Western University, Canada.
Nurs Ethics. 2019 Aug;26(5):1337-1349. doi: 10.1177/0969733018763996. Epub 2018 Apr 3.
While conscientious objection is a well-known phenomenon in normative and bioethical literature, there is a lack of evidence to support an understanding of what it is like for nurses to make a conscientious objection in clinical practice including the meaning this holds for them and the nursing profession.
The question guiding this research was: what is the lived experience of conscientious objection for Registered Nurses in Ontario?
Interpretive phenomenological methodology was used to gain an in-depth understanding of what it means to be a nurse making a conscientious objection. Purposive sampling with in-depth interview methods was used to collect and then analyze data through an iterative process.
Eight nurse participants were interviewed from across practice settings in Ontario, Canada. Each participant was interviewed twice over 9 months.
This study was conducted in accordance with Health Science Research Ethics Board approval and all participants gave consent.
Six themes emerged from data analysis: encountering the problem, knowing oneself, taking a stand, alone and uncertain, caring for others, and perceptions of support.
This study offers an initial understanding of what it is like to be a nurse making a conscientious objection in clinical practice. Implications for nursing practice, education, policy, and further research are discussed.
Addressing ethical issues in nursing practice is complex. The need for education across nursing, healthcare disciplines and socio-political sectors is essential to respond to nurses' ethical concerns giving rise to objections. Conscience emerged as an informant to nurses' conscientious objections. The need for morally inclusive environments and addressing challenging ethical questions as well as the concept of conscience are relevant to advancing nursing ethics and ethical nursing practice.
虽然在规范和生物伦理文献中，出于良心拒绝对医疗护理实践具有重要的影响，但缺乏对护理人员在临床实践中提出出于良心拒绝对其本身和护理职业意味着什么的理解的证据。
指导这项研究的问题是：安大略省注册护士出于良心拒绝对他们来说意味着什么？
解释现象学方法被用来深入了解作为一名出于良心拒绝对护理人员意味着什么。目的抽样与深入访谈方法结合使用，通过迭代过程收集和分析数据。
从加拿大安大略省的各个实践环境中采访了 8 名护士参与者。每位参与者在 9 个月内接受了两次采访。
本研究是根据健康科学研究伦理委员会的批准进行的，所有参与者都同意。
数据分析得出了 6 个主题：遇到问题、了解自己、采取立场、孤独和不确定、关心他人和对支持的看法。
这项研究初步了解了护理人员在临床实践中出于良心拒绝对他们意味着什么。讨论了对护理实践、教育、政策和进一步研究的影响。
解决护理实践中的伦理问题是复杂的。护理、医疗保健学科和社会政治部门都需要教育，以应对引发反对意见的护士的伦理问题。护理人员的出于良心拒绝对其护理工作具有重要的影响。需要有道德包容性的环境，解决具有挑战性的伦理问题以及良心的概念，这些都是推进护理伦理和道德护理实践的重要因素。
