Application of a Professional Ethical Framework to the Nursing Care of a Woman Seeking An Abortion
- Identify the Jonsen model of case analysis to ethical dilemnas.
- Apply professional nursing organizations’ ethical guidelines for practice to the case study.
- Critique the Jonsen model and professional ethical guidelines as frameworks for examining ethical dilemnas in daily clinical practice.
Case: A physician in a small community provides abortions in her office-based practice. On a rare occasion, the physician chooses to perform a first trimester aspiration procedure in the hospital setting due to a patient’s complex and unstable medical history. When the case appears on the operating room schedule, the nurses are surprised by the presence of the case and decline to assist with the procedure. Each nurse invokes his/her right to refuse an assignment based on their professional right of conscience. The physician is concerned about having to cancel the case and speaks individually with each staff member, asking each nurse to value the patient’s right to care and reconsider their decision. One nurse decides to provide nursing care for the patient.
Conclusion: It is necessary for nurses to have opportunities to engage in self reflection and values clarification regarding the intersection of personal beliefs and professional responsibilities. Staffing dilemmas such as described are more likely to occur in a unit that does not frequently care for such patients.
Nurses continue to face ethical dilemmas in reproductive health care that challenge their personal beliefs, their role of patient advocate, their belief in patient's right to care and their respect for patient autonomy in decision-making. Professional nursing organizations can provide guidance and opportunities for nurses to discuss the application of ethical frameworks to complex ethical cases.
Keywords: ethics, professional standards, Jonsen model, abortion care