ethics lecture rant (sensitive topic) - page 3

Today our lecture was on ethics and values in nursing care. We were discussing abortions and our teacher was explaining to us that we can refuse to care for a patient if say they are in the hospital... Read More

  1. by   fergus51
    Well thanks Soleilpie. I do love my babies. I didn't have nearly as many grey areas when I worked in L&D, but the NICU is much different. What's ethical to one person is completely unethical to someone else and sometimes two opposite scenarios can both be care consistent with keeping a nursing lisence... It's a mess some days! I know those parents have the right to determine their infant's code status and I certainly don't think it's my business to decide for them, but I think a nurse who agrees with the ethics of the treatment will be a much better resource for the family than one who doesn't. Sometimes the most ethical thing is admitting our deficits and seeking help if we can't do the best job.

    btw, if you are interested in the issue of dehydration and death, you can always google "terminal dehydration". Hospice and palliative care is certainly not an area I am well versed in. My only experience was with this one child and the specialist docs came to speak with us about it before that plan of care was instituted.
  2. by   Ginyer
    I think that whatever environment we decide to work in we need to be aware of the most common ethical dilemmas that may arise. NICU and PICU nurses will come across very sick terminal babies that are only being kept alive because their family is too devastated to let them go...all we can do as nurses is make sure the pt is as comfortable as possible and educate the family on the situation at hand. You can't say...ok I would never do this..this and this and then work in a place where you'll constantly be put in those situations. Someone who would have a hard time caring for a hooker or drug addict shouldn't work in the local charity hospital ER. I realize situations arrise that we can't anticipate but we should be aware of the obvious.
  3. by   Marie_LPN, RN
    I realize situations arrise that we can't anticipate but we should be aware of the obvious.
    Exactly. Thank you.
  4. by   Rhoresmith
    I worked as a hospice care aide for 4 years and it changed my thinking on dying. I saw patients who were in so much pain that they SCREAMED and begged to die, because the doctor would not up the morphine because it could cause them to go into Respiratory failure or get this one, they were concerned the patient would become addicted to the morphine. I am sorry but NO ONE should have to be in pain for days and days on end waiting to die. I do not believe in giving them drugs to kill them but keep them from being in severe pain YES. I would take care of a patient that had complications from an abortion Yes. I would take care of a patient that was a criminal and did a terrible crime because it is my duty as a NURSE. As a student I was concerned last April when my brother was hurt in Iraq, and we had a Musliem man in the hospital who was very vocal about the "murdering American soldiers in his country" and had many other comments about how they all deserved to die. I would have went in and cared for this man I would not have liked it but I would have cared for him to the best of my ability because that is what I feel that a NURSE does. I am not saying that I was very relieved that I didn't have to care for him but I would have. About the man who is harrassing the nurses shouldn't the hospital have a policy about this ? Not sure how to handle that one
  5. by   NurseFirst
    Quote from Rhoresmith
    I worked as a hospice care aide for 4 years and it changed my thinking on dying. I saw patients who were in so much pain that they SCREAMED and begged to die, because the doctor would not up the morphine because it could cause them to go into Respiratory failure
    Wow. I thought the hospice movement was based upon providing adequate pain relief. In fact, I think it was the hospice movement that promoted the idea of "pain cocktails" (not called such anymore that I know of, I think because they are so common.) Pain cocktails were basically giving the patient pain medication around the clock, that it was a lot harder to bring a patient's pain under control if you waited until they were in pain to give the medication.

    Someone else said
    "I know that what constitutes ethical versus unethical treatment can be hard to define and is subjective but for the most part, people tend to agree on what ethical treatments are."

    Disagree with this statement; if that were the case, ethical committees in hospitals would not be necessary.

    And to the poster who posted on assisted suicide:
    They have had assisted suicide in Holland for many years--and they have surveyed the physicians, assuring them of their privacy. They asked the physicians if they had ever assisted someone's death even though they had not asked...the number who answered affirmatively was surprisingly high.

    Also, many years ago I sat next to a woman on the plane who ran the local hospice program out of a local hospital (before hospices became so popular; in part, I think, because Medicare now re-imburses for it.). I made a comment that she must approve of Dr. Kevorkian. Nothing was further from the truth. She even mentioned that many of Dr. Kevorkian's patients were not even terminally ill, but, rather, chronically ill. One, in particular, that she mentioned was a lady (in Oregon, I think) who had just been diagnosed with Alzheimer's and, though early in her diagnosis sought Kevorkian's help to die. I can't help but think of her family who lost the pleasure of her company that would have been available to them until she became much sicker.

    NurseFirst
  6. by   fergus51
    Quote from Ginyer
    You can't say...ok I would never do this..this and this and then work in a place where you'll constantly be put in those situations.
    I get what you're saying but just wanted to point out the situation I described is one I've only seen once. It isn't an everyday occurence.
  7. by   Aneroo
    I had one instructor who cared and assisted in abortions when she was beginning (this was back in the day). She said she was ok in assisting until she herself had a miscarriage, and then she felt unable to assist with the actual abortion. Many of the people who were on the pro-life side when we had this lecture pointed out their choice was for religious reasons (living in the bible belt).
    In terms of refusing care for a patient, if you have a serious reason not to care for this patient, then that's fine...but be prepared to take care of someone else. We recently went over this in class. Example- Rn is assigned a patient who is also an alcoholic. She gets mad and refuses care for the patient. Do you get mad? If you check to find out what's going on, maybe her father was a raging alcoholic and she doesn't feel she can care for a patient without getting emotionally involved. I feel it's better for the patient...if the nurse refuses, and you assign her that patient anyways, "just because"...she's going to give poor care (hopefully not though).
    -Andrea
  8. by   Tweety
    I would never participate in the murder of a fetus, so don't ask me to.

    I will care for an admission who had complications relating from an abortion because that's a whole other issue to me.

    I think there is nothing wrong with reassigning patients we are uncomfortable with, especially if it's a moral issue.

    I work with a Jehova Witness who doesn't hang blood. She doesn't mind caring for patients that have received blood, but she won't hang blood. I don't see how asking a nurse to sacrifice his/her moral principles is helping the patient.
    Last edit by Tweety on Feb 6, '05
  9. by   lmcnabbkv
    I think being a nurse is a choice and I don't think anyone is forced into it. What comes along with being a nurse is having and conveying a non-judgemental approach to ALL of your patients not just the ones whose principles you agree with. I think if someone would refuse to care for a patient who was suffering from complications of an abortion, then they chose the wrong profession. Nurses ARE professionals and are expected to act as such. This sense of professionalism means treating every person as an equal no matter whether they are a homeless alcoholic, an HIV positive patient, or someone's grandmother!
    Our job is not to agree with our patients and what they do in their own lives, our job is to provide compassionate, unbiased care to them!!

    Grrr...people like this make me mad~~ :angryfire :angryfire
  10. by   lapappey
    I can and have refused to participate in abortions. I feel very strongly about the issue. For that reason, I would prefer not to care for a patient who was going through complications relating to one not because I would find doing so in and of itself morally objectionable, but because it would be hard for me not to judge. I would never dream of making a forthrightly demeaning comment or compromising care but it would just be awkward. If I had to, of course, I would take such a patient, but I think it would be better for all if someone who did not feel strongly about the issue did.
  11. by   RNSuzq1
    I feel very strongly about the oath and pledge we all must take when entering the Medical Field - First and foremost - do no harm!!! When we are faced with a patient in pain, in trouble, etc. - our first duty is not to pass judgement on them and the reason they are in pain, but to help heal them.

    I'm not only a Nursing Student, but a devout Roman Catholic, life in any way, shape or form is a precious gift to me. I know I will never take part in ending a life, but also know that I'll be faced with patients that have tried to end their life through attempted suicide, women who are bleeding to death from abortions, etc. My first priority will always be the patient in front of me and what I can do to help them "get well"..

    As much as it breaks my heat, It's not my job to judge someone as to why they wanted to end their life or the life of their unborn child. As painful as it is to think about - perhaps they thought that was their only way out or the only option they had. We all know that anyone who is so depressed, stressed out, etc. to go to those extremes is in desperate need of help and that is where we come in - we are here to help them through this and perhaps make a difference in their lives.
  12. by   Spidey's mom
    Quote from 3rdShiftGuy
    I would never participate in the murder of a fetus, so don't ask me to.

    I will care for an admission who had complications relating from an abortion because that's a whole other issue to me.

    I think there is nothing wrong with reassigning patients we are uncomfortable with, especially if it's a moral issue.

    I work with a Jehova Witness who doesn't hang blood. She doesn't mind caring for patients that have received blood, but she won't hang blood. I don't see how asking a nurse to sacrifice his/her moral principles is helping the patient.
    This makes perfect sense to me.

    steph
  13. by   RedSox33RN
    Quote from SusanNC
    I feel very strongly about the oath and pledge we all must take when entering the Medical Field - First and foremost - do no harm!!! When we are faced with a patient in pain, in trouble, etc. - our first duty is not to pass judgement on them and the reason they are in pain, but to help heal them.

    I'm not only a Nursing Student, but a devout Roman Catholic, life in any way, shape or form is a precious gift to me. I know I will never take part in ending a life, but also know that I'll be faced with patients that have tried to end their life through attempted suicide, women who are bleeding to death from abortions, etc. My first priority will always be the patient in front of me and what I can do to help them "get well"..

    As much as it breaks my heat, It's not my job to judge someone as to why they wanted to end their life or the life of their unborn child. As painful as it is to think about - perhaps they thought that was their only way out or the only option they had. We all know that anyone who is so depressed, stressed out, etc. to go to those extremes is in desperate need of help and that is where we come in - we are here to help them through this and perhaps make a difference in their lives.
    Very well put, Susan!

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