Dr. Shanna W. Akers is the dean of the Liberty University School of Nursing. Akers has filled a variety of influential roles in the medical community including critical care nurse, director of a cardiovascular service line, and multiple senior academic positions. She has presented on topics such as sudden cardiac death in women and congestive heart failure maintenance. Follow her on Twitter at @DrAkersRN.
____________________

Healthcare professionals are no strangers to ethical dilemmas – many of which surround the value of life. Broad topics such as abortion and “medical aid in dying” (formerly known as physician-assisted suicide) are routinely discussed in ethics meetings at healthcare systems around the country.

We must all use our voice. If we are not engaged in the conversation, our values and our beliefs will be sidelined for the preference of those with a louder voice. For healthcare professionals, this is no different.

Christian physicians, nurses, and other healthcare professionals must understand their personal beliefs and morals related to these potential dilemmas. They must also know how to advocate for self while understanding the resources available to support their conscientious objection.

Conscientious objection (CO) is the action of not participating in an activity because of one’s personal moral or religious beliefs. While cited frequently during times of war and when individuals are drafted into the military, CO can also be used to protect the moral integrity of the healthcare professional. Nurses may object to participating in an elective abortion on the grounds of CO and his or her personal value for life. Physicians may conscientiously object to engaging in medical aid in dying based on his or her worldview.

The impact of the COVID-19 pandemic has also created situations in which the religious freedoms of healthcare providers and patients alike have been in jeopardy. In recent news, a dying man was denied a visit from his clergy based on hospital policies that limited visitors due to pandemic concerns. A male nurse was asked to shave his beard, which was in violation of his personal religious beliefs, though a product was available that would have both protected him from contracting the virus and would have protected his religious integrity. These two examples are not anomalies in the challenges faced in healthcare today.

Personal CO rights for healthcare providers are protected under federal statutes, including, but not limited to:

• • The Church Amendments preserve the right to object to personal participation in abortion or sterilization procedures.
  • The Weldon Amendment prevents discrimination against a health system, hospital, or individual provider who does not engage in the provision of or payment for abortions.
  • The Affordable Care Act Section 1553 (42 USC 18113) protects those who oppose and refuse to participate in assisted suicide, euthanasia, or mercy killing.

These statutes protect the freedoms of individual healthcare professionals and healthcare organizations to object to these actions that are in opposition to their religious or moral beliefs.

While abortion and the freedom to conscientiously object continues, the discussion of the role of the healthcare professional in medical aid in dying has begun to pick up traction. In 2016, Canada legalized medical aid in dying. In 2019, the American Nurses Association updated its position statement on euthanasia to add consideration on the role of the nurse when a patient seeks medical aid in dying.

The American Medical Association’s “Principles of Medical Ethics” opinions 1.1.7 and 5.7 explore the argument from a medical ethics perspective where the physician must remain true to self and provide care to the patient. This internal conflict can be experienced when caring for the patient, providing end-of-life care, and minimizing pain and discomfort while at the same time caring for self, providing moral integrity, and maintaining emotional/spiritual well-being.

America is facing all-time high levels of burnout in both nursing and medical professionals. Some of this fatigue is due to the challenge of reconciling personal beliefs and religious morals with the trends of healthcare and the shortage of resources (both the scarcity of providers and of supplies). In higher education, faculty have an opportunity to build competencies in resiliency and guide students in their development of knowledge, skill, and attitude specific to their chosen profession. For those in medicine, nursing, and healthcare, faculty must explore CO through deeper discussion, provide resources for maintaining moral integrity, and support students in creating a voice for self-advocacy.

Thomas Jefferson stated on more than one occasion that scientia potentia est — knowledge is power. Knowing one’s freedoms to conscientiously object to actions (or inactions) that would violate one’s personal religious and deeply held morals is essential. And the use of this knowledge to give voice and action is fundamental to our ability to preserve this freedom for ourselves and the next generation.

To learn more about CO, protected freedoms for health care providers, and how to file a complaint, please visit the U.S. Department of Health and Human Services to download guidance and resources, including “Conscience Protections for Healthcare Providers” and “Conscience and Religious Freedom.”

This article is part of the Standing for Freedom Center’s Spring journal, Equality: A Dream for Patriots, a Mask for Tyranny.