Assisting in abortions

Nurses General Nursing

Published

I was watching an old episode of ER and it got me thinking (dangerous, I know). In the episode, an abortion clinic was bombed and the ER was receiving the casualties. One patient was in the middle of an abortion when the bomb went off and the abortion was not completed. When this was found out, the doctor's had to complete the abortion because she was bleeding out and crashing. An intern refused to participate even though without completing the abortion the patient would most likely die.

My question is, legally do nurses have to participate in a case like this? I've thought over the possible answers and can't decide.

Please, please do not turn this into a debate over whether or not abortion should be legal or not. I'm not looking into personal views, but the legalities of not participating.

Specializes in ICU.
I was watching an old episode of ER and it got me thinking (dangerous, I know). In the episode, an abortion clinic was bombed and the ER was receiving the casualties. One patient was in the middle of an abortion when the bomb went off and the abortion was not completed. When this was found out, the doctor's had to complete the abortion because she was bleeding out and crashing. An intern refused to participate even though without completing the abortion the patient would most likely die.

My question is, legally do nurses have to participate in a case like this? I've thought over the possible answers and can't decide.

Please, please do not turn this into a debate over whether or not abortion should be legal or not. I'm not looking into personal views, but the legalities of not participating.

In a case like this foetal demise would be immanent. It then becomes less an issue of aborting the baby than saving the mother. I work in a Church hospital that is historically opposed to abortions in a state that only legally allows abortion under very strict and circumscribed circumstances and yet the other week there was an "abortion" performed there because it was a rare, rare case of a cervical ectopic pregnancy with zero chance of the baby surviving and a huge chance for maternal demise. No-one had any moral or ethical problems with this, we just treated it as a sad case of foetal death and gave the poor woman all the support we could muster.

Specializes in ER/Trauma.
I doubt there such a thing as moral objection in law, which allows a nurse to abandon a pt.
I think this is the crux of the matter.

A similar debate rages on about prescription filling for contraceptives.

I thought the job of a nurse (or pretty much anyone in healthcare) was to provide for the comfort, care and wellness of patients.

Not be their moral judges.

Should I disrespect a "DNR" because I don't belive in "letting someone die" ?

But I suppose abortion is a big chunk of "grey".

Hmmm.....

Specializes in Critical Care.
I doubt there such a thing as moral objection in law, which allows a nurse to abandon a pt.

I would have refused to take any part in an abortion, whether it be from the start, or cleaning up the mess. I didn't assume the risk, the woman did. It's not my responsibility to compromise my values to mediate that risk.

I do not assume the responsibility of the risks that others take. In many cases, I do act to aid and mediate those risks, and, to the extent it doesn't conflict with my morality, that is my job. If, however, I refuse to act in ways contrary to my moral framework, my inability to act cannot cause that person's death. In that case, their participation in an abortion caused the death. It would be neither fair nor accurate to blame a nurse operating within his/her moral restraint for the results of another's action.

Let's put it another way, removing the radioactivity of abortion from the question. If a pt were to die unless immediately transfused, and the doc yelled at a passing by Jehovah's Witness (JW) nurse, "Quick, get that unit of blood up and running!", could that JW nurse refuse to participate in an action that is against the grain of his religious beliefs?

~faith,

Timothy.

Specializes in Education, Acute, Med/Surg, Tele, etc.

We discussed this very thing in Nursing school, and what I was told was that if you are going to object to anything...you better get it in writing with your contract with the employer right then and there when you sign on. If not, you don't have the right to refuse treatment or abandon a pt once they are in your care. The only grey area is that point of "accepting" a patient to be under your care officially... and those laws differ from State to State (then it can be possible to decline).

This became a huge deal in my area due to the fact that quite a while ago, cancer nurses were starting to have to provide chemo drugs to abort babys of mothers who were at risk of mortality if they continued with the pregancy. Many nurses (as I can certainly imagine) were very very upset about this and rules per facilities tightened up around here about declining treatments r/t moral/religious beliefs.

Specializes in Med/Surg, Ortho.

I dont think this would even be an "abortion" question if the woman came in to an ER bleeding to death. SHE is the one being treated at that point and if she is bleeding to death i really dont think it makes a hill of beans difference what caused the bleeding. You treat the patient at hand in the ER and leave the moral issues to the patients and the preacher. I guess what im saying is an ER is not the place for you to have the luxury of making a moral judgement on what someone has/was doing to get themselves there, and whether you want to take care of that particular patient, the issue is they ARE there and need help.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
I dont think this would even be an "abortion" question if the woman came in to an ER bleeding to death. SHE is the one being treated at that point and if she is bleeding to death i really dont think it makes a hill of beans difference what caused the bleeding. You treat the patient at hand in the ER and leave the moral issues to the patients and the preacher. I guess what im saying is an ER is not the place for you to have the luxury of making a moral judgement on what someone has/was doing to get themselves there, and whether you want to take care of that particular patient, the issue is they ARE there and need help.

:yeahthat:

This is interesting. I have saw on the news last year that alot of pharmacists in this area (I don't know about other areas) refuse to fill perscriptions for bith control pills because it is against their religious beliefs. Is this LEGAL for a pharmacist to do this?

I'm a pharmacist. We are ethically permitted to refuse to fill any prescription for any reason.

Right now on CNN, there's a story about a woman who walked into a pharmacy with a "bomb" demanding drugs. I thought at first that it might be Plan B but it was pain pills.

If the nurse feels morally offended by taking part in a procedure than she owes it to herself to stand by her convictions. Her self-respect should lead her to make her own decisions in life. Yes, she may lose her job, and have to suffer nagging guilt, but she can be comforted by remaining true to herself.

I would have no problem assisting in this situation. I would also have no problem standing in for a nurse who was morally offended by it. I respect people with strong convictions.

A nurse cannot abandon a patient - period. A nurse can notify a supervisor that the care she would be providing to that patient is against her religeous or moral beliefs. The supervisor will try to find someone else to care for pt. blah, blah, blah - same thing most everyone else has said.

We had a patient with a partial molar pregancy, 20+ weeks, good FHR, beautiful baby on ultrasound - mom dying before our eyes. Ethical consult in a catholic hospital at 0200, emergency abortion before day shift. The supervisor informed everyone involved what the situation was, asked if they would be able to care for this patient and offered to call someone else in if they were not comfortable caring for her.

Extremely sad situation for all involved, but the ethical dilema was handled 'textbook'. And yes, this is a real story. I was supposed to work that night but switched with another nurse. She was not happy with me the next day.

I'm a pharmacist. We are ethically permitted to refuse to fill any prescription for any reason.

Right now on CNN, there's a story about a woman who walked into a pharmacy with a "bomb" demanding drugs. I thought at first that it might be Plan B but it was pain pills.

I'm just curious as to why you would think right away she wanted Plan B? Do you live in an area which has few pharmacies? I'd think that in any town that one could find a pharmacy/pharmacist who is willing to dispense Plan B. I'm thinking that someone would be extremely desperate to obtain Plan B to go to such outrageous measures.

To the original topic: although we must define within ourselves our own moral compasses, it needs to be repeated that "ER" is fiction. What are the chances that one would meet up with circumstances such as this? For something to happen on this level I believe that we would be facing another crisis on the level of 9/11. However, up until 9/11 I suppose we didn't even consider that an event of that magnitude could possibly take place.

I am with Barbyann,

If you don't want to participate don't. It takes all kinds to make the world go round, so there ought to be someone around who doesn't feel the same way. I worked in a PACU that did partial birth abortions and all of the nurses took care of these patients. The problem was that some of the nurses treated these patients pretty poorly because they didn't agree with their choices. It just wasn't a problem for me. So if the issue arises, look for someone that can work with the situation.

As a nurse, particularly an ER nurse, you assume the responsibility of saving the lives of people who take risks you may be against--every day. For example, you might be morally against IV drug use, but if a patient is brought through the doors comatose d/t heroine overdose, do you refuse to administer narcan? That would be construed as negligence and/or abandonment.

As a previous poster mentioned, if this woman was bleeding out d/t a spontaneous abortion there would be no debate. Regardless of the cause of an emergency situation, in the case of imminent death, failure to provide any and all life saving measures is negligent.

Unless, of course, the patient is DNR status.

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