Nurses face different types of ethical dilemmas in their profession. The dilemmas are encountered in the process of providing health care to patients (Schroeter, 2014). Addressing these dilemmas requires nurses to make critical decisions that have the potential to affect them and their patients in various ways. The main challenge in the nursing profession is lack of right and definite solutions to the ethical dilemmas. An ethical dilemma refers to a problem that does not have a distinct solution. It is important for nurses to practice professionalism in order to address such challenges satisfactorily (Schroeter, 2014). Ethical dilemmas can be solved through the application of different ethical choices that health care practitioners deem appropriate. An example of a dilemma encountered by nurses is abortion. The main challenge faced in dealing with abortion issues is the struggle to balance between legal and professional expectations. Abortion is legal in some states and illegal in others. Deciding whether to embrace it based on personal beliefs, ethical reasons, and legal provisions is difficult.
Ethics of abortion
Abortion refers to the process of terminating a pregnancy before birth by removing the fetus or embryo (O’Malley, 2013). People abort for several reasons that include rape, preservation of the mother’s health, defects such as genetic, mental or physical limitations, government policy (population regulation), and social factors such as poverty and fear of motherhood. Among these reasons, abortion for the sake of protecting the mother is the most acceptable while abortion for social reasons is the least acceptable. Proponents of abortion argue that a mother has the right to decide whether they want to keep the pregnancy or not. They further argue that a woman can abort if she determines that she cannot be able to take care of the baby due to certain physical, mental, or financial limitations. Finally, they argue that illegalizing the procedure increases the prevalence of illegal abortions carried out every day by mothers. On the other hand, opponents present arguments that reveal the unethical nature of abortion. They argue that abortion is murder because an embryo or fetus is a being that possesses life. Abortion is wrong because the mother might experience serious psychological and health issues after undertaking the procedure and thus affect her well-being. For instance, she might be overcome by guilt and depression or she might become infertile if the abortion is conducted unprofessionally. Finally, they argue that instead of conducting an abortion, it is better to keep the pregnancy and then give the child to an adoption agency.
Ethical issues that nurses face regarding abortion
There are six core principles that apply in the nursing profession with regard to addressing the issue of abortion. These principles include autonomy, beneficence, non-maleficence, veracity and justice (Butts & Rich, 2013). Nurses apply these principles while addressing abortion issues. Beneficence refers to any act of thoughtfulness that focuses on doing good to others. A nurse has the moral obligation to do what is right even though it goes against the wish of the patient (Butts & Rich, 2013). Health care practitioners are guided by the principle of professionalism with regard to acting in ways that protect, preserve, and improve the welfare of patients (Ulrich, Taylor, Soeken, O’Donnell, Farrar, Danis & Grady, 2010). Nurses should always make decisions that contribute towards the improvement of patients’ welfare and health. In addition, they should refrain from actions that harm their patient (Butts & Rich, 2013). Women chose abortion for varied reasons. Before conducting an abortion, a nurse should evaluate the mother’s reason for undergoing the procedure in order to determine whether conducting the operation is in line with the code of ethics that govern the nursing profession. Based on the principle of beneficence, a nurse should not conduct an abortion if the procedure is likely to cause harm to the mother or affect their physical or mental wellbeing. A mother could disregard the danger of aborting and request a nurse to carry out the procedure. However, the ethical principle of beneficence does not allow a nurse to endanger the life of a patient (Butts & Rich, 2013). On the other hand, if the life or the health of the mother is in danger, the nurse should do what is in the mother’s best interest and help her to carry out an abortion. It is imperative for nurses to consider the legal implications of their actions. The law allows abortion in certain situations.
Autonomy is another principle that helps nurses to address the ethical dilemmas they face at work. Professional autonomy refers to the authority conferred on nurses to make decisions and act based on their professional knowledge base (Butts & Rich, 2013). On the other hand, patient autonomy refers to the freedom that allows patients to determine their treatment plans. Respect for patient autonomy also includes seeking the consent of patients before performing any medical procedure, keeping patient information private, and giving the patient all information regarding the state of their condition (Ulrich et. al, 2010). Under this principle, the nurse is obligated to counsel a mother who wishes to abort and give the necessary information regarding their condition. The nurse should explain the risks of abortion to the mother and get her consent to carry out the procedure (O’Malley, 2013). The nurse should also keep the information private and refrain from divulging any information regarding a mother’s decision to abort to anyone. It is very difficult for nurses to balance autonomy and beneficence in dealing with abortion issues. This challenge arises when a patient’s decision conflicts with the nurse’s duty to refrain from any act that could harm the patient. In such situations, health practitioners should try as much as possible to respect the autonomous decision of the patient and ensure that they provide all the necessary information regarding the medical risks associated with carrying out the procedure. The nurse’s priority should be doing what is in the best interest of the mother.
Non-maleficence is a principle that requires nurses to avoid doing any harm to patients (Butts & Rich, 2013). In that regard, nurses should avoid carrying out dangerous procedures and treatments that might affect patients negatively. This principle is highly limited because abortion is dangerous and involves many risks. The ethical implication of non-maleficence is that the nurse is obligated to engage in practices whose benefits outweigh the risks (Butts & Rich, 2013). Applying this principle within the context of abortion requires nurses to avoid procedures that might harm patients. If a mother does not have a solid reason for aborting, the nurse should not assist her because by doing so, she will be harming the fetus. On the other hand, if abortion is the only way to preserve the health of the mother due to complications related to the pregnancy, then the nurse is obligated under this principle to help the mother abort.
Veracity is an ethical principle that requires nurses to maintain truthfulness and openness when divulging medical information to patients (Mohammad & Chagani, 2014). The nurse should provide a patient with the information they request regarding their condition and avoid concealing any details. One of the provisions of abortion laws in states that allow the procedure is the disclosure of information regarding the risks associated with abortion to patients who ask for the procedure (Mohammad & Chagani, 2014). Therefore, it is illegal for a nurse to conceal certain information from a patient in order to influence them into taking certain decisions. For instance, it is illegal for a nurse who is an opponent of abortion to provide misleading or vague information to a patient in order to deter them from aborting. Justice is an ethical principle that is related to veracity. Health care professionals are required to be fair and available to provide the necessary help that patients need (Butts & Rich, 2013).
In 1977, the Hyde Amendment was enacted into law by the Congress (O’Malley, 2013). It allowed women to use Medicaid funds to pay for abortions in case the pregnancy resulted from rape or incest, or if the pregnancy was endangering the life of the mother (O’Malley, 2013). In this case, it was imperative for physician to provide a conformational report that the pregnancy was endangering the life of the mother. In such situations, nurses are not faced with dilemmas. However, in cases where mothers disregard the warnings and decide to keep their pregnancies, then nurses face an ethical dilemma. The constitution of the United States allows abortion but provides states with power to control it to fit their legislation requirements (O’Malley, 2013). For instance, certain states do not allow late term abortions. Abortion is a dilemma that many nurses struggle to address because of conflicts between their professional duty and personal convictions. Nurses should not allow their personal convictions and beliefs to compromise their professional duties (Butts & Rich, 2013). A nurse might be against abortion under all circumstances. However, professionalism requires that they provide confidentiality, autonomy, privacy, justice, beneficence, fidelity, and non-maleficence to the patient (O’Malley, 2013). In case a nurse is unable to carry out an abortion due to their beliefs, they should request to be replaced by a nurse who does not have such beliefs.
Nurses face different types of ethical dilemmas in their work. The main challenge they face is the conflict between professional ethics and legal requirements. In addition, many are affected by the influence of their personal beliefs and convictions on their work. Abortion is an ethical dilemma that nurses face and that needs to be addressed through sound ethical choices. There are certain principles that aid nurses in making decisions while addressing abortion issues. These principles include beneficence, autonomy, justice, veracity, non-maleficence, and fidelity. Nurses should always evaluate the reasons for abortion in order to decide whether carrying out the procedure is in line with professional ethics and legal requirements. The law allows abortion in cases where the pregnancy endangers the life of the mother or in situations where the pregnancy resulted from incest or sexual assault. Nurses should always act in the best interest of the patient, refrain from performing nay harmful procedure, make decisions that promote the health and welfare of patients, and provide all the information regarding the risks associated with abortion. In addition, keeping patient information private and confidential is important. Nursing ethics require all health care practitioners to act in the best interest of patients. For instance, nurses should use their professional knowledge to advice patients regarding the risks of abortion and answer any questions the patients ask.
Butts, J. B., & Rich, K. L. (2013). Nursing Ethics: Across the Curriculum and Into Practice. New York, NY: Jones & Bartlett Publishers.
Mohammad, S., & Chagani, I. (2014). Telling the Truth: A Tussle Between four Principles of Ethics. Journal of Clinical Research and Bioethics, 5(2), 1-2.
O’Malley, C. M. (2013). Legal and Ethical Issues Concerning Pro-Life Choices. The Journal of Undergraduate Nursing Writing, 6(10), 45-50.
Schroeter, K. (2014). Do You Use your Professional Code of Ethics? Journal of Trauma Nursing, 21(3), 87-88.
Ulrich, C. M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M., & Grady, C. (2010). Everyday Ethics: Ethical Issues and Stress in Nursing practice. Journal of Advanced Nursing, 66(11), 2510-2519.