Nursing and Its Ethical Issues
The nursing profession is faced with numerous ethical challenges or issues. Abortion is one of the major challenges that are faced by nurses today. This is because it has varied emotional, spiritual, and psychological effects on women who commit it. Thus, health care professionals, especially nurses and physicians, are obliged to provide social, psychological, emotional, and spiritual support to such women.
Abortion refers to the process of terminating a pregnancy by removing or expelling an embryo or a fetus from the womb before birth. Abortion is the deliberate termination of pregnancy. Abortion is different from miscarriage, because abortion is a deliberate or an intentional act which aims at terminating the pregnancy, while miscarriage is unexpected premature birth of an underdeveloped fetus. Abortion is also considered as one of the most controversial and sensitive issues in the society today. It has continued to attract harsh and conflicting viewpoints from people with different religious, political, and socio-economic perspectives and professional backgrounds.
Nursing and Abortion
Although many people do not support abortion, it has been found that the rate of abortion is rapidly increasing in the modern society. It is estimated that more than forty one million abortions were performed in 2004, and forty three million others performed in 2008. The percentage of abortion was estimated to be twenty one percent in 2010 across the globe, twenty six percent in developed countries such as the United States and Europe, and nearly twenty percent in underdeveloped and developing countries such as Kenya and Ethiopia. Kebede, Hilden, and Middelthon (2012) define the percentage of abortion as the number of abortions that are performed out of one hundred known pregnancies, where known pregnancies include all live births, abortions, and miscarriages. According to Kebede, Hilden, and Middelthon (2012), the rate of abortion in countries with restrictive abortion laws is almost the same as the rate of abortion in countries where abortion has been liberalized. However, the rate of unsafe abortions is two to three times higher in countries where abortion is restricted, as compared to countries where abortion has been legalized. This is because of the use of unprofessional methods during abortion, which make the abortions highly unsafe. Risen and Thomas (2008) also affirm that restrictive laws have been associated with the rapid increase in number of unsafe abortions. Higher numbers of incidences of unsafe abortions are also frequently reported in underdeveloped and developing countries. This is because of inaccessibility of professional medical services and lack of modern contraceptives. In 2002, it was revealed that more than half of women who commit abortion have attempted using contraceptives in order to prevent unintended pregnancy.
Reasons for Performing an Abortion
Women perform abortions for different reasons. Some of the most common reasons cited by women for committing abortion include postponing childbearing to a more suitable time, directing or focusing family resources on existing children; avoiding disruption of one’s own education, socio-economic factors, such as the inability to raise additional children, lack of support from the father, loss of income and unemployment, and unwillingness to raise a child conceived as a result of rape or incest.
The Ethicality of Abortion in the Context of Nursing and How Nurses Should Approach Abortion While Still Upholding Legal and Professional Ethics
In the nursing profession, the issue of abortion has equally attracted contrasting viewpoints. Opponents of abortion argue that nurses should not aid abortion practices, because it is a form of murder. On the other hand, proponents of abortion argue that nurses should assist women who opt to abort, because it is in line with their professional code of conduct, especially when the life of the mother is endangered. These varying points of view has led to highly heated and controversial debates on whether or not it is ethical and moral for nurses to be directly involved in abortion.
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One of the major concerns about abortion is the manner in which it is conducted. According to Russo and Steinberg (2012), most abortions are not conducted by trained healthcare providers or medical professionals. This has led to the increase in number of unsafe abortions, which account for more than seventy thousand maternal deaths every year worldwide. In addition, approximately five million women are admitted into healthcare institutions as a result of unsafe abortions. Thus, the role of nurses in conducting abortion and the prevention of unsafe abortions which may lead to maternal deaths has become a hot topic of discussion in the society today. Many people have criticized nurses for being involved in unethical practices during abortions. According to Russo and Steinberg (2012), nurses should conduct abortions in accordance with the legal provisions of the Nursing Act of 1967. Nurses should also take into consideration various ethical issues surrounding abortion.
According to a popular opinion, nurses should ensure that abortions that have been legalized or authorized are conducted in a safe and effective manner, which does not threaten the life of the mother. Abortion should not result into the death of the mother. Nurses are also responsible for creating awareness on abortion and its complications and for encouraging women to use family planning in order to prevent unwanted pregnancies, which may lead to abortions in the future. A research study by Hoban, Rathavy, and Lam (2010) about one thousand women who had aborted over a period of five years revealed that unwanted pregnancies account for more than thirty percent of annual abortions in the United States of America. Nurses are also responsible for helping reduce the rate of abortion in the country by discouraging it.
Nurses should also provide contraceptive services to all women in the society to enable them prevent unwanted pregnancies. Probably, an increase in the availability of effective contraceptive services to childbearing women would help reduce incidences of unwanted pregnancies and, hence, reduce abortion rates. Nurses should ensure that family planning and maternal health services are readily available to women. Nurses should also provide adequate health education services to women. In addition, nurses should also ensure that pregnant women have limited access to abortion services. This would help in reducing the number of abortions that are reported every year.
In cases where abortion has been legally allowed, for instance, in cases of pregnancies resulting from rape or incest or in situations where a fetus has fetal defects, nurses are responsible for ensuring that abortion is performed in a safe manner. The nurses have to ensure that appropriate medications and surgical procedures are used during the abortion. Nurse should also ensure that abortion is conducted carefully, especially when the pregnancy threatens the life of the mother. Nurses should discourage women from seeking to terminate their pregnancies using unsafe methods such as self-abortion or relying on people who do not have solid medical trainings to assist them during abortions. Nurses are also responsible for ensuring that severe complications or life-threatening effects of abortion such as incomplete abortion, damage to internal body organs, and excessive bleeding are prevented during abortion.
Nurses are also obliged to work closely with the federal government, governmental agencies, such as the United States Department of Health and Human Services (USDHHS), and non-governmental organizations, such as the World Health Organization (WHO), in advocating for safe abortions in the country. They should also advocate for legalization of abortion in order to help in reducing incidences of unsafe abortions in areas where restrictive abortion laws exist. Risen and Thomas (2008) estimate that approximately twenty million unsafe abortions are performed every year. This figure can be reduced considerably by the help of nurses. Complications of unsafe abortions account for approximately eight percent of maternal deaths worldwide. Unsafe abortions also result into secondary infertility among women.
According to Hoban, Rathavy, and Lam (2010), approximately twenty four million women suffer from secondary infertility resulting from unsafe abortions worldwide. The rate of unsafe abortions has increased from forty four percent in 1999 to forty nine percent in 2008. More than thirty seven thousand deaths resulted from unsafe abortions in 2010. This accounted for more than thirteen percent of all maternal deaths during that year. Nurses should also discourage pregnant women from committing abortions based on less serious social or health concerns. For example, nurses should discourage pregnant women from aborting their children because of socio-economic factors such as unemployment or low family income. This is because life is sacred and should not be taken away.
Nurses are usually faced by numerous ethical issues which require careful decision making. For my part, nurses should be able to uphold both legal and professional ethics when faced with challenges relating to abortion. They must also consider critically the legal, moral, and ethical implications of conducting an abortion. Nurses should ensure that the health risks that are associated with abortion are minimized. For example, nurses should ensure that hazardous equipments are not used during abortions. Nurses should also ensure that abortions are conducted by well trained medical professionals who are duly registered. Abortion should be conducted in safe environments and sanitary facilities. Nurses should also be guided by the legal responsibility to save lives. They should adhere to the provisions of the Abortion Act of 1967.
Nurses should also provide accurate and the latest clinical and legal information pertaining to abortion to women who would like to perform an abortion prior to committing the actual act. Definitely, nurses are responsible for and obliged to provide a competent and supportive nursing care to women undergoing abortion. Nurses should provide care services without imposing personal beliefs on patients who choose to abort. They should also provide counseling services to pregnant women who consider terminating their pregnancies before and after the abortion in order to enable them make right choices. Since abortion has been legalized in the United States of America, nurses should be actively involved in the education, counseling, and care of women seeking abortion services.
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