Introduction: Nursing, Its definition and Key Ethical Postulates
Over the course of the history of nursing, a number of conflicts has been spawned. In their pursuit for the code of nursing ethics, specialists have fought their way to making the state recognize people’s rights for being treated like human beings. Among the cases mentioned most often, the issues related to abortion, personal information and the right to be provided with life essentials must be brought up.
When Ethics and Law Clash in a Conflict: Handling the Difficulties
Abortion issue: when one of the lives tips the scale
There is no need to stress the fact that abortion remains a very debatable issue for a very understandable reason. One might argue that technically, there is no problem regarding abortions, at least in the USA, since a human fetus is not considered a live being yet and, therefore, there technically is no crime in aborting it. The given idea, however, is relatively new and reflects the results of nurses’ attempts to influence the public opinion concerning abortions in order to save women’s lives.
In the argument concerning abortions, the case of Roe vs. Wade can be regarded as the pivoting point of considering abortions legal in the USA. The given case is a clear-cut example of how nurses fight for their patients’ rights and follow the nursing code of ethics, disregarding the legal obstacles.
Even though, according to the Texas law, abortions were prohibited in the state, after incredible efforts of the plaintiff, it was considered that the choice between giving birth and making an abortion must not be the prerogative of anyone else but a woman herself. It must be admitted, though, that the changes in the Texas law were made so that the patients’ lives should not be in peril:
It is also essential to mention that the solution provided by the Supreme Court aligns with the rights of human beings in general, which can be traced in the details of the verdict. For instance, while it was considered legal to perform abortions, it was stated that abortions are only possible before the third trimester, since in the third trimester, the fetus is legally considered a human being and, therefore, is granted the right to live.
The given specifics of the jury’s judgment, however, can also be regarded as the concern for a woman’s health, since an abortion performed in the third trimester is a threat to a woman’s life.
It is worth mentioning that the Roe v. Wade case is often regarded as the “physical-assisted suicide”. Moreover, the opponents of the plaintiff claimed that the “outline of the common law could have served only to mislead the Court into thinking that abortion was not illegal at common law, even after quickening” (Keown, 2006).
The given statement, being clearly absurd, since the opponents read the attitudes on abortion into the common law. The argument that tops this absurdity states that, by claiming her rights, Roe neglected the historical traditions of the USA (Dresser, 2007). The fallacy of the given argument is clear; as human development in general and medicine in particular advance, people’s attitudes towards certain legal, medical, political, economical issues, etc., changes in accordance with the acquired knowledge.
Appealing to historical traditions to prohibit abortions in the XXI century is practically the same as appealing to the historical traditions of the Medieval Era to bring back tortures in the European countries.
The Grahame Pink case: hear someone blow the whistle
Confidentiality has always been one of the top priorities in nursing. According to the nursing code of ethics, none of the patient’s data is to be disclosed to a third party under any circumstances due to the confidentiality principle. The given principle seems reasonable enough, since, being under the doctor’s supervision, a patient becomes highly vulnerable and bound to confide any information concerning his physical or psychological specifics, as well as a number of intimate details concerning his/her life. Once such information gets in the wrong hands, a patient’s life will be in peril.
However, the given problem appears to be a double-sided sword, which the famous Grahame Pink case proves. According to the records of the case, Graham Pink informed the authorities concerning “what he regarded as poor standards of care for older people in a hospital in Stockport” (Beech, 2007, 43).
The given action can be considered from several viewpoints. On the one hand, seeing how the older people at Stockport suffered from the low-quality services, which might have probably led to their untimely death, Pink did the right thing informing the authorities. On the other hand, though, according to the nursing code of ethics, informing the authorities on the state of the patients was a wrong move, since none of the patients’ personal data is to be disclosed to any third party. Herein, the state of the older patients being their personal information, Pink clearly had no right to tell anyone about it.
The given case shows how complicated the problem of nursing vs. the law is. In Pink’s example, it is clear that the line between the “personal information” and the “information on maltreatment” has not been drawn. Therefore, it can be assumed that most of the problems touching upon the issues of nursing ethics and state law appear due to the imperfections of both.
The Nebraska case: let them eat cake
Perhaps, one of the most famous, if not the most famous, case concerning the conflict between law and nursing ethics that have occurred over the past few years, is the famous Nebraska case known as “Nebraskans for a human care amendment”. According to the Nebraska State Constitution as it was before the amendment, the provision of food and psychological support was to be offered to all those who require it.
The people, who were terminally ill, however, were considered as the patients who no longer need food or water provision whatsoever in the light of the fact that they were going to die soon. For a considerable amount of time, the state authorities have been failing to see the fallacy in the given judgment. Indeed, according to the law, it is acceptable to consider the people who are terminally ill as the ones that are at the death’s door. From the point of nursing ethics, however, such approach is despicable.
As a result, after several approaches to convince the authorities to change the law had been tried in vain and the situation has finally reached its boiling point, several concerned citizens, nurses being among them, filed a petition called Nebraskans for a human care amendment. According to the text of the amendment, a person, who is terminally ill, should not “have medical interventions nor food and water withheld nor withdrawn in terminal conditions” (Furlong, 2008, 30).
The given petition, however, also pointed out that, as long as a patient is able to express his/her will and, thus demands the withdrawal of food and provision, (s)he is free to have them withdrawn from him/her. Despite all the efforts that have been undertaken so far, the Nebraskan petition has not been approved by the local authorities yet.
However, nurses do not retreat and continue their crusade against the despicable laws that collide with the basic principles of the ethics of nursing. According to Furlong (2008), “Nebraska nurses responded and continue to respond to the proposed petition drive that did not get on the ballot in November, 2006, using the media to get their points across” (41).
The Issues That Are Yet to Be Solved: When Law Meets Ethics and Bids Good-bye
Even nowadays, nursing ethics can clash in conflict with law. One of the most graphic examples of such cases is the issue of euthanasia. For quite understandable reasons, the decision concerning the patient’s right to terminate his/her pain is still in development.
A matter of life and death: the slippery issue of euthanasia
The Nebraskan case concerning the provision of food and water to the terminally ill and especially the note saying that the services will be terminated as soon as the patient wishes picks another debatable issue which, unfortunately – or, fortunately, one might argue – has not been solved yet. While in some states of America, as well as in several other countries, euthanasia has been allowed legally, the given problem is still far too big not to address it.
The cui bono, cui prodest dilemma remains the key problem in the given case. Since a person’s death can be very favorable for a wide range of people, starting with relatives up to acquaintances and business partners, it is likely that the euthanasia problem will not be resolved unless the means for a person to communicate his/her will to die will be provided for any medical condition, including coma and insanity.
Conclusion: The Questions That Will Never Be Answered
Judging by the number of arguments that the issues mentioned above spawn, it is safe to say that most of the present-day controversies appearing when nursing ethics and law collide will not be solved easily. Nevertheless, one must admit that nurses have shown impressive persistence over decades and even centuries in their effort to help patients and fulfill their duties despite the legal restrictions.
Hence, one might assume that, once nurses are as strong-willed and as driven by their willingness to help those who suffer as they have been all these years, some ethical dilemmas will be solved eventually.
Reference List
Beech, M. (2007) Confidentiality in health care: conflicting legal and ethical issues. Nursing Standard, 21(21), 42-46.
Dresser, R. (2007). Protecting women from their abortion choices. The Hastings Center report, 41(4), 13–14.
Furlong, E. A. (2008). Right or wrong: Legal and ethical issues and decision-making. In S. Lewenson & M. Truglio-Londrigan, Decision-making in nursing: Thoughtful approaches for practice. Sudbury, MA: Jones and Bartlett Publishers.
Keown, J. (2006). Back to the future of the abortion law: Roe’s rejection of America’s history and traditions. Issues in Law and Medicine, 22(1), 3–37.