Electronic Thesis and Dissertation Repository


Master of Science


Health and Rehabilitation Sciences


Dr. Marilyn Evans

2nd Supervisor

Dr. Andrew Johnson

Joint Supervisor


This thesis considers how conscientious objection of a nurse or physician in a rural setting should be addressed when that objection is based on a centrally held value or belief, and considers whether current strategies are morally sufficient. Current literature fails to specifically consider the complexity and challenge facing health care professionals with limited support, time, and resources who encounter conscientious objection in the rural environment. Conscience and conscientious objection are explicitly defined based on a literature survey, and reflective equilibrium is used to assess evidence from law, policy, and published sources. The author concludes that current strategies fail to meet moral obligations to rural nurses and physicians and recommends a strategy of accountability and openness requiring physicians, nurses, and administrators to defend their reasons for conscientious objection and expecting peers and subordinates to respect objections that qualify as conscience based. This strategy provides an "at the bedside" method for ensuring objections are documented, allowing for accountability at all levels of care.