Ethical issues are a daily problem of nursing job with no difference in the place where he or she works. Unfortunately, such problems have no definite solution. Everything depends on choices which can be either “right” or “wrong.” Even though the decision depends on a particular nurse, it is important to follow the “no harming” aim. The principles of nursing ethics teach knowledge about beliefs, experiences and values.
The amount of ethical issues is enormous. One of the most relevant ones is the problem of abortion, the interruption of pregnancy. The artificial abortion, which is a deliberate interruption of pregnancy, refers to the moral and ethical issues. It is the “open moral problem” in the field of medicine. The medical side of the issue is well understood and “successfully” implemented. Nevertheless, the problem of abortion remains to be “open” in the sense of moral ways of its solving. In relation to this, it is not just a breaking of generally accepted moral canons, but the absence of such rules. Nevertheless, a problem still exists, where the confrontation of two opposing points of view is born.
The first one claims that the abortion is a purely personal or intimate problem that applies to the woman. This is simply one of the medical operations, where (as in the case of any other surgery) a physician and patient solve all problems. In other words, abortion is a medical issue. The second point of view is the opposite pole: abortion offends the morality, so there is an ethical problem. Moreover, it is the hardest one. After all, before coming to a doctor, the woman struggles with a moral issue of life or death of the future human. After that she goes to the doctor, whereas the ethical meaning of the question does not disappear, but it becomes even more complicated: a third man gets involved in making this decision, and if he or she does the job as a doctor, he or she becomes an accomplice of the murder. It is a murder because, unlike any other surgeries, this has a purpose of interrupting one’s life, to kill a completely helpless, powerless, innocent suffering human.
The problem of abortion has evolved from a medical and ethical issue long time ago and formed a deep political problem. In fact, two opinions divided supporters into the camps of pro life and pro choice. The subject was so close to each citizen that the conventional interlayer of abstention has almost gone. The first “pro life” part definitely “knows” that abortion is a sin, crime and murder, as the child’s life begins at the moment of impregnation. The other “pro choice” part is strongly convinced that up to a certain stage of development the child is part of his or her mother’s body, so his or her life depends on the mother’s discretion. Such sharp ideological opposition remains to be a heated discussion of the problem of abortion.
In general, both pro and contra positions have arguments that prove their opinion. Speaking about the opponents, they are totally against abortion, and their position has its spotless proof. They say that abortion is the murder because the embryo becomes a human being at the 21st day of gestation, when the child’s heart begins to beat. Moreover, their argument is about the indecisiveness of the women who come to the doctors with abortion requests. It happens often that unplanned pregnancies turn to be wanted, when it is already too late. Abortion means not only the death of the unborn child, but also causes life-threatening complications that may lead to the woman’s death. In general, abortions can be safe for the mother’s life, especially in the period of a first trimester (Medical News Today, 2013). Even professional doctors with up-to-date equipment risk causing sepsis, recurrent miscarriages and various infections. Moreover, the health problems do not limit just with physical problems, the consequences of abortion are also connected with the mental well-being. These might be, for example, guilt and depression.
In favor of this operation, the abortion supporters count for the dependence of a child’s life on mother’s decision not only because it is her child, but also because she will be the one who overcomes pregnancy with its “specific” well-being, gives birth and, afterwards, is responsible for all aspects of the child’s life. In addition to that, they underline the fact that a strict ban on abortions will lead to the illegal and unsafe surgery performed by doubtful doctors in doubtful places (Jones, 2007). It is not a secret what complications the abortion may cause even if the woman comes to a highly professional doctor who does the operation with the best equipment in a highly safe hospital. Therefore, the complications after the “doubtful” abortion may be doubled, tripled or eternally multiplied.
All the previous arguments make sense, but, as a result, they all lead to the main dilemma. This is about the period of embryo’s development. The question is, when exactly a fetus becomes a human being. It is an important nuance because it might answer the moral question of abortion. If the fetus is not an alive human being with rights, but just a part of a woman’s body, the abortion does not differ from any other operation on other organs. In this case, when the embryo is a relatively conscious person, the abortion is the process of real life interruption. According to this, abortion can be the double-sided operation: up to the period of human being formation, it would be the casual operation, but after that moment it will become the immoral murder of the innocent child that cannot protect his or her life.
In the process of every decision-making, the nurse should remember the following. The pro-life and pro-choice movements are going to confront his or her forever. The question is what is right: to protect even undeveloped life or let woman to decide about her pregnancy. Nurses usually make their decisions based on their own values and beliefs. This question has no direct and right answer. The confrontation of freedom and control reveals the other two sides of the dilemma. On the one hand, a person is free to decide even when understanding the possible harm. On the other hand, the nurse should take the situation under his or her control and do everything possible to prevent the action. It is the same situation as if a patient refuses to eat. The nurse understands that it is harmful for the patient’s health. In such case, no one would think whether the nurse has right to influence the patient's decision. It is the same with the abortion. It is important to save the child’s life and protect the mother’s health by convincing this woman to change her opinion. Moreover, the nurses as well as the doctors pledge to protect the life and health, but never harm. In any case, abortion is the breaking of both rules: it is the murder of a child and the possibility to harm the woman’s health.
As the opinion of the women, government and the active people, the position of nurses can also differ. Another side of this choice lies on the ground that abortion is considered to be just another operation. This means that this should be a personal woman’s problem, but not the nurses’ or doctors’ one. They have to perform the operation without any additional moral questions. Without a doubt, this point of view is not popular among the medical workers, but it exists.
Most of the nurses usually support the moral side, so that they try to convince the woman from doing abortions. Some of them decline participating in abortion performance. Rarely, they quit jobs. This is a radical measure. Anyway, the nurses know what they need to do. They have to protect life. Therefore, they should “thousand” times reask the woman, “million” times remind her about the moral aspect of the future operation, the possible consequences, risk and mental problems that might follow. However, when the woman is confident about her decision and the law allows performing abortion, sometimes it is better not interfere in the process of decision-making..
Moreover, the nurses should pay attention to the peculiarities of the woman’s religious views, to her diagnosis; for example, her health condition does not allow her to carry a fetus to a certain term, and the development of the embryo can be defected. Undoubtedly, the last argument is not the reason to kill a child, however, in certain cases, it may become the best solution. There are seven reasons of abortion permission. The first, second and the third consider the life, physical and moral health of the woman. The fourth is about the process of impregnation: rape or incest. The following points are related to the fetal impairment, financial problems and requests (Word Population Policies, 2011). Subsequently, the opinion about the morality and immorality of abortion has many nuances; each of them is worthy to be observed.
It is clear that the abortion issue will remain an “open” moral problem as long as the abortion exists or until there will be found moral ways of its solution. The analysis of the situation shows that the main difficulty on the way to this goal is the cornerstone in the respect and status of the human fetus. This issue plays an important role in the disclosure of abortion as an ethical problem. What is the degree of elaboration of this issue in the scientific literature? Analysis of existing sources is disappointing. To date, there is a problem of determining the age at which the embryo becomes a human being, whereas he or she may be regarded as a person with rights under the protection of the law.
In general, abortion cannot be the choice of one person – mother. It involves the opinions and actions of everyone who has anything to do with that. In such situation, the pregnant woman is the “guilty” person who provokes the nurses and doctors to participate in her “crime” according to her decision (Jones, 2007). Unfortunately, such situations cause the ethical problems for nurses. Even though, the legislation and the professional guidelines show the directions for the nurses’ actions, the medical workers also leave themselves the right of individual decisions based on their personal positions.
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