Conscientious Objection

The right to conscientious objection based on religious, ethical, or cultural beliefs is quite well accepted in the health professions, though it is usually couched in terms of the right not to participate in abortions or sterilizations. Circumcision is pretty far off the radar screen but it certainly falls under the same set of principles. Although training programs might vary in their policies, students should theoretically have a similar right to conscientious objection.

Following are some sources discussing the right to conscientious objection in health care, some of which specifically relate to circumcision:

  • JCAHO (the Joint Commission that accredits hospitals) requires that hospitals have some kind of Human Resources policy in place to make reasonable accommodations to staff ethical objections, as long as patient care or treatment are not compromised.

The statement says nurses should have the right to conscientious objection, for example, to abortion, sterilization, and “any other procedure,” which would cover circumcision. It recommends that every institution have a written policy protecting these rights and making reasonable accommodations for nurses with such objections. It also says: “The refusal should not jeopardize a nurse’s employment, nor should nurses be subjected to harassment due to such a refusal.”

  • Several medical associations’ circumcision position statements acknowledge the right to conscientious objection to circumcision, including the British Medical Association and the Royal College of Australasian Physicians. The College of Physicians and Surgeons of British Columbia used to also, but they have retired their position statement in deference to the Canadian Paediatric Society’s upcoming revision of their national position statement.
  • Code of Ethics for Registered Nurses in Canada (applies to student nurses as well), Appendix D
    Code of Ethics 2008

    “Anticipating and planning to declare a conflict with conscience:

“Ideally, the nurse would be able to anticipate practices and procedures that would create a conflict with his or her conscience (beliefs and values) in advance. In this case, the nurse should discuss with supervisors, employers or, when the nurse is self-employed, persons receiving care what types of care she or he finds contrary to his or her own beliefs and values (e.g., caring for individuals having an abortion, male circumcision, blood transfusion, organ transplantation) and request that his or her objections be accommodated, unless it is an emergency situation.”

“Ideally, nurses in positions of formal leadership would ensure that workplaces have a policy in place to deal with matters of conscience so that a nurse can be exempt from participating in procedures he or she considers morally objectionable without being penalized.””

  •  Family physician Michelle Storms MD speaks about her experience as a conscientious objector to circumcision, including discussing harassment by other health professionals. An inspiring and empowering video for all health professionals.