Ethical considerations

  1. Doing my ethics paper and looking for input concerning ethical implications of treating or refusing to treat patients convicted of child sexual abuse, child rape and murder or other similarly repulsive acts. Having a hard time finding any articles on this specific subject. Suggestions, opinions, general ramblings....? There must be some of you who've dealt with these situations before...how'd you do it? Any inner conflicts? Thanks.
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  2. 18 Comments

  3. by   SportyNurse
    Not really a huge ethical dilemma there... I treat every pt equally no matter what. I've had experiences at county with a lot of inmates from the state prison here which happens to house mainly sex offenders. My personal philosophy is that I don't need to know what they did in order to do my job and take care of them. It would be highly unethical not to take care of them.

    I did have one pt who was trying to get under my skin and told me about all the things he did to little boys (I have two sons). I hope he rots in hell, however for those 8 hours I gave him the same care I gave everyone else. Another nurse had the same pt and chose to ignore his requests for pain meds (s/p hip repair), and was in no hurry to provide care. I really think that was wrong.
  4. by   karenG
    I've had this dicussion many times, and the general feeling is that though we may not agree with what they do etc, at the end of the day, they get the same treatment as every other patient. Its not my place to judge someone- there is already someone who does that! I'm happy to wait for him to judge and deal with them appropriately!!


    if you expand this ethical dilemma... how do you feel if you are a devout christian asked to treat a person who is wiccan? Or a muslim who has a completlely different view on life to a christian? or a middle european man who has is a total MCP and treats woman badly?? do you make an ethical judgement that that person does not fit my view on life and therefore does not deserve treatment?? some countries/religions/health care beliefs do not sit well with mine but we are people and we are different.

    should we only care for people who meet our view of acceptable behaviour? there are a few patients I wouldnt care for if this was the case!! But we accept that there are differences.

    I guess what I am saying is, I dont feel I have the right to judge someones behaviour and deny them good health care. there is a saying 'there but for the grace of God go I'. Its a good saying and one I think of when i meet someone who behaves in a way I find totally unacceptable.

    rambled enough!

    Karen
  5. by   JBudd
    I'm not responsible for his behavior, only my own.

    I refuse to let the person you describe have enough power over me to change my behavior: I will provide good care for anyone.

    Having stated my philosophical conviction, I have to admit that some of the prisoners brought into my ER in shackles may not get as much conversation as others; but they get their meds and teaching and treatments at as high a professional level as anyone else. Frankly, the guards don't encourage a lot of familiarity with the really hard core ones.
  6. by   augigi
    I found a bunch of journal articles on this when I searched "refusal to treat", if you want to try that.
  7. by   snowfreeze
    Occasionally there are true ethical reasons for not treating a patient. One might be that the patient did harm to yourself or a family member of yours in the past. You would have serious issues treating that patient. The patient would probably have serious issues with you being their nurse.
  8. by   Amber_student_nurse
    Nurses can make a conscientous objection meaning can refuse to treat (look after) the patient on the basis that it conflicts with her ethical standing. Has to be a strong objection and not impair on patient care.
  9. by   Farkinott
    Thankfully if I feel I cannot deal with a patient because i have issues with who they are or what they have done my organisation accepts that and I wil be reassigned. If you loathe someone and can't provide a level of care that you would to any other client then you need to acknowledge that and make note of it to your superiors. As nurses we are human and we need to acknowldege it.
  10. by   RNsRWe
    I can and will refuse an assignment if I feel that I cannot give that patient the level of care expected of me. There will be someone else who can and will take that assignment. What I won't do is take an assignment I shouldn't (for whatever the reason) and then not give appropriate care.

    Better to let someone else deal with it; you're bound to get someone else's "I can't handle this" one day.
  11. by   pkapple
    Agree with all the above, worked in a facility that assisted with fetal termination, not routine abortions, but dead fetus, late term genetic stuff, etc. the policy there was a nurse with strong conviction could refuse and take a different assignment, it wasn't a case by case the nurses declared the conviction/religious issue early on and everyone abided by it.
    Now in a small facility with no other staff available-one would be obligated to provide care, we are nurses..it's what we do!
  12. by   BSNtobe2009
    Quote from SportyNurse
    Not really a huge ethical dilemma there... I treat every pt equally no matter what. I've had experiences at county with a lot of inmates from the state prison here which happens to house mainly sex offenders. My personal philosophy is that I don't need to know what they did in order to do my job and take care of them. It would be highly unethical not to take care of them.

    I did have one pt who was trying to get under my skin and told me about all the things he did to little boys (I have two sons). I hope he rots in hell, however for those 8 hours I gave him the same care I gave everyone else. Another nurse had the same pt and chose to ignore his requests for pain meds (s/p hip repair), and was in no hurry to provide care. I really think that was wrong.
    I agree with how you handled it, as difficult as it may have been. I would think it would be a violation of everything we learn to do.
  13. by   autumnd
    Something I realized is that those people may be convicted, but sometimes you never know if you're treating someone who has committed the same acts but was never convicted or ever suspected in life. They say those people come in all forms - they look like the friendly grocer, your neighbor...sadly, there are many times family relatives commit these things to their own nieces and nephews. I know it's not a pleasant thought, but it is the reality.

    I know it must be hard to treat someone who you know has committed offensive acts that you feel strongly against, but I guess like some others said previously in this forum, they are there as patients to receive care, and we put ourselves at legal risk and have our ethics questioned as professionals if we don't treat them. I guess I can't speak for myself because I am not a nurse yet. I am applying to nursing schools and hoping I get in January (!)...I'm new here. A classmate who gave a talk about the importance for nurses to know how to deal with stress, told the class about this site - that it has forums to talk to others, and good for nurses to get support because it's a good way to handle stress.

    Thanks for reading. This was my first post.
  14. by   Marie_LPN, RN
    As much as i may hate and despise people who do things like that, when they are my pt., i have to give equal care to all.
    Last edit by Marie_LPN, RN on Oct 3, '06

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