ORIGINAL RESEARCH article
Front. Med.
Sec. Healthcare Professions Education
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1683300
Conscience Clause in Brain Death Care: Ethical and Legal Perspectives of Polish Nursing and Midwifery Students
Provisionally accepted
- Poznan University of Medical Sciences, Poznań, Poland
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Background: The conscience clause allows healthcare professionals to refuse participation in procedures that conflict with their ethical or religious beliefs. While intended to protect moral autonomy, its application, particularly in the context of brain death and organ donation, raises complex ethical and legal challenges. This study aims to explore the attitudes of young nurses and midwives in Poland toward the conscience clause in relation to brain death, including their ethical concerns, perceived consequences, and views on legal regulations. Methods: A cross-sectional survey was conducted among 269 master's students of nursing and midwifery at the Medical University in Poznan, Poland. Participants completed a questionnaire covering ethical dilemmas, legal opinions, and potential consequences related to invoking the conscience clause. Descriptive statistics and logistic regression were used to analyze the data, with significance set at p < 0.05. Results: Most respondents supported both respecting patients' beliefs (90.3%) and the right to act according to their own conscience (68.4%). However, they expressed concerns about negative social and professional consequences, such as strained relationships (40.2%), job loss (43.9%), or legal action (56.9%). Attitudes were shaped by religiosity and political views. Religious participants were more likely to support conscientious objection in organ retrieval (OR = 2.08). At the same time, right-leaning students were less likely to support invoking the clause when mandated to disconnect a brain-dead patient. Respondents favored structured national regulations (81.8%) over institutional discretion or full abolition of the clause. Conclusions: Young healthcare professionals report facing significant ethical and legal dilemmas related to brain death, and their views appear to be associated with personal values
Keywords: Brain Death, Conscience clause, End-of-life care, Ethical and legal dilemmas, Medical Ethics, Midwives, Nurses, Religiosity
Received: 11 Aug 2025; Accepted: 22 Sep 2025.
Copyright: © 2025 Czekajewska, Walkowiak, Jelińska and Domaradzki. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Justyna Czekajewska, justynaczekajewska@gmail.com
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