April 16, 2009, 6:36 pm

Don’t Tread on My Conscience

mdpracticeyellAh, here we see the interns taking notes during “Nurse Abuse 101”.

It seemed to be a popular elective for those doctors of the Marcus Welby era.

He was only nice to Consuelo, he yelled at everyone else.

And eighty per cent of you have no idea who I’m talking about!

Youngsters!

I feel like I should go put in my teeth and hearing aids.

I’m not sure if I just got old and doctors now defer to my age, but with very few exceptions, you don’t hear the ranting and screaming you did in the 70s and 80s.

From the doctors.

I now rant and scream on a regular basis.

Go figure.

(Photo credit: The nurse is named Judy Strickland and the photo was taken in New York by photographer Grey Villet for Life Magazine, September, 1971)

*******************************

UPDATE: The following is supposed to be an opinion piece on how I feel about the possible rescinding of the Conscience Clause.  I could have just said, “I think rescinding the clause sucks”, and left it at that. Instead, I tried to be “artistic” about how I said it.  Now, the terms “weasel” and “Nazi” are being found in association with this post.

I’d like to make one thing clear.  In thirty one years I have never refused to care for a patient.  EVER. I do not judge my patients. EVER. And everyone wants to know what I’d refuse to do, well, let me just be blunt:  I would never actively participate in the process of an abortion.

There.

The elephant in the room has been named.  It’s the only thing I’d ever have to excuse myself from.

And it has never come up in thirty one years of nursing.  And it never will because knowing that I feel the way I do, I have steered clear of fields where that would be an issue.

I guess I need a class in writing, because what I wanted to say apparently has left people thinking I run around with my Christian nose in the air judging everyone around me and refusing care at random based on my moral whims.

Now I guess I’ll get hit for using the “A” word.

That’s what I get for putting religion and politics in a post.

Won’t happen again.

The post remains below as originally written.

******************************

To my patients,

When you present to my hospital for care, you have my utmost respect.

As a person.

As an individual.

Your race, color, religion, sexual orientation or medical issues make no difference in the quality of care I will give, or the compassion you will receive.

You see, I respect you.

Your right to live your life as you choose.

Your right to love who you choose to love.

Your right to make the decisions you choose to make.

*****

I also have rights.

As a person.

As an individual.

The right to my own beliefs.

Personal, religious and political.

Sometimes, my personal beliefs will not mesh with yours.

There might be an occasion where I cannot participate in an aspect of your care that results from a decision you have made.

To do so would be to violate my deepest convictions of what is moral. Or just. Or right.

*****

I’ll state this directly.

I have religious beliefs that might preclude me from active participation in certain aspects of your medical care.

This is not a condemnation of you, my patient.

You have the right to act in accordance with your beliefs.

I can respect that right.

And I have the right to act (or not act) in accordance with mine.

Ah, there’s the rub.

*****

For you see, my patient, that you have options.

If I cannot help you in the way you desire,

If your request would cause me to deny my deepest belief system,

I cannot act.

But I can, and will, give you all the information you need or request, withholding nothing,

So that you are able to find a health care provider or facility that can help you.

And I do it without judging, trying to dissuade, persuade or throwing a guilt trip in your path.

You have options.

I do not.

*****

You, my patient, have the option of finding a health care provider who can help you.

Of being true to yourself.

And I can assist you in doing that.

Happily and without judgment.

I do not have the option of acting against my belief system.

I do not have the option of being untrue to myself.

*****

You see, my patient, you can get what you need from many different places and from many different providers.

You have the right to do that with a clear conscience.

I have to look at myself in the mirror every morning.

I have the right to do that with a clear conscience.

Or, I did.

Until now.

*****

I was protected by the Conscience Clause.

President Obama is considering reversing some of its provisions.

I can live my values and allow you, my patient, to live yours.

I’ll even help you get to where you need to be.

My patient, I fight for your rights.

Your right to do as you choose, live as you choose.

Access medical care as you choose.

Who is fighting for my rights?

*****

Think what you will about the economy.  The stimulus package. The War on Terrorism, where ever it is being fought today.

But, Mr. President, you rescind that clause and you destroy part of a fundamental American right.

My right.

To the freedom of religion.

What comes after that, Mr. President?

What right of mine will you chisel away next?

*****

I cannot, nor will I, ever pass judgment on my patients.

I fight for their right to make their decisions that affect their health care, whether I am in agreement or not.

So, who is fighting for my rights?

…….

I’m listening.

Mr. President.

***********************************

UPDATE:  I’m getting some interesting feedback and thought I would link back to them, both pro and con!

41 Comments

  • Healthcare Today
    Healthcare Today

    April 16, 2009 at 6:44 pm

    Don’t Tread on My Conscience // Emergiblog…

    Patients have a right to their belief system, and to have it respected. I have a right to mine. Where is the respect?…


  • Kirst
    Kirst

    April 16, 2009 at 7:51 pm

    Wow what a powerful post!!! So well written.
    Unfortunately there are still screaming Dr’s out there.
    My old surgeon was/is still one. I have felt embarrassment for the staff involved when she rants on at them. I can see there humiliation and palpate it. Its not o.k.
    I have recently put in a complaint re Dr Disfigure, included in my complaint is the way she has treated the other staff, mainly nurses, and how on a occasion her abusive attitude actually broke down my relationship with my nurse at the time.
    The nurse was being pushed by that Dr into pushing me to eat while I had a Mechanical Bowel Obstruction. She was also yelled out for changing my diet chart to Nil By Mouth, when she had confirmation of my B.O. The nurse then fought with me to eat.
    That caused tension to the point I wouldn’t let that nurse, care for me again. Later on the nurse held out an olive branch, and I also understood that she was placed under extreme pressure. It wasn’t her fault, she was wearing it from both sides. She did nurse me again and I think she does a splendid job.
    I will defend anyone who has been treated like dirt. Regardless of occupation, ethnicity, religion. Abuse is abuse it doesn’t discriminate.


  • Edwin Leap
    Edwin Leap

    April 16, 2009 at 7:52 pm

    Kim,

    Outstanding! Bravo! A truly beautiful expression of what so many of us are feeling.

    Edwin


  • Aura
    Aura

    April 17, 2009 at 2:35 am

    Hi Kim, love your blog!

    I was just wondering if you could give a couple of examples of situations where your conscience/morals might preclude you from giving nursing care.

    As a 3rd year nursing student, I haven’t YET come across a situation like that. However, I’m sure I will soon be enlightened whether by other nurses or experience!


  • Kim
    Kim

    April 17, 2009 at 4:09 am

    Kim,

    I do understand where you are coming from, even as a liberal there are things that my conscience would twinge at concerning the care of individuals.

    I was wondering if you have the link to where President Obama makes these statements, or perhaps a news story about him reversing the Conscience Clause? I did not see it listed as a source.


  • rlbates
    rlbates

    April 17, 2009 at 4:46 am

    Great post, Kim, but the problem is not all will do as you do and not judge. Some will not even pass on the information needed as they think that will violate their conscience. Wish everyone felt like this:

    “But I can, and will, give you all the information you need or request, withholding nothing,

    So that you are able to find a health care provider or facility that can help you.

    And I do it without judging, trying to dissuade, persuade or throwing a guilt trip in your path.”


  • linda-lou
    linda-lou

    April 17, 2009 at 5:39 am

    “I was wondering if you have the link to where President Obama makes these statements, or perhaps a news story about him reversing the Conscience Clause? I did not see it listed as a source.”

    Try Google. This is a very hot topic for debate right now.


  • Kim
    Kim

    April 17, 2009 at 6:25 am

    When I googled it I found articles that paint a very different picture then the one Kim has painted. I want the one she had in mind while writing this. I like to see all sides of a matter rather then just one.


  • Unconscience « DUNCAN CROSS
    Unconscience « DUNCAN CROSS

    April 17, 2009 at 7:01 am

    […] am not in a sympathetic mood when it comes to religious belief and health care. Which brings me to Kim at Emergiblog, who is sad to see the “Conscience Clause” go; here’s a few key quotes, minus […]


  • Reality Rounds
    Reality Rounds

    April 17, 2009 at 7:57 am

    Compelling post Kim! Of course the elephant in the exam room is abortion (don’t be so naive commenters). The Bush Administration ruled to allow even ancillary workers in a health care facility to not provide information or services which they believed to be in opposition to their own moral understanding. This decision was made in the waning moments of the Bush presidency. It is great that Kim’s patients have access to other health care professionals who can counsel and give them options that she is religiously opposed to. I wonder if the patient in rural North Dakota would have that same luxury? This post reminds me of when I was in nursing school, and nursing students from another school had to take care of Richard Speck while he was dying. You know, the Richard Speck that murdered 8 nursing students in the 60’s. I may have to post on that one day. Thanks for the great post Kim!


  • […] Read the rest. […]


  • jamjar
    jamjar

    April 17, 2009 at 12:44 pm

    I usually enjoy your posts Kim, but not this one. I have been an RN for 40 years. While I have strong religious and ethical beliefs I feel that we cannot judge and we cannot refuse to care. It’s a slippery slope when we use something like the rule of conscience to “guide” our practices. I cannot judge the HIV/AIDS patient or the pregnant unwed mother but I can and will provide care. An extreme example- I believe in the sanctity of marriage and that children should only be conceived in a marriage. That being said what should I do with the unwed pregnant teen who comes in bleeding? She has committed a “sin” and her pregnancy violates my religious beliefs. I shouldn’t treat her, right? This rule of conscience can be used in so many ways that are cruel and evil. I am not a Nazi. I don’t agree with what the teen did but I’ll be damned if I don’t treat her and make every effort to save her life and that of her child.


  • Karen Moeller
    Karen Moeller

    April 17, 2009 at 12:45 pm

    Kim, you write: “There might be an occasion where I cannot participate in an aspect of your care that results from a decision you have made.”

    I sit here wondering what that occasion might be. I think you should spell it out. Be specific. Have you actually been in a position of this type? If so, how did you handle it?

    I think further elaboration would help to understand what you are espousing.

    Nursing seems to have so many wonderful opportunities that I can’t imagine a nurse having to accept any position that would compromise principles.

    KarenM in NC


  • Walt Trachim
    Walt Trachim

    April 17, 2009 at 1:40 pm

    A thought-provoking post. So much so, that I wrote about it, and it can be found at the following:

    http://manchmedic.blogspot.com/2009/04/whos-judging-who.html


  • Basiorana
    Basiorana

    April 17, 2009 at 7:41 pm

    I oppose the conscience clause.

    But I agree with your right to not practice procedures you disagree with.

    Because you, unlike many who took advantage of the clause, do not restrict access to the procedures. You simply refer. You make sure that you refer them to someone they could access. I’m sure you would not turn away an ectopic pregnancy (that’s the only emergency abortion I can imagine– and doesn’t gynecology handle those, too?), but would simply take some other nurse’s patients so she could.

    I think the law should be rewritten. All providers should have the right to refuse to perform any procedures themselves– provided they do not lecture or judge, and they refer to another practitioner who will do it. In an emergency, that means someone else in the hospital at the time; in a non-emergency, someone the patient can practically go see in a timely fashion. So if a pharmacist wants to refuse Plan B, and they live in the middle of nowhere and the nearest pharmacy is an hour away, no. But if they are in suburbia and are across the street from another pharmacy, and they call over and ask the other pharmacist if they are willing to take it and the other pharmacist agrees, I have no problem with them discretely sending the patient across the street.

    I support your right to refuse to perform abortions until refusing actually prevents a person from getting one. From what you’ve said, that has never been the case. I applaud you, but remember, repealing this law is about the women in Kansas who can’t get birth control, not about a woman in San Francisco who has a different nurse perform her abortion than the one who did her intake.


  • Laura
    Laura

    April 17, 2009 at 10:32 pm

    >I support your right to refuse to perform abortions until refusing actually prevents a person from getting one. <

    At which point… what?


  • Bo
    Bo

    April 18, 2009 at 7:40 am

    When I was in nursing school, one of my clinicals was the outpatient surgery department. And the particular surgery I was assigned to was an abortion done under general anesthesia. I remember the doctors and nurses ridiculing the patient as they performed the surgery, and the whole thing made me sad….

    This was a very good and thought-provoking post.


  • dr nic
    dr nic

    April 18, 2009 at 8:27 am

    I’m with you on this one Kim. I once got into a very heated debate with a commenter on a friend’s website, who tried to argue that because I didn’t want to participate in elective abortions I had no business being in medicine. It was very frustrating.


  • Basiorana
    Basiorana

    April 18, 2009 at 8:38 am

    “I support your right to refuse to perform abortions until refusing actually prevents a person from getting one.

    At which point… what?”

    At which point you can still refuse. But the person who was denied health care should have the right to sue you, and have your license revoked, because you caused them harm (physical, emotional, and financial) not because of an innocent mistake or a medical decision, but because of a religious belief they did not hold. If you don’t want to perform abortions, you don’t have to go into obstetrics and gynecology or outpaitent surgery. If it bothers you, there are a lot of nursing roles where you are desperately needed that will never ask you to take part in an abortion. Geriatrics, for example, or neonatal nursing, or something similar. I can sort of understand the dilemma of a pharmacist who trained before Plan B came out and now has to distribute it, but a nurse does NOT have to pick one of the few fields where abortions happen and even in those fields, she’s unlikely to be working alone in the only facility that can perform the abortion within a reasonable distance, so if she managed to make sure she was literally the only nurse available to help a doctor perform an abortion and then refused and the doctor couldn’t continue without her, she DESERVES to lose her license, because I can’t imagine that scenario coming up, ever, except by the nurse’s own design. I doubt Kim would have chosen to work in obstetrical surgery, for example, knowing they perform abortions there.


  • Laura
    Laura

    April 18, 2009 at 3:59 pm

    “But the person who was denied health care should have the right to sue you, and have your license revoked, because you caused them harm”

    That goes to a serious entitlement mentality, in which non-emergency health care is is a right which people may receive on demand from people required to give it. I can understand the concept of EMPTALA. But we’re not talking about life-threatening situations. Let’s assume I’m a Christian who really loves to deliver babies and/or care for women and loves small-town life. Because I hold a view that only fifty years ago was entirely unremarkable, I should now be subject to restrictions on my profession and/or where I live, and on my free speech?

    Abortion supporters seem to have invented a right to be referred, as opposed to the already existing right to pick up a phone book and find your own provider. You’re advocating a society that is less free than what we have right now. In a more free society, people who want abortion can go find one, and people who believe abortion is wrong can refuse to perform them or assist people in getting one.

    I’m not even in health care. I went right through nursing school and loved the book work, but when it was time for clinicals I realized I liked computers better than people. 🙂 But this isn’t just about health care.

    We also have similar religion/job conflicts with Muslim cab drivers, store clerks and other jobs that may intersect with alcohol, pork, etc. A Christian photographer in AZ was fined about $4k by a human rights commission for refusing to photograph a same-sex commitment ceremony.
    There are a lot of jobs that societal trends are now shutting people of faith out of, and I think it bears a lot more debate than it’s currently being given.


  • Nurse K
    Nurse K

    April 18, 2009 at 4:26 pm

    I’m an atheist and wouldn’t assist in an elective abortion either. When you see well-formed hand-sized 20-weekers die c/o miscarriage, it’s a sad day when you want to “help” people end the life of similar babies who would otherwise survive.

    Basiorana,
    Physicians have the right to terminate the physician/patient relationship at any time for any reason unless they are in the midst of an emergency stabilization under EMTALA (or someone needs to stabilize them). No doctor should be forced to provide means to end the life of a baby if he/she does not want to. That’s just silly. Besides, Plan B is OTC.


  • ThirdDegreeNurse
    ThirdDegreeNurse

    April 18, 2009 at 6:24 pm

    I’m having a hard time believing that you NEVER judge your patients, Kim. It’s not humanly possible, unless you’re far, far above the madding crowd. And if you are, I’m sure you’re not wearing scrubs.

    BTW, there are good reasons for women having safe, legal abortions, rather than having them done in the back room with a coat hanger, don’t you think?


  • Laura
    Laura

    April 18, 2009 at 6:48 pm

    I don’t see what the big deal is about judging, if by judging you mean “form an opinion about.” We all do that every day about everyone we encounter, at some level. The key is to keep that opinion to yourself… something we should generally do in polite society anyway. My clients have no idea what I think of them, nor should they. That’s just being professional, something that isn’t restricted to health care practitioners.


  • Reality Rounds
    Reality Rounds

    April 18, 2009 at 7:14 pm

    Nurse K: “Plan B is OTC”.
    Yes, but under Bush’s Conscience Clause, that pharmacist could refuse to give anyone Plan B if he/she was religiously opposed to it. It is still under the control of the pharmacist. Physicians certainly are not forced to perform abortions, but they are obligated by law to council woman of their reproductive rights. Remember, abortions are not illegal in this country, no matter what your religious or moral views may be.


  • Judah Ivy
    Judah Ivy

    April 18, 2009 at 7:48 pm

    ThirdDegreeNurse,
    I’ve never understood the coat hanger argument.
    If abortion IS murder (Which many believe) than this “back alley coat hanger” argument is the equivalent of saying “Wouldn’t you rather have all murders safely and cleanly performed in a surgical environment rather than in a back alley with a handgun?” – to have the medical sanction on that sort of thing would just serve to make it more horrific.


  • Aura
    Aura

    April 19, 2009 at 2:16 am

    I would have thought that it is possible to be pre and post natal nurse without needing to do abortions. Most abortions happen in abortion clinics or hospital clinics in which case it is a huge part of your role. In the case of an emergency nurse, if a patient presented with an ectopic pregnancy, it is a medical emergency and you are saving the mother rather than aborting the child. There are so many nursing roles that it should be possible to find a career that agrees with our principles.

    If an organisation offers certain services and we work for that organisation, we are obliged to provide said care. Yes, it is human to have opinions and sometimes (internally) pass judgement, but the patient should not be aware of our feelings. The education that we provide to our patients should be along “evidence based guidelines” and company policy not personal religious beliefs.

    Patients approach us for health care not religious counselling. If we feel unable to provide certain care and we cannot work out an arrangement with our colleagues to step in in these situations, then look for a job that suits you better.


  • Basiorana
    Basiorana

    April 19, 2009 at 7:04 am

    “it’s a sad day when you want to “help” people end the life of similar babies who would otherwise survive.”

    No. Not similar babies. There are only three providers in the entire US that perform abortions after 20 weeks. Everyone else just gives you a C-section or induction and tries to save the baby if your life is in danger. When anyone talks about abortion access, they’re talking about early, pre-viable pregnancies, because late abortions are so incredibly rare and usually are more like inductions and then allowing the child to die because care is futile.

    “Plan B is OTC”

    You have to get it from the pharmacist himself so he can make sure you aren’t on any conflicting meds that could hurt you. So you don’t need a prescription but you do need a pharmacist.

    “Let’s assume I’m a Christian who really loves to deliver babies and/or care for women and loves small-town life.”

    Why are you working for a provider who performs abortions, then? I’m not saying an independent practitioner needs to perform them unless it really is an emergency, like an ectopic. You can send someone to a clinic in the nearest city for a non-emergency, unless you’re talking sending them several states away or some other situation where the delay will create ethical concerns with the later abortion. But if the doctor or clinic you work for performs them, why are you working there as the only possible nurse? That’s your own fault. That’s EXACTLY like a Muslim working at a restaurant they know serves alcohol and pork and then refusing to serve it. Find another job. I won’t work in a supermarket and then refuse to sell you cigarettes because I believe they are horrible, don’t work for a doctor who performs abortions and then refuse to give me one.

    “Abortion supporters seem to have invented a right to be referred, as opposed to the already existing right to pick up a phone book and find your own provider”

    Except when you try to find an abortion provider, you get a deluge of crisis pregnancy centers. What’s more, it is INCREDIBLY time sensitive, as each week that it is put off creates an increasing moral dilemma. Finding and arranging an appointment with a primary care doctor, a common service, took me over a month with no referral or listing of doctors taking new clients. That could be the difference between an embryo and a fetus with an abortion provider.

    You have a right to practice your faith, but you do NOT have the right to impose it on me. If you refer me, you aren’t imposing your faith on me because I am not limited by your practicing your faith. As soon as you start lecturing me on abortions, refusing to help me find an alternative, whatever, you are imposing your religious beliefs on me, and denying me my right to not believe what you believe.

    “I’ve never understood the coat hanger argument.”

    Think of it this way. Would you rather any time a person killed in self-defense (abortions would usually fall under state self-defense rulings since they threaten the woman’s person– even a healthy pregnancy has risks), they themselves also died? Is it better to have self-defense killings be murder-suicides than just murders? Even if you don’t agree with it, that’s what pro-choice people are arguing.


  • Laura
    Laura

    April 19, 2009 at 7:52 am

    “Why are you working for a provider who performs abortions, then?”

    In this scenario, I’m NOT (and in this scenario, I could be any health care provider, not just a nurse). But a pregnant woman comes in an announces she wants an abortion. In your view, I’m obligated to refer her to someone: “You can send someone to a clinic” – i.e. do the very thing I am against – facilitate an abortion!

    “Except when you try to find an abortion provider, you get a deluge of crisis pregnancy centers.”

    Then people who support abortion had better get busy advertising. Planned Parenthood clinics – which enjoy massive taxpayer subsidies and are all over the place don’t seem to have any problems providing abortions and facilitating them. *Nothing* is stopping abortion supporters from taking out big ads and buying billboards to promote their product.

    “You have a right to practice your faith, but you do NOT have the right to impose it on me.”

    Again: I’m advocating a more free society. I personally am against abortions and would not assist them in any way at all. But if you want one, or want to help provide them, or to promote them, then go ahead. The onus is on you to promote what you want, not on me to promote what you want.

    Do you see that you’re advocating other people imposing their views on me? Let’s try your argument out on your side: You do have a right to practice abortion, but you do NOT have the right to impose it on me.


  • Basiorana
    Basiorana

    April 19, 2009 at 9:51 am

    “*Nothing* is stopping abortion supporters from taking out big ads and buying billboards to promote their product.”

    Every single time abortion clinics advertise publicly in any area where choice is ostracizd, there is a massive public outcry about corruption of youth. They are stopped by religiously motivated local ordinances, lawsuits, and vandalism. Indeed, most local towns argue against advertisement by saying that women who need abortions can get a referral from a hospital or their doctor. Meanwhile a crisis pregnancy center can take out a huge billboard by a highway and no one bats an eyelash, despite the extreme emotional trauma they inflict on the scared young women that come to them for help.

    Why, exactly, is it too much to ask that you give a woman a pamphlet on places that provide the service? You are not promoting them. You don’t offer them to anyone who does not specifically request one. You know the person already intends to at least look into an abortion. You’re just making sure they can do it in a timely manner– unless you beleive it’s equally bad to abort in the 5th week as in the 20th.

    You see, you claim to advocate a more free society, but you are actually advocating a more restrictive one. You favor the right of a single provider to prevent access to abortion over the rights of many, many women that provider may see to get unrestricted access to healthcare. You are actually infringing on their religious freedom, too, because you are denying them appropriate care not based on medical concerns, but on religious ones. You get your right to tell a woman you don’t do abortions and shove them out the door without any help at all, but they– many, many of them– lose the right to access appropriate, legally acceptable health care.

    Let’s say I oppose giving futile care to brain-dead persons. If I owned a hospital, should I, under the conscience clause, have the right to kick out patients who were brain-dead witohut transferring them to another facility that would care for them? They have no medical indication for requiring further care, since they are dead. Can I unplug them and send them home, even if their family opposes it? Or should I instead be obliged, not to continue care myself against my beliefs, but to arrange for transport to another facility?

    I have a right to access healthcare if it is available and I can afford it, regardless of the differences between my religious beliefs and yours. You have the right to find a job where you are not asked to do something you oppose.


  • Laura
    Laura

    April 19, 2009 at 10:32 am

    “They are stopped by religiously motivated local ordinances, lawsuits, and vandalism”

    Ordinances: If the local ordinances are a reflection of the public will, than that’s the very basis of our country’s government. You can vote out the pols who passed those ordinances and vote in new people to rescind them. Lawsuits: is it legal, or not? Let a court decide. Vandalism: Already a crime, let it be prosecuted as such.

    “despite the extreme emotional trauma they inflict on the scared young women that come to them for help.”

    Document that, please. And keep in mind that I can match you survey for survey and study for study about the extreme emotional trauma that abortion inflicts on scared young women that thought it would help and later regretted it, who say they were not given adequate information about the baby they aborted and instead were assured it was just “tissue” etc..

    “Why, exactly, is it too much to ask that you give a woman a pamphlet on places that provide the service? You are not promoting them.”

    Okay, as a thought experiment, how about we require Planned Parenthood to distribute literature listing Crisis Pregnancy Centers and the services they provide? Are you okay with that?

    “You favor the right of a single provider to prevent access to abortion”

    Is he blocking anyone, really? Kidnapping them and restraining them until after whatever week # society currently decides makes a live baby? He’s taking their phones and stopping them from calling around? No. He’s just not helping them. He’s passively sitting there, not helping.

    But you’re sayig that instead of passively sitting there, he has to take an active part in furthering an abortion. By your own argument, (with which I do not agree) if he doesn’t hand out the literature, then the abortion may not happen. So by handing it out, he’s actively helping a baby to be aborted. His beliefs are being violated. That is less freedom.

    “lose the right to access appropriate, legally acceptable health care.”

    No, they don’t. They can go get it. And abortion supporters should make it a point to find a way to keep these women informed without infringing on other people’s rights.

    And as a previous atheist commenter noted, all opposition to abortion is not religiously based. It is possible to make a sincere, informed case against abortion without once saying the word God.

    “Let’s say I oppose giving futile care to brain-dead persons. If I owned a hospital, should I, under the conscience clause, have the right to kick out patients who were brain-dead witohut transferring them to another facility that would care for them?”

    That’s not really a hypothetical – it’s been happening for some time. As a matter of fact, in Texas, the UK, and many other places you can legally pull the plug on those people. That’s another area which deserves a good deal more debate than is currently being given. In Texas, families are informed that the plug’s getting pulled on X date. It happens all the time, and not just to brain-dead people. Andrea Clark is a prime example; google her case. The onus is already on the family to find alternative care.


  • geena
    geena

    April 19, 2009 at 1:31 pm

    First of all, I am pro-choice. I am personally against abortion and would not personally have one done, but everyone else is on their own.

    This comment from Jonah:
    “I’ve never understood the coat hanger argument.
    If abortion IS murder (Which many believe) than this “back alley coat hanger” argument is the equivalent of saying “Wouldn’t you rather have all murders safely and cleanly performed in a surgical environment rather than in a back alley with a handgun?” – to have the medical sanction on that sort of thing would just serve to make it more horrific.”

    The difference is that in one situation, you are causing the death of one person. In the other situation, you are possibly causing the death of two people, or the death of one and maiming of the other.

    Abortions done in a controlled medical space are safer for the woman and pose less risk to her health.


  • Nurse K
    Nurse K

    April 19, 2009 at 6:55 pm

    Re: Plan B

    Aren’t there any capitalists here? Don’t pharmacies have a right to determine which drugs they do and do not sell? Certainly, if one pharmacy doesn’t want to sell something that is in demand, another one will decide to sell it. If you have to drive an extra 20 miles out of your way, so be it, that’s how capitalism works. That’s an obvious case of needlessly intruding on capitalism. Whether or not an individual pharmacist sells something that is in stock should be between the pharmacist and his employer.


  • […] tiene pérdida el link a un post de una enfermera de emergencias sobre cómo ella respeta a sus pacientes… y espera que también la respeten a […]


  • Rosemary
    Rosemary

    April 20, 2009 at 2:01 pm

    Kim, having had a worse reaction to a totally non nurse blog posting,about where I am living at present, complete with 100 + abusive comments I can relate to how you feel right now….time heals all wounds and self esteem and conviction do return- slowly. Keep blogging- I have chickened out for now but feel better when I read others who hold strongto their convictions/beliefs.
    Go well


  • […] Kim over at Emergiblog reminds us that she never passes judgment on her patients, and that nurses deserve the same fair treatment as […]


  • Wow
    Wow

    April 21, 2009 at 8:12 am

    I disagree with some of these comments entirely. Sorry, but when you choose healthcare, you are working for the patient, not yourself. It doesn’t matter what you believe. Should a doctor who believes in eugenics not allow a family with Cystic Fibrosis or diabetes to conceive? Should a racist doctor not treat a white patient trying to conceive via IVF with a black man? Also, just because YOU think premarital sex and pregnancy is a ‘sin’, it doesn’t mean everyone else does. Not everyone shares your religion. Your role is not to judge, your role is to provide healthcare for your scope of practice. If I had a deformed fetus or life-threatening pregnancy, I would abort. Why have a child who will suffer for their short life? Or risk my life and body for a baby that will likely die? Gastly. Anyone who is a proper healthcare provider will not impose their own values onto others who may not share their views. Especially when suffering is at stake. Are you going to deny giving someone a blood transfusion because YOU are a Jehovah’s Witness? Come on now. Accept that you will have to do some things in healthcare that you disagree with (including abortions), or get out.


  • Wow
    Wow

    April 21, 2009 at 8:20 am

    Note, this also includes “pulling the plug” on people who have no chance of recovery and/or a normal life. The fact is, even if they are not in any agony (which depending on their state they may be), you are wasting precious resources that could be used to save someone else or improve the health of someone who can recover. Yes, you are letting someone die, but keeping someone alive artificially is not natural in the first place. This is medicine. Doctors don’t mix personal values with ethics as much. It’s logic on a wide scale, not personal. Nurses should take that advice…use your head.


  • Laura
    Laura

    April 21, 2009 at 8:29 am

    “Sorry, but when you choose healthcare, you are working for the patient, not yourself. It doesn’t matter what you believe. … Your role is not to judge, your role is to provide healthcare for your scope of practice. … Note, this also includes “pulling the plug” on people … you are wasting precious resources

    NICE.


  • Laura
    Laura

    April 21, 2009 at 8:35 am

    Okay, sarcasm aside, let’s review what you just wrote, “Wow.”

    Health care professionals must be required to nonjudgmentally serve the patient regardless of their personal beliefs, never imposing their values upon others.

    Except when *you* conclude that their life is no longer worthwhile, in which case the plug should be pulled so that those resources can be devoted to someone you feel is more deserving of them.

    And you don’t see anything contradictory in your opinions?


  • Matt Freeman
    Matt Freeman

    April 24, 2009 at 10:38 am

    Very well written post. My wife is going to school to become a CMA for now. We talk often about the items that you wrote about. We are Christian as well and there is an obvious conflict.


  • Katie B.
    Katie B.

    May 5, 2009 at 8:05 am

    Unfortunately, you do not have your facts straight. The Obama administration is considering rescinding the midnight-regulation passed by President Bush that tacks on to existing regulations protecting health care workers. This new reg was an attempt to explain some of the ambiguous parts of the old reg, but instead it broadened the ambiguity. It gives providers the right to not only refuse to provide care, but the right to not refer the patient to anyone else that can give the care. It was a very poorly worded and politically motivated regulation, and needs to be rescinded. You are still protected by the existing regulations that were passed in the 1970s after Roe v. Wade.


About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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