Conscience, Conscientious Objection and Commitment: Midwives, Nurses, and Abortion Care

This chapter is concerned with conscience and the role it plays in the work of midwives, nurses, and other healthcare practitioners in the provision of termination of pregnancy services. The first section outlines the standard account of “conscience” as an inward-looking faculty or process by which we can discern moral truths to guide and motivate human action. It further explains the notions of “freedom of conscience” and “conscientious objection” as they are generally articulated and defended in bioethics and law. The second section outlines and explains a feminist account of conscience which views it as informed, enabled, and constrained by social and institutional relations of power. It also discusses the notion of “conscientious commitment” which signals that conscience is not simply the purview of those who refuse to provide termination of pregnancy services-it also applies to those who do, often at great personal cost. We conclude with the suggestion that ethical stances are taken in specific real-world contexts and that the shared range of tasks and psychosocial supports involved in the delivery of any kind of clinical treatment may work to reduce what seem like intractable conflicts in the case of abortion care. The context of these considerations is that of Ireland, a country that had, until January 2019, one of the most restrictive pieces of legislation on abortion in the world.