Introduction
Ethical issues comprise the principles that dictate what is bad and/or good. However, in the nursing practice, agreeing on what is right or unjust is incredibly difficult. Developing a clear understanding of the ethical principles that guide the process of delivering services in nursing care is critical in enhancing the delivery of professional healthcare (Moore & Savage, 2008). The adoption of ethical principles calls for nurses to make decisions to do what is right in every situation. With the ethical and moral dilemma on whether abortion should be legalized or not, nurses encounter a myriad of challenges in determining whether to conduct the procedure and under, which circumstances. This paper highlights some nursing ethical issues concerning abortion.
Historical Perspective
In the United States, legislation of abortion began in the early1820s. The laws forbid abortion in case a mother had been expectant for four months. In the case of Roe v. Wade in 1973, the Supreme Court ruled that the 14th amendment to the constitution of the United States made a provision for women to seek abortion as a fundamental right unless a state had a compelling issue against it, or had an interest in it. The ruling marked the hallmark of considerations of ethics in abortions. A particular interest also arose on whether medical practitioners including nurses have any ethical mandate to agree with the decision made by women who seek an abortion under circumstances not set out above.
Legal and Ethical Issues in Abortion
The central task that health care workers are charged with is to ensure that the life of people is saved through putting in mechanisms of ensuring that people do not succumb to various ailments. The main question that nurses have to evaluate is whether they should treat abortion as a political, legal, or social challenge that they have to make decisions about together with how making such decisions would affect their professional code of ethics. For instance, before making a decision to execute abortion, nurses have to make decisions on whether abortion amounts to murder or not. If it amounts to murder, it implies that nurses operate against the very core professional mandate of saving a life. Since murder is illegal and prohibited by law, making a decision on the necessity and circumstances under which people should be allowed to procure abortion with the help of a nurse raises the question of whether the law must legislate morality (Bankole, Singh & Haas, 2008). If this case prevails, it also becomes necessary to evaluate the extent to which the law should legislate morality together with the extent to which nurses should act against such legislation where necessary. In the attempt to resolve the ethical question of the necessity of abortion, nurses have also considered various approaches and arguments in support of and against the practice of abortion. These include aspects of discrimination, deprivation, and arguments pertaining to uncertainties.
Deprivation
One of the ethical considerations of issues of abortion from nursing practice is that it is morally wrong as it amounts to eroding the rights of a fetus to life and hence the right to enjoy the valuables that life offers. This claim borrows from the assertion that killing adults is wrong since it deprives them of the right of living a fruitful and valuable life. Hence, killing is very inappropriate and ethically and morally wrong. Since a fetus has an opportunity of growing into an adult, killing it is also ethically and morally wrong from a nursing ethical point of view (Bankole, Singh & Haas, 2008). Nevertheless, it is crucial to note that not all abortions are unjustifiable from this account, for instance, in a case where failure to conduct the procedure amounts to the threatening of the future valuable life of the mother carrying the pregnancy.
From the perceptive of deprivation, whether it is necessary or ethically correct in the nursing practice to conduct abortion is dependent on the thread of reasoning that a practitioner or any other party upholds. For instance, some nursing scholars argue that a fetus does not have an equal personal identity similar to that of an adult. This means that a fetus does not have similar features such as those of adults. Hence, no substantial deprivation of the future or significant harm is done when abortion is conducted. Other nursing scholars agree that the fetus has a future whose deprival amounts to no significant wrong to it although it is not appropriate to be deprived of it.
Discrimination
In the professional practice code of ethics, nurses should not conduct their work in a discriminating manner. Guided by this principle, it introduces the questions of whether they should permit abortion to take place within the health facilities they work for especially in the light of the argument that abortion amounts to an act of discrimination of the unborn. In this context, people should not deny the fact that fetuses have equal rights to life just like all other people and that no group of persons has more rights to life relative to others. Nevertheless, philosophers debate about this position by claiming that the characteristics of a fetus that make it be considered having equal rights to life in relation to its counterpart adults are not necessarily morally relevant with reference to the psychological and or physical stages of development. In this regard, abortion is an ethical practice to the extent that it is conducted to save the life of the mother who has already experienced and is still enjoying, the value of life.
From the above arguments, the pressing issues in nursing practice, which help to evaluate the ethics behind abortion lie in the need to clearly define whether a fetus is a person or not. This reduces to a legal battle for the fetus’ legal status. If it could be legally acceptable that a fetus is indeed a person, it is then an act of murder and that nurses should distance themselves away from it, as it is unethical and one that contravenes their professionalism mandates. However, even if it would be legally acceptable that a fetus is a person, it would still be justified in the event that it is necessary for the bodily anatomy of women. Nonetheless, this does not mean that it is outrightly ethical in the nursing practice. States cannot make it mandatory for women to carry on with their pregnancies throughout the whole term. Perhaps nurses should intervene if women express their displeasure with the pregnancy. However, it is also perhaps much ethical to finish the term, with nurses not aiding mothers to terminate their pregnancies.
The question of the need to protect the right of the bodily autonomy of women and/or whether it is ethically appropriate for nurses to aid women to achieve the rights attracts different views of abortion from the nursing point of reference. One of such perspectives is that people must place claims on certain aspects of their personal and bodily autonomy, which must also be applied to the conception process in any democratic and free society (Grimes, Benson, & Singh et al., 2006, p.1908). Considering the serration that autonomy and freedom of choice are ethical requirements, the main interrogative is to determine the extent to which such autonomy should be exercised. Is it then ethically appropriate for nurses to help in abortion at the will of the mother? A response to this interrogative calls for consideration of arguments of uncertainty with regard to abortion.
Uncertainty Opinions
People who uphold pro-life opinions within the nursing fraternity embrace the belief that ambiguity on whether the unborn have the right to exist gives a clear indication and validity of the argument that conducting abortion is tantamount to a mindful slaughter of another person. This means that, if a nurse is not well aware of whether a fetus has a right to life, it is discriminating but also ethically and morally wrong to treat it as if it did not have rights. In fact, if it is known that the fetus has the right to life, a nurse must conduct the procedure to protect its life. Consequently, it sounds pragmatic to argue that the arguments of uncertainty fail to work to justify the nursing ethical approach towards abortion to the extent that failure to prove the right to life for a fetus in a more persuasive manner does not mean that a nurse should act contrary to the professional mandate of saving a life.
The major debate on whether a nurse should treat a fetus in a callous way oscillates around the determination of the premise of whether actually a fetus is a person with certainty. The point of contention among people who are inclined to the school of thought that fetus‘ right to life needs to be protected is that, even if it could be proved with reasonable accurateness that a fetus is not a person, it is fallacious to presume that it has no moral standing(Grimes, Benson, & Singh et al., 2006, p.1910). In fact, some people object to conducting abortion even if they had prior intentions to do so when they become cognizant in the later stages of pregnancy that something with the fetus makes it more similar to a baby. Should nurses then engage in aiding people to execute abortion especially where service seekers have not yet developed this cognition? Response to this query continues to attract a heated debate in the nursing fraternity.
Conclusion
Every profession is guided by a set of values and principles. In the nursing field, as argued in the paper, determining whether it is appropriate or not to aid women in executing abortion is a matter of consideration of the impacts and arguments on situations that prompt the validity of the decision to procure abortion. Such provisions are also enshrined within the legislation of many nations. The paper maintains that the appropriateness of the need of a nurse to aid a woman to procure an abortion is a compromise between the need to respect the rights of body control and anatomy and ethics in the nursing profession.
References
Bankole, A., Singh, S., & Haas, T. (2008). Reasons Why Women Have Induced Abortion: Evidence from 27 Countries. International Family Planning Perspectives, 24(3), 117–127.
Grimes, A., Benson, J., & Singh, S. et al. (2006). Unsafe Abortion: The Preventable Pandemic. The Lancet, 368(9550), 1908–1919.
Moore, L., & Savage, J. (2008). Participant observation, informed consent and ethical approval. Nurse Researcher, 9(4), 58-69.