The constant debate over the rights of those who identify with a particular sexual identity seems never-ending. How does it affect nursing? How does the new proposed bill in Michigan make the situation change? Find out the facts before forming an opinion.
Patients come in all sorts of flavors. You have your frequent flyers, your noncompliants, your criminals, and your sweet little senior citizens. All patients are different, and this is part of the joy of nursing. Everyone has their own story, and we get to listen to them, help them, and see them flourish. While not everyone agrees with it, patients come in all kinds of sexual orientations, too. You can have those who are gay, bisexual, transexual, or transvestites. Just a normal day on the job for a nurse, right?
Sexual identity is a hot button issue, and it is becoming hotter. The internet almost blew up a few weeks ago about a Michigan law that purported to allow EMS personnel to deny treatment to patients who identified with a particular sexual identity. Supposedly, this bill allowed medical personnel to refuse based on religious beliefs. You can't believe everything you read on the internet, folks, and there is more to this story than meets the eye. It still brings up the ethical question: can medical workers refuse to treat those who violate a strongly held religious belief?
The bill currently under consideration in Michigan is called the Religious Freedom and Restoration Act, or RFRA. It is currently in the Michigan house, where it was proposed, and still has to work through the system and be signed by the government before it is law. Therefore, the RFRA is not a law in Michigan, despite what the internet says. It is a long, long way from that, and it could change drastically as the politicians get their hands on it. No need to worry, really. It's just an idea at this point.
Another crucial bit to understand is that the bill does not specifically give medical personnel the right to refuse treatment to gay people. The bill doesn't mention medicine or homosexuals at all. Instead, the bill suggests that a person who is by law required to act can choose not to act due to a strongly held religious belief. This means that it could be used as a defense in court if the one who should act is sued by the one not acted upon. Mostly, this would entail civil cases, but this isn't where the story ends.
As most lawyers do, far more has been read into this bill than originally intended. Opponents of the bill have suggested that this law could be applied to medical personnel, from doctors to nurses to EMTs. In fact, it could affect any person required by law to act, and they would be in their rights to refuse. Please note, this is not what the bill says, but it is merely a possibility that could be read into the law to protect a medical professional who didn't act when they were required to.
It also brings up the idea of religious freedom. If you know that someone is gay and you disagree with that, do you have to act? The proposed law technically says no. When you hold a sincere and strong religious belief about something, the state cannot force you to act against those beliefs -- even if it means that someone else suffers because of it. This is a bit about the separation of church and state in addition to medicine. How far do religious beliefs go? Can you refuse someone anything because they don't agree with your religious point of view? For instance, should you be forced to rent your property to someone who is gay? According to this law, you wouldn't have to, and that would get you out of a discrimination suit.
Despite the fact that this bill is far from a law and despite the fact that it doesn't directly affect medical workers, it does bring up a disturbing question: do nurses have the right to refuse to treat patients who are gay? Look at it this way: Do we have the right to refuse treatment of someone with HIV or Ebola? Do we have the right to refuse treatment of a patient whose religion is different than ours? Do we have the right to refuse treatment to those who have a violent criminal past? I have taken care of child molesters, rapists, and murders. I certainly don't agree with their actions, but I took care of them to the best of my ability.
Why is it different for someone of a different sexual orientation? It all boils down to the patient. Here is someone sick in front of you. Does it matter how they have sex? Does it matter what they believe? Do you have the right to play God and decide who lives and who dies? No matter who our patients are, I believe that we have the legal and ethical responsibility to care for them to their last breath. We didn't come into nursing to pick and choose those that we will care for, and politics does not belong at the patient's bedside. Instead, nurses should care for who they are charged with -- criminal, homosexual, black, white, Islamic, or whatever. No one should be denied care, and that includes the modern day lepers, those with a different sexual identity.
References
Michigan House Bill No. 5958; Accessed January 9, 2015
http://www.legislature.mi.gov/documents/2013-2014/billengrossed/House/pdf/2014-HEBH-5958.pdf
Snopes; Slake Michigan; Accessed January 9, 2015
snopes.com: Michigan Exempts Emergency Medical Personnel from Treating Gay People?
I would personally never assist with an abortion but I would never apply for a job at an abortion clinic and expect them to accomodate me either. I have worked in Christian based facilities whenever possible because it allows me to practice without conflicting with my faith. I don't tell my patients or supervisors what to believe but they don't tell me what to believe either. It's about what you value most and how far you are willing to go to uphold those values.
I would personally never assist with an abortion but I would never apply for a job at an abortion clinic and expect them to accomodate me either. I have worked in Christian based facilities whenever possible because it allows me to practice without conflicting with my faith. I don't tell my patients or supervisors what to believe but they don't tell me what to believe either. It's about what you value most and how far you are willing to go to uphold those values.
I understand and respect that. What I find unacceptable is for someone to choose a specialty where for example abortions are part of the medical care provided, and then refuse to take part. That way patients suffer, and don't get the care that they're legally entitled to.
Personally I'm against circumcisions of male infants (or any male under the age of eighteen), so when I work anesthesia I rotate between adult Trauma and Neurology. It's a choice I've made, since I know that I'll never have to take part in circumcisions in those specialties.
I live in Michigan, and my answer to Lynda's question is: No. A thousand times no. How I feel about a person's lifestyle has no bearing on the quality of care I provide to my patients. If I'm even aware of their lifestyle (and often I'm not), I don't have to like it, but they are no less deserving of the best care I can give them than anyone else. Frankly I'm more upset about this bill even being considered than I am about anything my patients might be doing in their personal lives.
Utterly ridiculous. As healthcare professionals we are to treat everyone equally and provide standard care and that is what we signed up for. Those who don't want to and try to refuse treatment based on religious beliefs or personal issues (besides one in which endangers the provider) should never have started nursing in the first place. You know what you signed up for, so either shut up or get out.
I don't really see this as plausible enough to discuss. When the topic is refusing to take part in a patient's care for religious reasons it is generally assumed that the patient will not be abandoned but that someone else will provide that care.
The tenet of providing care regardless of race, creed, color etc is deeply ingrained in the culture of nursing, the question isn't really a new one. We weathered the very intense gay man/HIV/AIDs hysteria back in the day. As a practical matter I don't think this will impact healthcare providers very much.
The history of this bill would be interesting. Who initiated it, how did it even make it the Michigan legislature?
To me, I would think the person that introduces the bill is doomed to political failure.
It is important that we, as nurses and medical professionals, become politically proactive and thru our states nursing association, band together to defeat these types of laws.
You know, it is refreshing to hear so many nurses and healthcare providers agreeing with me. I think the bill is BS, too. I also think that the hoopla surrounding it is hysteria. It's a hypothetical and a legal issue. When writing this, I felt more like I was writing an investigative law article than a nursing one.
I think that most of us are smart enough to avoid the abortion issue, if it bothers us. Would you take care of a woman who came into your ER after a botched abortion? Would you have a hard time with that? Personally, I wouldn't, but now I am curious. I would take care of anyone I was assigned to, but I don't hold these strong beliefs. Even if I did, I would still provide my very best care.
I really love this discussion, and I'm proud to be part of a profession with such integrity.
Lynda
This law, if passed, and used roughshod, will be challenged due to Civil Rights laws, EMTALA, CMS and if REALLY out of control, The Supreme Court.
It wound get that far when people start getting fined due to CMS, even if someone attempts to evoke a state law, Federal law supersedes state law in situations such as this, along with enforcement of fines...when it hits someone's pocket book, there will be a change in tune...
As nurses, it not about our OWN personal views; rather, it is about the patient.
I find those who can't reconcile those issues are ones that have contentious ethical conflicts, which usually lead to burn out, or landing in hot water in their jobs.
Libby1987
3,726 Posts
I'd like to think we healthcare peeps would police ourselves if it did pass, we would not tolerate this behavior in a peer, they would be ostracized out of town.