Yalım 3 and Keles ¸et al 18 argue that more and more Turkish healthcare professionals are refusing to care for certain patients due to their biological sex and taking refuge in the concept of CO to justify their decision.…”

“…13 They have also raised concerns that CO may place a burden on patients and other colleagues, reduce the quality of health services and care, disproportionately affect those living in rural areas, and result in discrimination and abuse. 12–14…”