Clear Policy, Clear Conscience

Abstract

The creation of policies to mediate conscientious disagreements between healthcare professionals and those they serve presents a unique challenge for Canadian policy makers. As policies related to conscience issues are developed and refined, policy makers will need to investigate not only cases where conscientious disagreements have escalated into conflicts, but also the many situations and contexts in which healthcare professionals and their patients have been able to find positive resolutions. Such positive outcomes are frequently observed in palliative medicine. Palliative care teams throughout the world have earned a reputation for generating a high degree of patient and family satisfaction despite the teams’ regular exposure to the end-of-life ethical challenges from which conscientious disagreements are likely to arise. My research used interviews and focus groups to bring description to the deliberative processes of the Saskatoon Health Region’s palliative care team. These data were analyzed and presented to two interpretive panels, the members of which commented as to whether or not the processes described might be used to inform the development of a policy framework to facilitate the positive resolution of conscientious disagreements in other areas of the healthcare system. This policy framework holds the promise of promoting a culture of ethical awareness within healthcare institutions, thereby decreasing the moral distress experienced by healthcare professionals, minimizing the financial and emotional costs of protracted court cases, and enhancing the relationships between healthcare professionals and their patients.