If nurses can anticipate
a conflict with their
conscience, they notify
their employers or
persons receiving care
(if the nurse is self-
employed) in advance so
can be made.
Code of Ethics
for Registered Nurses
• Advise the appropriate parties regarding unresolved concerns and, when
feasible, inform the colleague(s) in question of the reasons for your action.
Know what immediate help is available to your colleague(s) and be ready
to help the colleague(s) find these resources.
• Nurses who engage in responsible reporting of incompetent, unsafe or
unethical care are supported by their colleagues, professional association
and/or professional college.
Ethical Considerations in Addressing Expectations That Are in
Conflict with One’s Conscience
Nurses may not abandon those in need of nursing
care. However, nurses may sometimes be opposed to
certain procedures and practices in health care and
find it difficult to willingly participate in providing care
that others have judged to be morally acceptable.
Such situations include, but are not limited to, blood
transfusions, abortion, suicide attempts, refusal
of treatment and medical assistance in dying. The
nurse’s right to follow their conscience in such
situations is recognized in the
’s provision for
If nursing care is requested that is in conflict with the nurse’s moral beliefs
and values but in keeping with professional practice, the nurse provides safe,
compassionate, competent and ethical care until alternative care arrangements
are in place to meet the person’s needs or desires. But nothing in the Criminal
Code compels an individual to provide or assist in providing medical assistance
in dying. If nurses can anticipate a conflict with their conscience, they notify their
employers or persons receiving care (if the nurse is self-employed) in advance so
alternative arrangements can be made. (G7)
Specifically, with respect to medical assistance in dying, nurses consult CNA’s
Nursing Framework on Medical Assistance in Dying in Canada
(2016b). This framework
includes details about the changes in Canadian law (the Criminal Code of Canada),
which now permits medical assistance in dying, and detailed guidance for nurses.