Consequences for Patients of Health Care Professionals' Conscientious Actions: The Ban on Abortions in South Australia
Journal of Medical Ethics. 1994 Jun; 20(2): 80-86.
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.' 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.
Abortion; Autonomy; Beneficence; Conscience; Civil Disobedience; Dissent; Ethics; Fetal Development; Health; Health Care; Health Care Delivery; Justice; Law; Law Enforcement; Legal Aspects; Moral Obligations; Moral Policy; Morality; Morbidity; Nurse Patient Relationship; Nurses; Nursing Ethics; Patients; Political Activity; Pregnant Women; Professional Ethics; Psychological Stress; Public Policy; Punishment; Refusal to Treat; Rights; Risk; Selective Abortion; Socioeconomic Factors; Technical Expertise; Therapeutic Abortion;
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Kuhse, Helga; Singer, Peter; Rickard, Maurice; Cannold, Leslie; van Dyk, Jessica (1997-08)OBJECTIVES: To determine the relationship between ethical reasoning and gender and occupation among a group of male and female nurses and doctors. DESIGN: Partialist and impartialist forms of ethical reasoning were ...
Kuhse, Helga; Singer, Peter; Rickard, Maurice; Cannold, Leslie; van Dyk, Jessica (1997-08)