‘Intentionally ending the life of an innocent baby does not treat any illness’

Nurses say proposed abortion legislation could mean nurses giving up jobs on conscience grounds

The Irish Times

Patsy McGarry

Proposed abortion legislation could force nurses and midwives out of a job, it has been claimed.

Campaigners for a No vote in the referendum on the Eight Amendment say the conscience clause promised by the Government in legislation if the measure passes is inadequate.

“We are concerned about freedom of conscience and have seen how Scottish midwives lost their case in the UK not to be involved in abortions,” said Mary Kelly Fitzgibbon, of Nurses for Life, a nurse, midwife and a lecturer. . . [Full Text]

Abortion: INMO calls for conscientious objection safeguards

Nurses union has had no discussions to date with HSE about the implications of repeal

The Irish times

Barry Roche

The Irish Nurses and Midwives Organisation expects the same conscientious objection protections that exist for nurses under the Protection of Life in Pregnancy Act to be afforded to nurses and midwives in any forthcoming legislation in the event of the Eighth Amendment being repealed.

INMO director of social policy and regulation Edward Matthews said that nurses and midwives are afforded the same protections as medical practitioners when it comes to conscientious objection to carrying out a termination of pregnancy. . . [Full Text]

HHS rules prevent providers from being forced to do things that violate moral convictions

The Hill

Reproduced with permission

Diana Ruzicka*

In the April 4, 2018 article, HHS rule lowers the bar for care and discriminates against certain people, nursing leaders, Pamela F. Cipriano and Karen Cox, wrote that the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) Proposed Rule: Protecting Statutory Conscience Rights in Health Care; Delegations of Authority expands the ability to discriminate, denies patients health care and should be rescinded. These accusations are unfounded and the rule should be supported.

What the rule does is “more effectively and comprehensively enforce Federal health care conscience and associated anti-discrimination laws.” It is not an effort to allow discrimination but an effort to prevent it by enforcing laws already on the books and gives the OCR the authority to oversee such efforts. This is something that nursing should encourage because it supports the Code of Ethics for Nurses (code).

The code reminds us that, “The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence and continue personal and professional growth.”

It is precisely because nurses are professionals who hold themselves to these standards that patients have come to see nurses as persons worthy of their trust, persons in whose hands they are willing to place their lives. Being granted by the public this weighty and solemn responsibility is humbling and must never be taken lightly. Thus the nurse’s duty to practice in accord with one’s conscience, to be a person of wholeness of character and integrity, is recognized by the.

It is odd that, despite supporting a nurse’s duty to conscience and the right to refuse to participate in an action to which the nurse objects on the grounds of conscience, Cipriano and Cox insist that the nurse, must assure that others make the care available to the patient. This suggests a failure to recognize that referring the patient to someone who will do the objectionable act in place of the nurse can make the nurse complicit.

The culpability of complicity is well recognized in law and ethics, as an accomplice is liable to the same extent as the person who does the deed. Thus, to make a referral and be complicit in an act to which the nurse conscientiously objects, also violates conscience. We doubt nursing leaders actually support this, as the consequences would be chilling.

When persons are made to violate their conscience, to set it aside, to silence it, moral integrity is eroded and moral disengagement progressively sets in. To move from caring for our fellow human beings to acting on them in ways that our conscience tells us we should not, requires powerful cognitive manipulation and restructuring to free ourselves of the guilt associated with this violation of our deeply held moral or religious beliefs.

Moral disengagement has frightening negative consequences, namely a pernicious dehumanization of persons, including oneself and of society as a whole. Rather than a nurse being someone of moral courage, ethical competence and human rights sensitivity, as our code directs, a nurse would have to be someone who is willing to surrender their conscience to expediency, powerful others, or whatever happens to be permitted by law at the time and place.

No longer would patients find that nurses are persons they can trust. It is precisely because nurses practice in accordance with their conscience that the public continues to grant them high scores on honesty and ethics.

None of this is to say that nurses may abandon patients. By promptly seeking a transfer of assignment that does not involve the objectionable act or by transferring the patient elsewhere without making a referral, the nurse continues to uphold the code by “promoting, advocating for and protecting the rights, health and safety of the patient [and, at the same time,] preserving wholeness of character and integrity.”

Clearly, refusal to care for a patient based on an individual attribute is unjust discrimination and has no place in nursing or health care. But that is not what the rule does. It protects the right to object to being forced to participate in an act that violates a person’s deeply held moral convictions or religious beliefs and from discrimination as a result of one’s refusal to participate in such an act.

To call for rescinding the rule, whose purpose is to protect this fundamental human right, would be short-sighted and could make unjust discrimination more likely and harm not only nursing but also the patients we serve.

 

Conscientious objection to participation in abortion by midwives and nurses: a systematic review of reasons

Valerie Fleming Lucy Frith, Ans Luyben, Beate Ramsayer

Abstract

Background

Freedom of conscience is a core element of human rights respected by most European countries. It allows abortion through the inclusion of a conscience clause, which permits opting out of providing such services. However, the grounds for invoking conscientious objection lack clarity. Our aim in this paper is to take a step in this direction by carrying out a systematic review of reasons by midwives and nurses for declining, on conscience grounds, to participate in abortion.

Method

We conducted a systematic review of ethical arguments asking, “What reasons have been reported in the argument based literature for or against conscientious objection to abortion provision by nurses or midwives?” We particularly wanted to identify any discussion of the responsibilities of midwives and nurses in this area. Search terms were conscientious objection and abortion or termination and nurse or midwife or midwives or physicians or doctors or medics within the dates 2000–2016 on: HEIN legal, Medline, CINAHL, Psychinfo, Academic Search Complete, Web of Science including publications in English, German and Dutch. Final articles were subjected to a rigorous analysis, coding and classifying each line into reason mentions, narrow and broad reasons for or against conscientious objection.

Results

Of an initial 1085 articles, 10 were included. We identified 23 broad reasons, containing 116narrow reasons and 269 reason mentions. Eighty one (81) narrow reasons argued in favour of and 35 against conscientious objection. Using predetermined categories of moral, practical, religious or legal reasons, “moral reasons” contained the largest number of narrow reasons (n =  58). The reasons and their associated mentions in this category outnumber those in the sum of the other three categories.

Conclusions

We identified no absolute argument either for or against conscientious objection by midwives or nurses. An invisibility of midwives and nurses exists in the whole debate concerning conscientious objection reflecting a gap between literature and practice, as it is they whom WHO recommend as providers of this service. While the arguments in the literature emphasize the need for provision of conscientious objection, a balanced debate is necessary in this field, which includes all relevant health professionals.


Fleming V, Frith L, Luyben A, Ramsayer B. Conscientious objection to participation in abortion by midwives and nurses: a systematic review of reasons. BMC Medical Ethics. 2018;19:31. doi:10.1186/s12910-018-0268-3.

Nurse practitioners not always compensated for providing medical assistance in dying

Ministry of Health and Long Term Care does not provide fee-for-service the way it does for physicians

CBC News

Angela Gemmill

The Nurse Practitioners Association of Ontario says some of its members are helping to provide their patients with medically assisted deaths without compensation.

It wasn’t until April of 2017 that nurse practitioners (NPs) in Ontario could prescribe the controlled substances used for medical assistance in dying (MAID).

Since then about 40 NPs across the province have provided either patient assessments or the procedure itself.

A patient must be assessed by two independent health care providers. This can be either a physician or a nurse practitioner. The procedure is the same regardless of who provides it.

One nurse practitioner in Sudbury, Ont. says it’s important for her to provide support to patients who want to take this step. She admits that medical assistance in dying is rather limited in Sudbury, in that not a lot of physicians or nurse practitioners are willing to provide it for patients. . . [Full text]

 

Palliative care nurses quit ‘houses of euthanasia’

Catholic Herald

Simon Caldwell

Belgian nurses and social workers who specialise in treating dying patients are quitting their jobs because palliative care units are being turned into “houses of euthanasia”, a senior doctor has alleged.

Increasing numbers of hospital staff employed in the palliative care sector are abandoning their posts because they did not wish to be reduced to preparing “patients and their families for lethal injections”, according to Professor Benoit Beuselinck, a consultant oncologist of the Catholic University Hospitals of Leuven.

He said that after more than 15 years of legal euthanasia in Belgium “palliative care units are … at risk of becoming ‘houses of euthanasia’, which is the opposite of what they were meant to be”. . . [Full Text]

Complaint filed with federal agency by Rockford nurse over abortion mandates

rrstar.com

Georgett Braun

ROCKFORD.  A local woman has filed a complaint with a federal agency alleging that she was forced from her job in 2015 at the Winnebago County Health Department because of abortion mandates.

The complaint was filed Tuesday with the U.S. Department of Health and Human Services by attorneys representing Sandra Rojas.

The complaint alleges that Rojas, a pediatric nurse who worked 18 years at the Health Department, objected to a requirement that nurses be trained to make referrals to abortion providers and to help women obtain abortion drugs. . . . [Full Text]

Quebec nurses back euthanasia for the demented to the hilt: survey

BioEdge

Michael Cook

An overwhelming majority of registered nurses working in Quebec nursing homes support euthanasia for dementia patients who have left a living will, researchers from Canada and the Netherlands. In an article in the journal Geriatric Nursing.

Euthanasia is legal in Canada, but only for patients who are competent, even if they had expressed a request for “medical aid in dying” in their lucid moments. However, this restriction is under pressure. After a man killed his demented wife, the Quebec Minister of Health and Social Services asked experts to study whether MAiD could be provided for patients with advance directives.

Although only doctors are able to euthanize patients, the researchers point out that “Given their unique experience and expertise, nurses’ voice must be taken into account in deciding whether or not to modify the current legislation to give incompetent patients access to MAiD.”

Five hundred and fourteen nurses were surveyed; 219 responded. Of these, “83.5% agreed with the current legislation that allows physicians to administer aid in dying to competent patients who are at the end of life and suffer unbearably. A similar proportion (83%) were in favor of extending medical aid in dying to incompetent patients who are at the terminal stage of Alzheimer disease, show signs of distress, and have made a written request before losing capacity.”

Just as interesting as the nurses’ attitudes towards incompetent patients was their feelings about how they would like to be treated themselves should they become demented. If diagnosed with Alzheimer’s, 79% said that they would make a formal request to die. If a love-ones were diagnosed, 65% would call a doctor to euthanise them (provided they had left a request).


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Nurses’ perspectives on whether medical aid in dying should be accessible to incompetent patients with dementia: findings from a survey conducted in Quebec, Canada

G. Bravo, C. Rodrigue, M. Arcand, J. Downie, M.-F. Dubois, S. Kaasalaine, C.M. Hertogh,S. Pautex, L. Van den Block

Abstract

We conducted a survey in a random sample of 514 Quebec nurses caring for the elderly to assess their attitudes towards extending medical aid in dying to incompetent patients and to explore associated factors. Attitudes were measured using clinical vignettes featuring a hypothetical patient with Alzheimer disease. Vignettes varied according to the stage of the disease (advanced or terminal) and the presence or absence of a written request. Of the 291 respondents, 83.5% agreed with the current legislation that allows physicians to administer aid in dying to competent patients who are at the end of life and suffer unbearably. A similar proportion (83%, p = 0.871) were in favor of extending medical aid in dying to incompetent patients who are at the terminal stage of Alzheimer disease, show signs of distress, and have made a written request before losing capacity.


Bravo G, Rodrigue C, Arcand M, Downie J, Dubois M-F, Kaasalaine S, Hertogh CM,  Pautex S, L. Van den Block L. Nurses’ perspectives on whether medical aid in dying should be accessible to incompetent patients with dementia: findings from a survey conducted in Quebec, Canada. Geriatr Nurs. 2018 Jan 3. pii: S0197-4572(17)30319-1. doi: 10.1016/j.gerinurse.2017.12.002.

Christian nurse sues hospital for requiring her to assist abortions

Lifesite News

Claire Chretien

DURHAM, North Carolina, November 3, 2017 (LifeSiteNews) – A Catholic nurse is suing Duke University Hospital, claiming that the university discriminated against her religious and pro-life beliefs by requiring her to assist in abortions.

Sara T. Pedro was told during her employee orientation that Duke University Hospital provides no exceptions to employees in its Emergency Department who don’t want to participate in abortions. The lawsuit, filed by The Thomas More Law Center on Pedro’s behalf, says that Duke’s Emergency Department performs “a large number of abortions.”

The lawsuit claims that Pedro faced retaliation and discrimination after she made a written request to be exempt from the pro-abortion policy. . . [Full text]