Values in Vocation
Throughout history, there have been numerous ethical dilemmas faced by medical professionals as they are required to provide beneficent care for the patient while accounting for the patient’s wishes, and without compromising their own moral values. However, many medical health professionals end up providing patient care that may contradict their own personal beliefs due to feeling obligated to their vocation. This is especially true of nurses because of their requirement to fulfill the doctors’ orders and their devotion to patients’ needs. One dilemma that has been widely controversial in recent years is abortion. As a nurse, the ethical dilemma arises as to whether their moral obligation to protect and promote life is compatible with participation in the termination of pregnancies.
The responsibilities of a registered nurse encompass a wide variety of duties depending on the institution and the patient’s diagnosis. Typically, registered nurses “provide and coordinate patient care, educate patients and the public about various health conditions, and provide advice and emotional support to patients” (“Registered 48”). Providing and coordinating patient care can include administering medications and treatments, collaborating with doctors or other members of the healthcare team, and providing assessments of the patient’s conditions and symptoms. The specific nursing interventions will depend widely on their area of practice. As for an abortion nurse, their responsibilities are to review the patient’s options, to take laboratory evaluations, to perform the sonography, and even to administer the medication which will terminate the pregnancy if the patient is eligible for the non-surgical procedure (Goss 47). There are many aspects of nursing care that must be taken into consideration.
In the medical field, abortion is defined as the “premature exit of the products of conception: the fetus, fetal membranes, and placenta from the uterus” (Glenton 730). The procedure is conducted by medical professionals such as doctors or registered nurses. Various types of abortion procedures exist depending on the trimester of the pregnancy. Up to the first seven weeks of pregnancy, a nurse may administer a combination of medications such as Methotrexate and Misoprostol to induce the uterus to release the developing tissue (Abortion). Up to the first twelve weeks of pregnancy, a minimally invasive procedure of manual vacuum aspiration can be performed (Abortion). Within the second trimester, a dilation and evacuation procedure can terminate a pregnancy up to sixteen weeks’ gestation in which the cervix is dilated and the fetal tissue is evacuated (Abortion). Lastly, an induction abortion which is rarely performed where “salt water, urea, or potassium chloride is injected into the amniotic sac” (Abortion). Abortions during the third trimester are not legal in numerous states due to the viability of the fetus, or the fetus’ ability to survive outside the womb. The procedure will affect the unborn child, the patient, the patient’s family, and the healthcare team in various ways.
One instance in which every previously stated person is effected is through determination of when life actually begins. The two opposing views that exist are that life begins at conception versus life beginning when the fetus becomes viable. One federal law referred to as the Unborn Victims of Violence Act, states that an individual must be punished for “intentionally killing or attempting to kill a human being” while in the mother’s womb; although this does not include abortions (Unborn). Many individuals argue that if someone else could be held responsible for the homicide of an unborn child, then a mother must be held to the same standard. According to Christian beliefs, life begins even before conception as stated in the Bible that before God “formed you in the womb, [God] knew you, before you were born, [God] set you apart” (Jeremiah 1:5). Contradictory to the belief that life begins at conception, some people may believe that life begins after the fetus becomes viable, or able to survive outside the mother’s womb. Historically, in court case of Roe v. Wade, the decision was reached that “the word ‘person,’ as used in the Fourteenth Amendment, does not include the unborn” (Landmark 661). Many ideas exist as to when life begins, which is why it is important for a nurse to determine their own personal beliefs and determine whether participating in termination is congruent with their own beliefs. Developing personal beliefs is important because the consequences of abortion may have long-term psychological effects such as guilt, shame, blame, depression, and more on those included in the procedure.
Within the realm of healthcare, abortion remains controversial due to the benefits versus the harmful effects of the procedure. One benefit for the patient is the alleviation of a consequence that may cause more trauma. For example, a longitudinal three-year study showed that “about 15,000 abortions are attributed to rape and incest – representing 1.5% of all abortions” (Glenton 730). The circumstances that surround abortion may be more traumatic than the abortion itself, and women may be forced to live with the consequences of someone else’s actions long after the incident. Terminating their pregnancy may reduce their risk of longer-term psychological damage, and increase the rate of the emotional healing process. Another situational aspect included in the healthcare examination is the possible decrease in child abuse that stems from unwanted pregnancies. According to a study among expectant mothers, “women with unwanted pregnancies may be at elevated child abuse risk” (Rodriguez 65). In this case, the healthcare worker may want to assess whether the benefit outweighs the risks of future consequences for the patient and the baby. An additional situational element that may need to be taken into consideration is the financial resources of the mother to support herself and the child. One survey displayed that “73% of respondents said they could not afford to have the baby” (Lawrence). The quality of the child’s life appears to be an important aspect of nursing considerations to determine the nurse’s ethical decision to participate in the abortion of a patient.
Numerous other ways in which the medical field attempts to debate the ethical standards of abortion occurs. One of these arguments is the justification of abortion as a means of population control. According to the Center of Disease Control, “a total of 652,639 abortions were reported” during the year 2014 (Registered). Population increase subsequently increases issues such as malnutrition, poverty, and lack of resources. Those employed in the healthcare industry may evaluate the risk for maternal injury and death caused by self-induced abortions when contemplating whether to participate in a patient’s pregnancy termination. According to the World Health Organization, an estimated “68,000 maternal deaths” worldwide resulted from unsafe and unlawful abortions (Elizabeth and Iqbal). A nurse may consider this prevalence when deciding how their moral or ethical values are affected by participating in a patient’s abortion.
From a nurse’s perspective, there are many different considerations that contribute to the ethical dilemma of determining whether to participate in a patient’s abortion procedure. The determining factor typically is the nurse’s own moral values and beliefs. However, nurses are not legally bound to participate in the treatment plan for a patient in which they conscientiously object. A nurse must assess whether it is morally right to terminate a pregnancy before the natural childbirth. The choice of participation is up to the nurse as much as it is up to the patient. The nursing healthcare profession is one in which the nurse and the patient or client must be in agreement with the treatment plan and administration.