Introduction
Nurses encounter numerous dilemmas in their daily life notwithstanding the working environment. Regardless of where the nurses work, they face multiple ethical dilemmas, which affect them as well as the patients. Bandman and Bandman (2002) argue that there is no “correct” answer to an ethical dilemma. According to Bandman and Bandman (2002), a moral dilemma refers to “a problem without a satisfactory resolution” (p. 37). In the nursing profession, ethical practices entail meeting the needs of patients without hurting them. Nevertheless, individual nurses have different definitions of ethical practices. Thus, nurses may use different approaches to solving a single dilemma. One of the ethical dilemmas that nurses encounter frequently is assisting patients who intend to procure an abortion (Bandman & Bandman, 2002). The decision that nurses make when dealing with the issue of abortion depends on one’s values and beliefs. A nurse who values life may not rush to do an abortion without evaluating the situation of the affected patient. Besides, such a nurse may be cautious when directing patients how to exercise their rights. This paper will discuss how nurses are supposed to handle the ethical dilemmas that are involved in the procurement of an abortion.
The Values at Stake
Different professions and associations structure their ethical issues differently. However, all health care professionals are supposed to “act in the best interest of the patient and her welfare” (Bandman & Bandman, 2002, p. 47). The principle of beneficence requires nurses to discharge their duties for the best interest of the patients regardless of whether the services are in line with the moral beliefs. Nurses are obliged to not harm patients at all costs. Therefore, nurses are supposed to ensure that they understand the desires of patients before performing an abortion. Besides, they need to consult their colleagues and obtain informed consent from the patients. Davis, Fowler, and Arosker (2010) allege that the nursing profession has translated its core values into precise ethical principles. Such regulations are essential given that the values may at times contradict or seem to point in diverse directions. Davis et al. (2010) allege, “The beneficence can quickly turn into paternalism in the hands of a highly trained health care provider caring for patients with inferior knowledge” (p. 114). According to the International Code of Medical Ethics, nurses are obliged to preserve human life at all costs. The World Medical Association (WMA) requires nurses to abstain from performing an abortion. Nurses are only supposed to perform an abortion after they ascertain that the life of the child or the mother is in danger.
Nurses may have different opinions on the obligation to protect human life based on their stances towards the existence of the unborn child. In case a nurse is not sure whether to conduct an abortion due to their position towards the unborn child, they are supposed to walk away (Davis et al., 2010). Nurses are expected to ensure that they do not offer services that are against their religious or moral beliefs. The professional medical association has policies that allow nurses to withdraw from providing services that contradict their beliefs and values. Nevertheless, nurses should ensure that their acts do not deprive the patients of their dignity. Nurses have to ensure that their decisions are known to the patients and recommend them on the next course of action. They are not supposed to abandon patients. Instead, they should refer them to other medical professionals who are ready to lend a hand. In case of emergency, the principle of beneficence supersedes the moral and religious beliefs of a nurse. The nurse is obliged to perform an abortion in the event of an emergency. Failure to perform an abortion in the case of an emergency may lead to a nurse facing prosecution or even losing the license to practice as health care personnel (Davis et al., 2010). The professional association holds that a nurse’s religious or moral beliefs should not supersede a patient’s autonomy. Therefore, a nurse cannot use the right to withdraw from services as a reason to deprive patients of their right to health care.
The Principle of Justice
In some instances, pregnant mothers may request for abortion after realizing that they might give birth to children with mental or physical disabilities. Some ethicists maintain that possible disability should not be used as a justification to acquire an abortion. A nurse should know that even the disabled have their rights. Allowing mothers to do abortions due to fear of giving birth to disabled children amounts to a violation of the rights of persons with disability (Gallagher, Porock & Edgley, 2009). It signifies that the life of people with disability is less valuable compared to that of healthy individuals. A majority of persons who are born with disabilities claim that they are happy to be alive. Thus, before a nurse performs an abortion, s/he should consider the plight of the unborn child. What would the unborn child prefer if it had a chance to select between abortion and being born? Would the child regret being born disabled? These are critical questions that a nurse should ask. In such a situation, a nurse should use the principle of justice to make an ethical decision (Gallagher et al., 2009).
The principle of justice requires a nurse to consult all the parties that might be affected by abortion. Even though nurses are obliged to respect the patient’s right to autonomy, they should ensure that they make decisions that are fair and just. The nurse should consider the views of a husband when dealing with a married woman. Besides, a nurse must consider the opinions of other health care workers. The principle of justice ensures that nurses operate within the established legal and ethical guidelines (Gallagher et al., 2009). Consulting family members before performing an abortion can prevent possible litigations. Apart from considering the desires of family members, a nurse should also examine the preference of a fetus. A fetus cannot express or formulate its preference. However, the pro-life activists fight for the rights of the unborn. Failure to consider their views constitutes unethical practice (Kane, 2009). Therefore, for nurses to ensure that they resolve the ethical dilemma of carrying out an abortion, they have to consult all the stakeholders who might be affected and consider the rights of the fetus.
The Principle of Veracity
A majority of greedy nurses carry out abortions without considering the real situation of a patient. Such nurses are normally after money, and they do not care about the circumstances that may have led to a patient opting to terminate her pregnancy (Kane, 2009). Consequently, they end upending the life of an unborn child that is not in danger or does not put the life of the mother at risk. Kane (2009) argues that nurses should apply the principle of veracity when deciding to conduct an abortion. They should be honest in acknowledging and accepting the plight of a patient. Besides, they should let patients understand the full implications of conducting or not conducting an abortion (Macciocchi, French & Bush, 2009). Being honest will give the patient an opportunity to decide whether to go on with the abortion or not, therefore absolving a nurse from any possible outcome. Nurses should embrace a deontological outlook on medical ethics. They must make decisions based on their intentions rather than the results. Even though a majority of abortions may not develop complications, their intentions may be unethical. Consequently, before conducting an abortion, it is imperative to understand its purpose and discuss the possible alternatives with a patient. Some patients procure an abortion to enable them to continue with immoral behaviors like prostitution. Assisting such a patient would amount to the promotion of moral decay in society (Macciocchi et al., 2009). Therefore, it is imperative to consider the intentions of a patient before assisting them to do an abortion.
Conclusion
Ethical practices are paramount in the nursing profession. They ensure that nurses handle patients in the right manner. Besides, ethical practices guarantee that nurses give precedence to the interests of the patients. Nurses face numerous ethical dilemmas when dealing with cases of abortion. Even though the medical policies oblige nurses to respect the patient’s right to autonomy, the medical personnel should ensure that they observe the principle of justice when carrying out an abortion. Besides, it is imperative to follow the principle of veracity. A nurse should be candid with a patient. A patient must understand the repercussions of conducting an abortion. Nurses should consider the intentions of a patient prior to assisting her to perform an abortion. Considering the plan of a patient would help to discourage women who perform an abortion so as to remaining in unethical businesses like prostitution.
References
Bandman, E., & Bandman, B. (2002). Nursing ethics through the life span. Upper Saddle River, NJ: Prentice-Hall.
Davis, A., Fowler, M., & Arosker, M. (2010) Ethical dilemmas & nursing practice. Upper Saddle River: Pearson Education.
Gallagher, K., Porock, D., & Edgley, A. (2009). The concept of ‘nursing’ in abortion services. Journal of Advanced Nursing, 4(1), 849-857.
Kane, R. (2009). Conscientious objection to termination of pregnancy: The competing rights of patients and nurses. Journal of Nursing Management, 17(1), 907-912.
Macciocchi, S., French, L., & Bush, S. (2009). Ethical issue: Doing good: The pitfalls of beneficence. Journal of Head Trauma Rehabilitation, 24(1), 72-74.