Nurses' perspectives of conscientious objection and ethical challenges in abortion care.

Authors

Miriam Dill, Danielle Dunne

Published in

Nursing ethics. Pages 9697330261465872. Jul 12, 2026. Epub Jul 12, 2026.

Abstract

Abortion rates in England and Wales have reached record levels, highlighting the increasing need for skilled and ethically grounded nurses in abortion care. Despite its clinical importance, nurses involved in abortion services frequently encounter ethical tensions when their personal beliefs conflict with professional responsibilities. This literature review explores how nurses navigate conscientious objection (CO) and related ethical challenges within emotionally complex clinical environments. A structured search was conducted across CINAHL Ultimate, SCOPUS, Embase, and PsychINFO (via EBSCO), using the SPIDER tool to identify qualitative studies addressing nurses' experiences in abortion care. After applying rigorous inclusion and exclusion criteria, five studies were selected for critical appraisal. Thematic analysis following Braun and Clarke's six-step framework reveals three overarching themes: personal versus professional conflicts, institutional and organisational barriers to conscientious objection, and conscience formation and ethical growth. Findings indicate that nurses frequently suppress personal emotions to meet professional expectations, often without adequate institutional support. The absence of clear policies on CO, coupled with high workloads, staff shortages, and inadequate resources, further complicates their ability to exercise moral agency. Participants reported feeling ethically unsupported, emotionally isolated, and constrained by workplace cultures that discourage open discussion of values. At the same time, conscience was found to be fluid and shaped over time by experience, reflection, and contextual influences. This review concludes that systemic barriers and a lack of policy clarity undermine nurses' ethical resilience in abortion care. To address this, healthcare organisations must implement clear and accessible CO protocols, offer structured ethics training and support emotionally reflective practice. Fostering a culture of inclusivity and ethical dialogue is essential to empower nurses and ensure equitable, compassionate care for women accessing abortion services.

PMID:
42437738
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.

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