The first step is to ensure you clearly understand the patient’s/family’s request. If you determine that the request conflicts with your personal conscience, first inform your supervisor of your objection. (Ideally, your supervisor should be informed about conscience objections proactively, as this impacts scheduling. Knowing about the potential for conscience objections makes it possible for them to schedule staff appropriately to care for all patients.) Then, inform the patient/family of all the treatment options available so they can make an informed decision without attempting to persuade them to select one course of treatment over another. This is especially important when your objection is guided by religious/moral beliefs rather than professional ethics. 

In addition to informing your supervisor, consult with the facility ethics committee and if appropriate, the pastoral care team. This can serve as a source of guidance and support for the provider as well as the patient.

Once it is established that a genuine conflict exists between the needs/requests of the patient and the personal conscience of the provider, it is appropriate for the provider to refuse to provide the procedure/treatment and transfer the patient to a provider who can give the patient the care they need.