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with conscience , and there are many situations where the healthcare practitioner may find it very difficult to do the right thing – such as being honest about a bad prognosis , challenging staffing shortfalls , or exposing unethical or incompetent colleagues and practices . Conscience enables us to act and choose behaviours that are in accordance with our most personal and moral aspirations and convictions .
We are often required to ascertain if , in an ethical sense , actions are right or wrong , good or bad . Conscience can be seen as the ‘ friend ’ of the healthcare practitioner in helping to make these judgements , and is therefore worthy of protection , respect , and accommodation .
Exemplary scenarios involving the role of conscience in clinical practice
As a CM practitioner I could not in all conscience recommend chemotherapy for my client . In fact , when health practitioners claim conscientious objection to some medical procedures , they are usually not interested in preventing other doctors who hold different moral beliefs from performing the procedure . They are usually only interested in , so to speak , keeping their hands clean according to their subjective moral standard .
• My conscience informed me that it was the right thing to do to treat my own wife for her illness .
• I followed the promptings of my conscience when I chose to inform my client ’ s wife that her husband has AIDS .
How are we to judge these actions ? It seems there might be at least three possibilities .
If you believe that the promptings of your conscience are sacred , that they indeed come from God or a delegate , then you have no choice to agree and be willing to face disciplinary action if judged to deserve it .
If you believe , perhaps like Rousseau , these promptings to be innate , psychologically imprinted like an instinct , and unchangeable , then again you feel obliged to act in accordance , though noting that there is no necessary reason why you cannot place them alongside your professional conscience and see which predominates . Are we not often challenged to confront an instinctive response and act with rational judgment ?
WE ARE OFTEN REQUIRED TO ASCERTAIN IF , IN AN ETHICAL SENSE , ACTIONS ARE RIGHT OR WRONG , GOOD OR BAD . CONSCIENCE CAN BE SEEN AS THE ‘ FRIEND ’ OF THE HEALTHCARE PRACTITIONER IN HELPING TO MAKE THESE JUDGEMENTS , AND IS THEREFORE WORTHY OF PROTECTION , RESPECT , AND ACCOMMODATION .
And if you see these promptings as coming from life experience and subject to introspection and analysis , then you are obliged to weigh them in the balance of your professional duties and make a reasoned judgement .
Conclusion
I see no easy way to determine the role that conscience should play in ethical decision making . And I admit to having no idea how it would be considered as a defence in a legal case . There are criminals on death row who admit to not having a conscience at all . There are Christians who believe conscience is the voice of God or a guardian angel . There are those who admit its existence but distrust its promptings as emotional rather than logical . Given these discrepant understandings , it seems the best course to consider is to act with recognition of your conscience ’ s place in your moral judgments and understandings but be willing to place them on equitable terms with your professional responsibilities and use your best reasoning and ethical standards to decide .
REFERENCES 1 . Rousseau , J . J . Emile , or on education , Barbara
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