Published Mar 9, 2004
Here is the situation-I am a junior SRNA and I'm doing OB tomorrow. It looks like some of my cases may be abortions-haven't been in this situation yet. Are students "frowned upon" if they aren't comfortable performing these cases?
Honestly, I'm not 100% sure how I feel about it-I'm still contemplating the issue. I hope to get some insight from current students or experienced CRNAs who have been in this situation already-how you handled it, thoughts, etc...
Jedav (P.S. I am a "converted" Catholic)
Interestingly enough, I had this discussion with one of my classmates recently. While I won't share my personal view, it was decided amoung us, that while in the clinicall phase, it is important to do the cases presented to you. My friend however, has no intention of doing abortions (elective) once graduated. Currently though he is doing whatever case comes his way.
I would suggest that you first look at the cases you are expected to do, and see if they are really against your moral agency. There may actually be reasons behind the surgery that you are not aware of, and will be able to sympathize with. Additionally, i would have a frank discussion with your clinical preceptor, and share your hesitation regarding this topic. Be very objective when presenting this though.
Its been many years since I was a student but I think it would be ok to request to be in another room.
My program discussed this issue with us early in our education. The faculty supports our individual decisions to participate or refuse to participate in such cases. However, I don't know any one in my class who has yet faced this dilemma. An honest and forthright discussion - before the day begins - with the preceptor would be my own path. Go with your best judgment, not what you think you should do because you are "just the student".
This scenario was brought up to us as nursing students, and the final conclusion was that you cannot withhold care simply because your morals go against it. This is because your primary function is as a healthcare provider, and as a healthcare provider, you made an oath to deliver healthcare to all those who come at your door.
You are correct in the face of trauma, or life threatening illness. However, in the context of the question there is no health risk. If there were, I am sure we would all provide care without question. This question is dealing with elective procedures. i.e. Not every case that makes it to the OR is medically indicated.
You are first a human being, then a student. No one said you had to put away your own moral code to be a student. I long ago made the decision that I would not participate in abortions, short of an emergency. If in the future I consider changing jobs, and am considering a hospital where these procedures are performed, I would let them know that a condition of my employment would be that I do not have to participate in these procedures. Interestingly enough, I would not be in favor of a ban on abortions, but elect not to participate in them myself. (No condemnation, however, for those who do.)
Before you start, make your decision, then let your instructors and preceptor know if you decide you cannot for moral reasons participate in the procedure. I'm sure this won't be the first time they faced this situation.
Kevin McHugh, CRNA
I have to agree with nilepoc. Where is it written that you have have to jeopardize your values to be a good healthcare provider? Not that I am making any type of judgement here. How about those programs where the anesthesia program is in a Catholic hospital and their students are not allowed to particpate in abortions? I can name a couple of schools where this is the case. If there is an emergency and you have to decide between the mother and the fetus then perhaps you have an ethical dilemma especially if you have a problem with abortions. In the case of elective abortions there is no dilemma. As long as the SRNA or CRNA or any person who works in the OR providing direct care make it known that they do not wish to participate in such cases then they cannot be forced to participate in such cases. If this was the case you would have heard of major battles being fought at the supreme court. At my clinical site those SRNAs and CRNAs, as well as OR nurses who wish to participate in elective abortions do so, and those who do not wish to do so do not.
Sorry, but I disagree completely. As kmchugh said, you are first a human being. Witholding care does not, in my opinion, include refusing to be a provider for an elective abortion. I am deeply commited to my own morals, and not passing judgement on any one else for theirs at all, but I absolutely could not bring myself to sell out the ideals I bear in my heart for any reason, even if it meant I could not go to anesthesia school at all.
I have always been told that I have the right to refuse to participate in procedures I believe are immoral, but I better be damn sure I tell the hospital ahead of time. I don't show up the morning of and say "Oh, I don't do that". I can't see why the school would have a problem with it if you are upfront and give them enough notice.
Just wanted to say thanks to all who replied and give you an update...It ended up that all of my cases that were D&C/D&E resulted from situations other than that of "elective termination"...nonetheless, I am sure that I will encounter this scenario eventually and I feel more adequately prepared in my response.
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