An Ethical Dilemma for a professional Nurse - Research Paper Example

An Ethical Dilemma for a professional Nurse The Ethical Issue in this case is the challenges facing both Mr. and Mrs. A, and the nurse providing health care services to them. Mr. A prefers to get his promotion rather than having a baby at that time, as this was something he worked many years for, and cannot afford any set back. According to Sherwin (1992), when facing troubling ethical issues, men in general always seek to gain the dominant roles, and choose without thinking that others can be hurt as a result of the decisions made. Mr. A on this occasion decide not to have the baby, without having any regard for his wife’s, their parents need for grandchildren, or the baby yet to arrive and cannot represent him or herself. Mrs. A. played the role Sherwin (1992), postulated she would when facing similar troubling ethical issue, in that she displayed an emphatic form of reasoning which propel her to seek an innovative way out of the problem, so that both parties benefit. She chose not to have the child in order to please her husband, who she believed deserve the promotion, so that in the end she is happy that he is happy. They achieved what Oberle and Bouchal (2009) called mutuality, in that both receive benefits, but this was at the expense of the unborn child, the wishes of their parents and the nurse administering support to them. Literature on Abortion The expulsion or removal of the fetus from the womb of a woman or abortion has been the subject of discussion for thousands of years, especially with regard to its ethicality, and has culminated into a divide where many professes to be either pro life or pro-choice, depending on the type of moral lens they are wearing, a significant percentage of the population be hold the middle ground or neutral status, sometimes for political reasons. Abortion has become a troubling moral issue in the lives of people especially in America, despite the (Rowe vs. Wade 1973) landmark ruling which have women the option to be pro-choice, because of the role of members of the American Medical Association has played in the early years according to The National Abortion Federation (2011). The organization sought to lobby the government to make the practice illegal in an effort to direct all patients to them, and eliminate the homeopaths, midwives, apothecaries, and other apothecaries from their patients (National Abortion Federation, 2011). In Latin America and the Caribbean, abortion laws are highly restrictive, according to Taucher (2004), Repolge, 2007, Boland and Katzive, 2008), especially in Chile, El Salvador, and Nicaragua, where it is totally prohibited. Government throughout the region has attached themselves to the Catholic doctrine, and adopted an inflexible position in debates concerning contraception and abortion, according to Humans Right Watch (2005). The women in Latin America because of this inflexible stand and the morality of the Catholic doctrine , which is based on a 1870 adoption of the concept of papal infallibility in pronouncement made ex cathedera, and because no new revelations has been made, are made to suffer immensely, according to Cook and Davis (2005). Abortion Statistics The US Center for Disease Control and Prevention, a division of Health and Human Service, has collected abortion surveillance data since 1969, and its latest report is for the year 2007 ( Center for Disease Control and Prevention, 2011). The report from 45 states showed 827, 609 cases of abortion occurring, with an abortion rate of 16 abortions per 1000 women aged 25 to 44, and a ratio of 231 abortions be 1000 live births. Compare to 2006, the rate and ratio was 2 and 3% respectively less, indicating some form of progress to that point according to the Center for Disease Control and Prevention (2011). Women in the 20-29 age group overall occupied 56.9 of all abortions, while the adolescent accounted for 16.5% rate and 14.5 abortions per 1000 women (Center for Disease Control and Prevention , 2011),. Reasons for Abortions Women may choose to abort their children for the following legally medical reasons 1. Their fetus have been found to have Tay Sachs disease, which is an inherited lipid disorder that causes damage to the tissues and nerves in the brain (Ballantyne et al 2009) 2. Anencephaly which is an untreated non-hereditary Cogenital condition, which is caused by a defect in the formation of the neural tube during fetal development, resulting in the absence of a portion of the brain of their unborn children (Ballantyne, et al, 2009) 3. The presence of Phenylketonuria (PKU) , which is an inherited error in the metabolism requiring a special phenylalanine free diet in early life during pregnancy –a commonality in developing world due to financial limitations (Christianson, Modell, 2004), 4. The identification of Thalassemia, a potentially manageable Cogenital disorder common in countries where Malaria is endemic –Latin America (Ballantyne et al 2009) Consequences of women not able to have abortion Women not able to have abortion according to Ballantyne may suffer psychological harm, when they are forced to carry the pregnancy of cogentially disordered fetus, due to lack of finances. They endure pain, and in later life may suffer from disempowerment in the reproduction process (Ballantyne, et al, 2009). Social Injustice is another consequence that befalls these women suffering from fetal abnormality and is able to secure abortion. They face the possibility of suffering from infections, and serious pains as a result of illegal and unsafe abortion Meanwhile, the wealthier women in developing countries can travel out of the countries to have safe abortions, according to Ballantyne et al (2009). Social Economic burden is also placed on women with unable abort their abnormal unborn children, in that they are unable to provide the financial resources to care for the children when they are delivered. They will also experience serious emotional burdens due to the fact the health services in most cases has to be the source of the provision on the service for these children for extended periods (Ballantyne et al, 2009). Nurses in regions like Latin America and the Caribbean, face ethically challenging issues, when dealing with pregnant mothers with various types of sickness, the threats of arrest and career ruinations for breaching the dominant Catholic rulings on abortion. Nursing Interventions Nursing Interventions can benefit females considering abortion, in that they can become trusting and confidential in the nurses providing support for them, and be able to relate all areas of concern, under the engagement aspects of relationship ethics, which according to Oberle and Bouchal (2009), is the art of relating to each other, in a trusting responsive manner. The process enables nurses to fulfill their responsibility and accountability role without imposing their personal values and beliefs on them when they are contemplating making vital life changing decisions. However, these life saving professionals from time to time, according to Keatings and Smith (2009), experience what is called moral adversity, as a result of disagreements over critical facts or concepts encountered during the process of administering their services. Nursing Standards Nursing Standards according to the College of Nurses of Ontario (2009) are expectations that contribute to the protection of the public, by informing nurses of their accountabilities, and what the public should expect from them in pursuit of their duties. The standard according to the institution, applies to nurses of all categories, regardless of their roles, areas of practice or job descriptions (College of Nurses of Ontario, 2009). Ethical Issues When facing ethical issues, emanating from various situations, according to the College of Nurses of Ontario (2009), and these values supports diverging course of actions, an ethical dilemma has developed. and this will require different approaches depending on the specific circumstance. Jameton (1984), adds to the scenario, by calling what the nurses face as ethical distress, in that they may know the right thing to do, but the various constraints make doing the right thing difficult (Jameton, 1984). A critical approach that nurses can take when facing these issues, involve paying close attention to all aspects of the issue, especially the clients beliefs, values, wishes, , and ethnic backgrounds, their personal beliefs and values, the organization standards and expectations, their responsibility to the team, and their professional expectations (College of Nurses of Ontario, 2009). Ethical Lenses Relational Ethics Ethics associated with conducting relationships with patients, families, colleagues, communities, or the environment using moral standards foundational to the nursing profession, according to Oberle and Bouchal (2009). The concept encompasses all who might be involved in the decision process and be affected by the outcome, and the invoking their cooperation. Relational Ethics consist of four aspects, namely embodiment, non-coercion, mutuality, and embodiment ethics, according to Oberle and Bouchal (2009). Feministic Ethics This ethical lens involve women taking careful attention to their patterns of thoughts, behaviors, values, and power in relationships during difficult decision making processes, according to Oberle and Bouchal (2009). It was also defined by Ethics Resources (2011), as an attempt in Western cultures to revise, reformulate, or rethink those aspects of traditional of their traditional ethics that usually depreciate or devalue women’s morale and experience (Ethics Resources, 2011). Had Mrs. A knowledge regarding how to apply feministic ethics, should perhaps would have had second thoughts about engaging in mutuality relational ethics, and facilitate her husband’s desire to abort the child in favor of his promotion. Mr. A showed little concern for Mrs. A increasing age, and the fact that after the abortion, if she survives, she may not be able to have another child. Applications A vital ethical aspect concerning the issue with Mr. and Mrs., is the non coercion aspects of relationship ethics, which Oberle and Bouchal (2009), describes as the process of not forcing other to make particular choices. The strength of this approach is that it gives patients free will to make their choices using their ethical values as the standard and not of the supporting nurses. On the other hand, the opportunity to help the patients to make the right decision may be lost forever, and may bring feelings of remorse for having failed to offer the help that matters. The engagement aspect of relationship ethics, according to Oberle and Bouchal (2009), involves relating to others in a trusting and responsive manner. This approach works well in conjunction to the non-coercive approach, in that patients will accept the bonds of friendship and trust and communicate all areas of concerns regarding ethically challenging decisions. This will allow the nurses, who according to Keatings, and Smith (2009), are supposed to possess sound knowledge base, ethics, ethical theory, practical theory, reasoning skills, and willingness to take risk and be accountable, to decide on the best intervention approach to use to effectively help them to arrive at the most appropriate decision. However, on the other hand, in case where the patients are seeking support that involves commitment to secrets that violates the values and beliefs of the nurses, the issues may end up as ethical dilemmas, because the nurses may want to help but not break their moral codes or hurt the feeling of the patients that have developed great levels of trust in them. Areas of Conflicts Areas of conflicts during the offering of interventions support, in areas of religious beliefs, which nurses are not prepared to violate by supporting abortion in any way, due to the fact that most religious organizations sees it as murder except under rape and life threatening circumstances. Relevance of the paper to the nursing profession from a relationship ethics perspective The paper serves to elucidate the inherent challenges the profession faces in offering the support needed by patients, and the adequacy of the ethical tools and standards available. It also test the moral balance of the nurses, and the quality and importance of the training have and will need to have, in combating the ethical challenges, which varies depending on the cultural and ethnic background, as well as the values system, and economic and financial capabilities of each patient. Research regarding more successful handling of moral adversity, as well as training in feministic ethics seems absolute necessity for the College of Nurses of Ontario, due to the growing diversity in the populations, abuse women in marriage and other relationship suffer due to the dominant and selfish roles men assume in ethical crisis, and the employment structure that prevail within the profession. Conclusion Abortions may take place due to several reasons, and according to Fry and Veatch (2006), it does not imply moral right even though there might be no legal restrictions within a country, however the Nursing profession should ensure it constantly monitors, and improve its ethical awareness to deal with all issues that may impose on them. Religion, prohibitive laws, selfishness, poor ethics, lack of knowledge, political gamesmanships, poverty, and land life threatening Cogenital diseases are all variables that may impact on mothers expecting to give birth. The right decision is often difficult to make knowing that a life is at stake. . Reference 1. Ballantyne, A., et al (2009). Prenatal Diagnosis and Abortion for Cogenital Abnormalities: Is it ethical to provide one without the other? American Journal of Bioethics 9(8) pp48-46 Print 2. College of Nurses of Ontario (2009). Ethics Practice Standards www.cno.rog/global/docs/prac/41034_ethics.pdf 07/11/11 Web 3. Jameton, A. (1984). Nursing Practice : The Ethical issue Prentice Hall, Englewood Cliffs, NJ Print 4. Sherwin, S. (1992). No Longer Patient, Temple Press Philadelphia PA p.55 Print 5. Oberle, K., Bouchal, R. (2009). Ethics in Canadian Nursing: Navigating the Journey Pearson Prentice Hall, Ontario, Canada Print 6. National Abortion Federation (2011). About Abortion www.prochoice.org/abot-abortion/indedx.html , 07/11/11 Web 7. Repolge, J. (2007). Argentina Tightens up Abortion Laws Lancet (369)9555, pp.15-16 Print 8. 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Feministic Ethics www.tflout.com/feministic.htm , 07/11/11 Web 15. Center for Disease Control and Prevention (2011). Mortality and Morbidity Weekly Report (MMWR), Abortion Surveillance Summaries Vol. 6 No 1 Print 16. Christianson, A., Modell, B., (2004). Medical Genetics in developing countries Annual Review of Genomics and Human Genetics 5 pp.219-265 Print Read More