Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
CCBI, St. Michael's College in the University of Toronto, Toronto, Ontario, Canada.
BMJ Open. 2022 Jul 27;12(7):e053880. doi: 10.1136/bmjopen-2021-053880.
Conscience is central to moral decision making. In the context of morally pluralistic workplaces today, healthcare professionals' conscience may prompt them to make moral decisions to refrain from providing services they morally disagree with. However, such decisions are largely viewed as contentious, giving rise to polarising arguments for and against healthcare professionals' freedom of conscience. Yet, little work has been done to understand and support healthcare professionals' conscience. Instead, the rising polarity related to healthcare professionals' freedom of conscience stems from a central lack of understanding of what conscience is and the relevance it holds for healthcare professionals' clinical practice. Therefore, the degree and extent to which healthcare professionals are supported to understand and use their conscience is unknown. The objective of this review is to critically analyse the scholarly evidence available to ascertain the effectiveness of interventions that support healthcare professionals to understand and use their conscience in care practice.
At least two reviewers will systematically review 10 interdisciplinary, scholarly databases to examine qualitative, quantitative and mixed-methods studies including clinical trials pertaining to interventions related to conscience for healthcare professionals. Databases to be searched include: the Cochrane Controlled Register of Trials, Medline, EMBASE, PsycINFO, Cumulative Index for Nursing and Allied Health Literature (CINAHL), Academic Search Complete, ATLA Religion Database, Religion and Philosophy Collection, PhilPapers and Scopus. Databases were searched in May 2021. Study screening, selection, extraction and risk of bias assessments on each study using the Mixed Methods Appraisal Tool will be independently conducted by independent reviewers. Descriptive data synthesis will be carried out. Statistical analysis and meta-analysis will be conducted as relevant, based on homogeneity of findings. The quality of the aggregate evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations criteria.
Ethical approval is not required for this review. This protocol will not involve individual patient information endangering participant rights. The results will be reported in a peer-reviewed journal and disseminated at conferences.
CRD42021256943.
良心是道德决策的核心。在当今道德多元化的工作场所环境下，医护人员的良心可能促使他们做出不提供自己在道德上反对的服务的决定。然而，此类决定在很大程度上被视为有争议的，从而引发了赞成和反对医护人员良心自由的两极分化观点。然而，对于理解和支持医护人员的良心，人们几乎没有做过什么工作。相反，与医护人员的良心自由相关的日益加剧的两极分化源于对良心是什么以及它对医护人员的临床实践有何重要性的核心理解的缺乏。因此，医护人员在多大程度上得到支持来理解和运用他们的良心尚不清楚。本研究的目的是批判性地分析现有的学术证据，以确定支持医护人员在护理实践中理解和运用良心的干预措施的有效性。
至少两名审查员将系统地审查 10 个跨学科学术数据库，以检查与医护人员良心相关的干预措施的定性、定量和混合方法研究，包括临床试验。将搜索的数据库包括：Cochrane 对照试验注册库、Medline、EMBASE、PsycINFO、护理学及相关健康文献累积索引（CINAHL）、学术搜索完整版、ATLA 宗教数据库、宗教与哲学收藏、PhilPapers 和 Scopus。数据库于 2021 年 5 月进行搜索。使用混合方法评估工具对每项研究进行独立审查员进行的研究筛选、选择、提取和偏倚风险评估。将进行描述性数据综合。将根据发现的同质性进行统计分析和荟萃分析。使用推荐评估、制定和评估标准（Grading of Recommendations, Assessment, Development and Evaluations criteria）评估综合证据的质量。
本综述不需要伦理批准。本方案不涉及危及参与者权利的个人患者信息。研究结果将在同行评议的期刊上报告，并在会议上发表。
PROSPERO 注册号：CRD42021256943。
