Specializes in Nurse Leader specializing in Labor & Delivery.
Actually, I mean that question in reference to the care you give, not what your personal opinion of this patient would be. Would you to refuse to provide nursing care to a satan worshipper?
Did you notice the poster's username (an allusion to the film Dogma, I believe)? I'm pretty sure that was a joke.
Specializes in Nurse Leader specializing in Labor & Delivery.
Well, I am a little tempted to put this in all caps, because I am not sure if you are missing this point, or disagree with it:
An individual nurse refusing to care for a patient is not the same as refusing a patient care.
Nobody in this thread has advocating terminating the basic human right of healthcare to anybody.
But what happens if ALL the nurses refuse to care for the patient? Since you accept refusal of care to be a valid option, it certainly opens the possibility that this could occur.
All of this is interesting and is a very good discussion.
Based on some of my own experiences and especially observations, I'm pretty sure that thoughts of a noble regard for humanity are often not the primary motivator for providing competent care to unsavory characters. My general observation would be that there's a big dose of feeling good and better-than about oneself for "rising above" that comes into play. I will take good care of you because I'm not like you. I won't stoop to your level. I'm actually a better human being. Look here what I'm doing despite what you did. I'm also better than my coworkers who are whispering about you.
That kind of internal dialog.
I think the whole thing is more egocentric or even narcissistic - and way less altruistic - than most will admit.
No I have never refused to care for anyone based on moral objection, I can't think of a particular case where I would. But I've experienced a bit of what I wrote above, and based on observation of other nurses in numerous scenarios, I know I'm not the only one. This is not my purposeful MO and I don't think it's other nurses' either, but rather thoughts and feelings that get people through sometimes. Maybe it is a defense mechanism, I don't know.
But I find it sincerely interesting that this topic usually includes some fairly righteous talk, given the observations above (which I personally believe are not uncommon).
All of this is interesting and is a very good discussion.
Based on some of my own experiences and especially observations, I'm pretty sure that thoughts of a noble regard for humanity are often not the primary motivator for providing competent care to unsavory characters. My general observation would be that there's a big dose of feeling good and better-than about oneself for "rising above" that comes into play. I will take good care of you because I'm not like you. I won't stoop to your level. I'm actually a better human being. Look here what I'm doing despite what you did. I'm also better than my coworkers who are whispering about you.
That kind of internal dialog.
I think the whole thing is more egocentric or even narcissistic - and way less altruistic - than most will admit.
No I have never refused to care for anyone based on moral objection, I can't think of a particular case where I would. But I've experienced a bit of what I wrote above, and based on observation of other nurses in numerous scenarios, I know I'm not the only one. This is not my purposeful MO and I don't think it's other nurses' either, but rather thoughts and feelings that get people through sometimes. Maybe it is a defense mechanism, I don't know.
But I find it sincerely interesting that this topic usually includes some fairly righteous talk, given the observations above (which I personally believe are not uncommon).
I don't know if I was one of the righteous or not.
But, I kind of agree with your point about motivation, including my own.
My providing care for patients, regardless of their backgrounds is definitely not altruistic or noble for me, and has everything to do with how I view myself rather than the patients inherent rights.
I like to see myself as a professional, and refusing care based on my beliefs would make me less professional. Whether or not some Nazi/Klansman/child molester has a basic human right to healthcare is completely irrelevant in my decisions.
I am pretty sure that that would be an egocentric decision on my part, but probably not narcissistic. It absolutely lacks altruism.
But what happens if ALL the nurses refuse to care for the patient? Since you accept refusal of care to be a valid option, it certainly opens the possibility that this could occur.
Yes it does.
While there are certainly real world examples of an individual nurse refusing to care for certain patients, are there everybody refused?
So, you are the manager.
The school shooter who killed a nurse's child was injured and needs care.
That nurse refuses.
What do you do?
If either you or prostudent think that is an outlandish example, go ahead and use one which you find more real world- there are thousands of possibilities in which somebody has a legit objection to caring for a particular patient.
I understand and agree with the "slippery slope" argument.
I don't know if I was one of the righteous or not.
Thank you for the discussion. It was a general statement about our collective and individual humanity and how it plays out. Not an indictment of anyone but just a take-off on the discussion that I find interesting. I will try to clarify:
Yes, the reason most commonly advocated to care for everyone without making morality judgments is because of a principle of regard for humanity/human beings and their rights. But I don't think when it comes right down to it that is the most common principal motivator. I just think that's an interesting human phenomenon.
How about this:
I do judge you, and I've judged that I don't want to be like you. Right now you need some help, and although I personally think you don't deserve it, I wouldn't want you to suffer ill effects because I chose to act in a manner consistent with they way you have acted - which I abhor.
I happen to think that's much closer to reality. ^
And is much more about the nurse than the patient.
This, too, has been portrayed dramatically - scenes like: "You're not dying on me, a$$shole." IOW, "I really don't care about you but I'm not going to leave any room for someone to say that your death had anything to do with faulty morals/ethics on my part." Or "......but I'm not going to act immorally, as you have."
Big difference between refusing care of a patient (the actual person) on moral grounds and refusing to take an active participation in an action.
Title VI of the Civil Rights Act of 1964 protects those who refuse to participate in abortions because of their religious beliefs.
From the patient's perspective the difference probably isn't all that big, if that one specific "action" is what they want and need.
We're not talking about the patient's feelings. We're talking about the civil rights of health care providers. If a constitutional civil right to not participate exists, the patient's objection to it is secondary.
It isn't about emotion, it's about the law.
I have no idea why you mentioned emotions in your reply to my post, since my comment was wholly based on logic.
I wasn't making a point about how a patient feels, or how I feel for that matter. The discussion here is whether the right of the patient to receive care is absolute, or if it's acceptable to start making exceptions where we allow a nurse to withhold care based on thenurse'svalues. This is about how a nurse's moral convictions are allowed to have a direct impact on patient care in a very concrete sense.
The thread OP started is about whether or not a nurse can refuse to provide care to a patient based on the nurse's moral objection.
I'm aware that lawmakers in your country have decided that it's sometimes acceptable to refuse care to a patient. You guys have made the choice, that in one specific instance, a nurse's religious or ethical convictions trumps a patient's right to receive the care they want. Other countries, like mine, have chosen differently.
If I interpret you correctly, you think there's a big difference if a nurse refuses to provide care, in the instances that your laws gives the nurse the right to do so, compared to when they refuse for a reason not protected by law. Since you say that a "patient's objection" is secondary, I guess you are of the opinion that a nurse's civil rights are more important than the patient's right to receive the care they are legally entitled to?
I'm personally not seeing the big difference. Refusing care is refusing care. I guess a nurse can feel better about refusing care and also be able to keep their job if they have a law which supports their right to refuse, but to me it doesn't make withholding care morally more justifiable. Merely legally.
I also doubt that the patient would see the big difference, if they found themselves in the unfortunate situation where all the available healthcare providers asserted their constitutional right. That would obviously be to the detriment of the patient.
Hypothetically, if the civil rights of the nurse to refuse to provide care were expanded to encompass more than just refusing to take part in abortions, would that make it ethically and morally acceptable for a nurse to deny those other medical services and care to other groups of people?
I have no idea why you mentioned emotions in your reply to my post, since my comment was wholly based on logic.
I wasn't making a point about how a patient feels, or how I feel for that matter. The discussion here is whether the right of the patient to receive care is absolute, or if it's acceptable to start making exceptions where we allow a nurse to withhold care based on thenurse'svalues. This is about how a nurse's moral convictions are allowed to have a direct impact on patient care in a very concrete sense.
The thread OP started is about whether or not a nurse can refuse to provide care to a patient based on the nurse's moral objection.
I'm aware that lawmakers in your country have decided that it's sometimes acceptable to refuse care to a patient. You guys have made the choice, that in one specific instance, a nurse's religious or ethical convictions trumps a patient's right to receive the care they want. Other countries, like mine, have chosen differently.
If I interpret you correctly, you think there's a big difference if a nurse refuses to provide care, in the instances that your laws gives the nurse the right to do so, compared to when they refuse for a reason not protected by law. Since you say that a "patient's objection" is secondary, I guess you are of the opinion that a nurse's civil rights are more important than the patient's right to receive the care they are legally entitled to?
I'm personally not seeing the big difference. Refusing care is refusing care. I guess a nurse can feel better about refusing care and also be able to keep their job if they have a law which supports their right to refuse, but to me it doesn't make withholding care morally more justifiable. Merely legally.
I also doubt that the patient would see the big difference, if they found themselves in the unfortunate situation where all the available healthcare providers asserted their constitutional right. That would obviously be to the detriment of the patient.
Hypothetically, if the civil rights of the nurse to refuse to provide care were expanded to encompass more than just refusing to take part in abortions, would that make it ethically and morally acceptable for a nurse to deny those other medical services and care to other groups of people?
I think you make good points. But, I think there is an important distinction between a nurse refusing to care for a patient, and a pt not receiving care.
As of yet, I haven't seen anybody in this thread claim some PT's are unworthy of care.
And, clearly these two are connected, and one can lead to another. But, they are still separate issues.
In other words, a hospital can respect a nurse's moral convictions while still upholding the patient's rights.
This is not theoretical- it is what happens. Where I work, periodically somebody requests to not have a particular patient for any number of reasons. I can't imagine if that reason was on moral grounds, the charge would not comply. Now, if a nurse refused every single pregnant woman on moral grounds, it would be time to have a discussion about work choices.
Specializes in Nurse Leader specializing in Labor & Delivery.
My question is, what would you do as her manager.
If it were a situation where the life circumstances of one specific nurse would make it such that caring for the patient would be a hardship for her (such as your example of a nurse caring for her child's murderer), I would ask another nurse to volunteer to take the patient.
If it was such that the patient was simply abhorrent and that all the nurses would find the assignment unpalatable, then I would explain that this is our job, and I expect them to provide professional, competent care for them, regardless of the situation.
I feel like your "child shooter being cared for by dead child's nurse mother" a good example of pro-student's "ad absurdum", though. I mean, I'm sure we can think of lots of ridiculous rhetorical situations to prove your point. No, I would not force a nurse to take care of her rapist, or her husband's murderer, or the guy who burned her house down, either.
No employer or other person shall require a physician, a registered nurse, a licensed vocational nurse, or any other person employed or with staff privileges at a hospital, facility, or clinic to directly participate in the induction or performance of an abortion, if the employee or other person has filed a written statement with the employer or the hospital, facility, or clinic indicating a moral, ethical, or religious basis for refusal to participate in the abortion.
A nurse or other provider is required to act in the best interest of the patient.
Justice underlies the principle of nondiscrimination and the obligation of nurses and other providers to work for the public good.
Having accepted a patient s nurse must not abandon a patient. BUT the nurse may withdraw from caring for a patient by transferring the patient to another provider willing and ready to take over care.
The caregiver's right to withdraw his or her services must not be used to deny a patients' right to care.
I think that like abortion any nurse who will refuse care to any patient needs to inform the employer before hire or ASAP after making that decision.
I have worked with Jehovah s Witness Nurses who will not administer blood or blood products. Management is aware and the schedule ensures sufficient nurses to provide that care to a patient who needs it.
I think if a nurse finds out an assigned patient committed murder (for example) that nurse needs to inform management so a willing nurse can be assigned.
Such actions will, in my state, prevent loss or discipline of a nurses' license. It may not prevent discipline or termination by the employer. For some loss of a job would be preferable to doing what that nurse thinks is wrong.
PS: I would not participate in abortion. In the very rare. nearly impossible event that I was the only person who could assist in termination pf pregnancy to save the life of the mother I would do so. That is because if it is too early to save the baby both mother and baby would die so saving the mother would be pro-life. I my opinion.
If it were a situation where the life circumstances of one specific nurse would make it such that caring for the patient would be a hardship for her (such as your example of a nurse caring for her child's murderer), I would ask another nurse to volunteer to take the patient.
If it was such that the patient was simply abhorrent and that all the nurses would find the assignment unpalatable, then I would explain that this is our job, and I expect them to provide professional, competent care for them, regardless of the situation.
I feel like your "child shooter being cared for by dead child's nurse mother" a good example of pro-student's "ad absurdum", though. I mean, I'm sure we can think of lots of ridiculous rhetorical situations to prove your point. No, I would not force a nurse to take care of her rapist, or her husband's murderer, or the guy who burned her house down, either.
That is also what I would do.
As far as the ad absurdem- sure. But, you don't have to try all that hard to come up with examples that don't meet your definition of ridiculous. There are plenty. It's just a question of where you draw the line, once you accept that there are instances in which refusing care on moral grounds can be acceptable.
klone, MSN, RN
14,857 Posts
Did you notice the poster's username (an allusion to the film Dogma, I believe)? I'm pretty sure that was a joke.