These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Consequences for patients of health care professionals' conscientious actions: the ban on abortions in South Australia.
    Author: Cannold L.
    Journal: J Med Ethics; 1994 Jun; 20(2):80-6. PubMed ID: 8083879.
    Abstract:
    The legitimacy of the refusal of South Australian nurses to care for second trimester abortion patients on grounds of conscience is examined as a test case for a theory of permissible limits on the autonomy of health care professionals. In cases of health care professional (HCP) conscientious refusal, it is argued that a balance be struck between the HCPs' claims to autonomous action and the consequences to them of having their autonomous action restricted, and the entitlement of patients to care and the consequences for them of being refused such care. Conscientious action that results in the disruption or termination of health care services, however, is always impermissible on two grounds. Firstly, because it is at this point that the action '... invades a patient's autonomy, puts a patient at serious risk ... [and] treats a patient unjustly' (1) Secondly, because the consequences of such refusals turn them into political acts--acts of civil disobedience. It is arguable that in order for acts of civil disobedience to be legitimate, certain obligations are required of the dissenter by the community. It is concluded that the actions of the South Australian nurses, which have over the last few years both terminated and disrupted second trimester services, are morally impermissible. The author's position is that nurses should provide health care to abortion patients regardless of the nurses' claims of conscientious objection. The case study pertains to a woman who has a second trimester abortion between 1988 and 1990 in South Australia in a legally-mandated hospital. During 1988-90 only one physician performed second trimester abortions; this amounted to about 10% of all abortions. The onus on abortion seekers is a very long travel time of 22 hours and 11 hours to Sydney or Melbourne. The reason for the limited services is the refusal by nurses to participate in abortions beyond 12 weeks. The author's position is that when disruption or termination of services results from conscientious objection, it is not justifiable. Refusal is not acceptable because it puts the patient at serious risk, interferes with patient autonomy, and is unjust. This action could be construed to be political and, thus, an act of civil disobedience, which is not permissible. Nurses are considered professionals, which infers that the role is important, monopolistic, reciprocal, contractual, and circumstantial. The role of nurses in this case is not dispensable and not substitutable because of training and skills. Nurses have a professional obligation to treat all patients. Ethical contractual codes assume that nurses' autonomy is sacrificed to further the autonomy of others. When life or health is at risk, a nurse has an obligation to help. The principle of autonomy does not legitimize conscientious action. Beauchamp and Childress indicate restrictions on autonomy, and Kantian ethical theory supports limitations to conscientious action. The consequences of actions must be weighed carefully and are dependent on the weight given to objections.
    [Abstract] [Full Text] [Related] [New Search]