Should NursesHave the Right to Refuse to Participate in Abortion Procedures?

 

Author: Ihsan Ullah (MScN AKU)

Should NursesHave the Right to Refuse to Participate in Abortion Procedures?

Abortion is defined as the termination of pregnancy before the fetus reaches viability. Abortion remains a prevalent practice globally; the World Health Organization reports that approximately 73 million induced abortions occur annually, with 45% being unsafe (WHO, 2024). Abortion is a complex issue that involves many areas, including healthcare, law, ethics, religion, and insights from the humanities and social sciences (Eagen-Torkko et al., 2025). As a fundamental principle of healthcare, nurses are required to provide respectful care to all patients. However, they should also uphold the ethical principles of beneficence and non-maleficence, as well as their religious beliefs, while delivering care. Therefore, nurses should have the right to refuse to participate in abortion procedures based on their religious, moral, and bioethical principles.

All religions view human life as sacred and strive to promote a respectful and peaceful existence. The Qur'an says, “Whoever saves the life of one person, it is as if he has saved the life of all humanity." "Whoever takes the life of one person, it is as if he has slain all of humanity" (Qur'an 5:32). The fetus has inherent moral value and the right to life from conception. Abortion is seen as taking a human life, which is considered morally wrong. Certain religious traditions, including some Christian denominations, uphold the belief that life begins at conception and view abortion as a sin. These beliefs significantly shape the moral stance against abortion. Consequently, in many places, abortion is either illegal or heavily restricted due to the conviction that it is morally wrong. Such laws aim to safeguard the fetus's right to life (Bok, 1974). Considering the above shreds of evidence, it is evident that abortion is discouraged across all religions and considered as taking away life from the fetus. Nurses, as healthcare professionals, have a moral obligation to uphold the sanctity of human life and refrain from participating in abortion procedures. By doing so, nurses can maintain their moral integrity and avoid compromising their religious beliefs.

Forcing nurses to participate in abortion procedures against their will violates their right to freedom of conscience. Conscience is the use of moral understanding in circumstances that need ethical choices regarding how one ought to behave. Many nurses experience moral distress and conscientious objection when faced with the prospect of participating in abortion procedures. This can lead to feelings of guilt, anxiety, and emotional turmoil, ultimately compromising their ability to provide quality care. The American Nurses Association Code of Ethics emphasizes respecting nurses' autonomy and moral integrity (Association, 2001). Additionally, the Abortion Act of 1967 in the United States allows healthcare professionals to refuse to participate in abortions if they have an ethical objection (Karabulutet al., 2022). Abortion is considered to conflict with fundamental ethical principles: beneficence, which means providing benefit; non-maleficence, which means avoiding harm; and justice, which means ensuring fair treatment. It is not only fatal for the child but also carries unwanted consequences for the mother. Therefore, based on the principles of bioethics, nurses’ right to autonomy to refuse to participate in abortion procedures should be respected.

It is argued that abortion is essential for preventing unwanted pregnancies. Denying this option may infringe upon women's rights to access scientific advancements, their freedom to make responsible choices regarding the number, timing, and spacing of their children, and their right to be free from suffering (WHO, 2024). However, it has been reported that 45% of abortions are unsafe, resulting in life-threatening complications such as uterine perforation, hemorrhage, and genital tract infections. Nurses are expected to respect the autonomy of the expectant mother and her family; however, they also have a moral obligation to protect the lives of human beings and to provide the greatest possible benefit.

  In summary, abortion results in the termination of a potential life and poses risks to the mother’s health. It is discouraged by all religions and is viewed as a violation of bioethical principles. It is thought that denying access to abortion violates a woman's right to make choices regarding her own body. However, considering the consequences of abortion, nurses must prioritize the principles of justice and non-maleficence over autonomy. Therefore, nurses have the right to refuse participation in abortion procedures based on their fundamental religious beliefs.