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Women

Termination of pregnancy: conscientious objection 

Legislation recognises that health care workers may have religious, moral or personal objections to abortion. This page highlights the issues around conscientious objection.

RCN guidance 

Section four of the original Abortion Act (1967) (Scotland, England and Wales) states that individuals were under no obligation to “participate in any treatment authorised by [the Act] to which [they have] a conscientious objection”. The Act does not apply to Northern Ireland*.

In 1990 the Human Fertilisation and Embryology Act (HFE Act) section 38 stated that “No person who has a conscientious objection to participating in any activity governed by this Act shall be under any duty, however arising, to do so”. However, this is limited to the termination procedure only and not to care provided before and/or after the procedure is carried out (Human Fertilisation and Embryology Authority (HFEA) Code of Practice 6th edition, Page 18, 2003).

The most recent HFEA Code of Practice 2017 discusses treating people fairly:

  1. “No person who has a conscientious objection to participating in any activity governed by this Act shall be under any duty, however arising, to do so.
  2. In any legal proceedings the burden of proof of conscientious objection shall rest on the person claiming to rely on it.
  3. In any proceedings before a court in Scotland, a statement on oath by any person to the effect that he has a conscientious objection to participating in a particular activity governed by this Act shall be sufficient evidence of that fact for the purpose of discharging the burden of proof imposed by subsection (2) above.”  HFEA Code of Practice 2017 (p.262 8th Edition)

As a nurse and/or a midwife who conscientiously objects under this legislation, you are reminded that you are accountable for whatever decision you make and could be called upon to justify your objection; therefore it is vital that any concerns or objections are discussed with your manager at the earliest opportunity. Section 38 of the 1990 Act also states that “In any legal proceedings the burden of proof of conscientious objection shall rest on the person claiming to rely on it” (HFEA Code of Practice 6th Edition, p.18, 2003).

It also states that “In any proceedings before a court in Scotland, a statement on oath by any person to the effect that he (she) has a conscientious objection to participating in a particular activity governed by this Act shall be sufficient evidence of that fact for the purpose of discharging the burden of proof” (HFEA Code of Practice 6th Edition, p.18, 2003).

The Human Fertilisation and Embryology Authority has further useful information on the subject, including the Code of Practice.

Can I refuse to care for a woman who is about to undergo or has already undergone a termination of pregnancy?

No, for the reasons stated above. Nor could you refuse to take part in an emergency during the procedure itself if you are present and the woman’s safety and well being is at risk. At all times the safety of the woman is paramount.

Voicing conscientious objection

If you have a conscientious objection to abortion you should discuss the issue with your manager and confirm your objection in writing. The issue should be dealt with sensitively, so that nurses, midwives, patients/clients and women can establish a successful therapeutic relationship. Article 4(2) of the Abortion Act 1967 and Article 38(2) of the HFE Act 1990 state that: “In any legal proceedings the burden of proof of conscientious objection shall rest on the person claiming to rely on it.” However, in Scotland the burden of proof does not rest with the healthcare professional who is objecting, if they swear an oath before a court of law explaining that they have an objection.

Emergency contraception

Emergency contraception is not considered to be an abortificant by the World Health Organization (WHO) and conscientious objection does not apply.

Further resources

BMA. Expression of doctors' beliefs. This guidance sets out the BMA's views on conscientious objection and the manifestation of religious and cultural belief for both doctors and medical students.

NMC. Conscientious objection by nurses and midwives. The NMC Code states that nurses and midwives who have a conscientious objection must tell colleagues, their manager and the person receiving care that they have a conscientious objection to a particular procedure. 

RCN Advice guide. Refusal to treat

Page last updated - 06/03/2019