Pro life or pro choice; this is what commonly comes to mind when the debate regarding abortion is provoked, intentionally or unintentionally. People usually debate taking the sides of either the mother or the unborn child. Not many have stopped to consider the effect of abortion on the people who actually have to perform and aid in the procedure. This is very similar to the people who give the lethal injection; even though they are only the masked men who play a part in the process, there is a great toll that is taken on their personal moral standing. The same idea applies to the nurses who aid in the process of abortion. Even though they are just middlemen, it is not a job to be taken lightly and no matter their position in the debate they still have to do their job. Regardless of the stance a nurse takes on the debate regarding abortion, the issue weighs heavily on his or her conscience eventually, if not immediately.
The debate regarding abortion deeply involves the consideration of personal ethics and morals and the stance each individual takes. The issue of abortion is very controversial even in terms of nursing. There are many laws and regulations that protect a nurse from having to be involved in the process of abortion if their religion or morals prevent them from being comfortable in the situation. It is the right of a nurse to decline aiding in an abortion procedure. They may be required to give care to the patient, when considering the involvement of the abortion itself. The American Nursing Association code clearly states that, “nurses care for patients regardless of the patient’s values and life style” (Ethical Dilemmas & Nursing Practice, 2010). 61 percent of nurses object to being part of the procedure but all agree that care is necessary before and after and should not be allowed to deny, regardless of comfort on the subject (Ethical Dilemmas & Nursing Practice, 2010). There have been state laws and institutional policies put in place to ensure that a nurse’s refusal to participate in an abortion will not hurt his or her career or punish them in anyway. Issues come up when a nurse who is accepting of early terminations accepts the participation in an abortion that is a late termination. The nurse will then have a hard time to decline being involved in the procedure because they can’t be selectively accepting, even though late terminations make many involved in the process uneasy. Refusal by the nurse to participate is based on religio-moral grounds; this is why selectively refusing to participate in abortions due to the gestation period or such may cause complications leading to nurses selectively refusing to give care. The problem that comes with selectively accepting or rejecting to give care promotes the judgment of the patient, which is unethical in the nursing world. As the book Health Care Ethics points out that an unborn fetus is still a human regardless of the fact that it is undeveloped (Page ). Seeing the fetus either by the patient or the health care provider takes a great weight on the conscience of the people who witness the procedure, regardless which side the person takes on the issue of abortion.
Despite the position a nurse takes when considering the issue of abortion, a nurse must give full potential of their care to a patient before and after the procedure in addition to providing aid if complications arise. Nurses are required to be trained on the abortion technique in a classroom format. Most often a video is shown that explains step by step what is entailed in the process. It is at this time that, many realize whether or not they are fit to assist and whether or not they are capable of moving past the fact that this deals with a tiny human being whose life is prematurely terminated (Yarbrough, Catherine Jean). Surgical termination can be done from a gestation period of seven to eleven weeks. This is normally a daylong procedure that requires an overnight stay. It has the most complications and calls for the most attention of nurses. As the article states, “the procedure is a vacuum aspiration, which involves a catheter being inserted through the cervix and suction being applied to remove the contents of the uterus” (Conscientious Objection to Termination of Pregnancy: The Competing Rights of Patients and Nurses). The procedure takes such a toll on the nurse because they are the ones who have to clean up the remains, and count them to make sure none of the fetus is still in the uterus. This causes moral, physiological, and physical discomfort to many nurses as well as the patients. There are psychological consequences that are uncertain but there have been reports of severe psychiatric disturbance in patients, 8 months after abortion for patients (Clinical Focus). This shows effect of an abortion can be very severe, psychologically and emotionally to the patient. Nurses are the ones who have to aid in the process and they have to participate in more that a typical patient. The emotional toll that the nurses have to handle seem far greater than that of the patient even though the patient may take a large toll emotionally themselves. The abortion process is very similar to that of an emergency D&C (Dilation (or dilatation) and curettage) which occurs during a miscarriage. Cathy Yarbrough is a nurse that has been working in the hospital for many years, she chose to decline being a part abortion procedures, however she has had lots of friends who chose to participate and who have themselves had abortions. During an interview she talked about how one of her friends had two abortions when she was young yet once she was ready to have kids, could not. This is not an uncommon matter. Many women who have abortions, due to scar tissue, become infertile and cannot have children when they want to because of the choices they made when they weren’t ready for a child (Yarbrough, Catherine Jean). Nurses are the ones who relate and emotionally aid the patients. Not only do they have to help themselves through the traumatic experience, but also they have to aid the patients who have complications, immediate and long term. No one takes the abortion process lightly. In addition to protecting the psychological stand point of the patient a nurse must constantly check on his or herself to be sure that the abortion process isn’t affecting them in a harmful way. The abortion process contains controversial issues that eventually impact the nurse in a negative way.
The issue of abortion takes a toll the nurses emotionally eventually if not immediately. Every nurse copes with the issue in different ways personally, however professionally it seems to be fairly consistent. Often the nurses convince themselves that what they are doing is good in terms of how the birth of a child may affect the patient. In the U.K. there was a study by the Journal of Advanced Nursing where nine nurses who work in the abortion field volunteered to show the effect of abortion on the nurses who execute the procedure. The nurses were all women and took a pro-choice stance. They stated that, “I think it should be any women’s right to have any procedure performed which they see fit at that time”. The nurses make it clear that they try to have an atmosphere in the office that is free of judgment. However this seems to be an oversimplification of a complex set of emotions as the nurses later confess to feeling uncomfortable and sometimes in violation of their morals by participating in the process (Journal of Advanced Nursing). The nurses convince themselves that they are doing a good thing; that they are helping to create a better life for the women by letting her choose to start a family on her time, regardless of the activities she participates in. Another one of the ways the nurse’s cope is by placing the levity of the situation onto someone else. They transfer the weight of the decision so it rests solely with the client, saying, “[the client] had to make the choice, I haven’t made it.... It is not my choice, it’s theirs” (Journal of Advanced Nursing). As accepting of the situation as the nurses in the study seem, they admit to avoiding situations that would provoke the question of where they work. This is because other people judge them and often it starts up a debate they would rather not partake in (Journal of Advanced Nursing). Though the nurses seem to be mostly accepting of abortion, many confessed to feeling uncomfortable with late gestation abortions. The women say that they simply have to put aside their feelings and do their job regardless of their level of comfort. The nurses feel a duty to their job and try to detach themselves emotionally as much as possible without sacrificing good service.
It is rare in this debate for people to consider the effects of abortion on anyone besides the potential mother. The patient often does not take into account, prior to the procedure, the effect that they are thrusting upon themselves and those who execute the process. The nurses who work in an abortion clinic have chosen to deal mainly with abortions. However as Dolores P. talks about in the article Ask an Abortion Provider, nurses and nurse practitioners in the abortion field are dying out. This could possibly be due to the negative affects the procedure place on the nurses. The article goes on to talk about how the issue of abortion is never an easy decision. It is weighed down heavily by personal reasons that result in an abortion. Many patients that come into the clinics do not consider or initially care about how the abortion may affect them or those who perform the procedure. It is hard to defend how the procedure can have negative results on the nurses who work in abortion clinics because they chose to be deeply involved with that field of work. Except to say that they may not realize possible ramification later on in their career. The nurses that work in the hospitals however do not choose to work with abortions directly. Patients will choose to come to a hospital instead of an abortion clinic to have the procedure done. Due to the negative consequences that many nurses feel when having participated in an abortion procedure there have been laws put in place to ensure that the nurses will be able to stay psychologically sound as well as able to give the appropriate care to the patients without being involved in the actual procedure. Many nurses in the hospitals do not want to be apart of abortions due to personal beliefs, as well as religious and moral reasons, however some agree to be involved in the procedure because of the complications that may occur when a patient is turned away due to reasons that are not medically related. Most abortion patients consider issues such as whether or not they should have the child instead of how an abortion may affect them both emotionally and physically and those who may also be affected by their decision. Abortion is a topic that is to be taken lightly by none; many psychological issues develop in those who are involved in the process, whether it be the patient or the nurses.
The negative effect of abortion on the nurses who are involved in the process is much larger than many would expect. The issue weighs heavily on the person’s conscious due to the moral values on life and how these values are influenced by faith, culture, and personal ethics. Even though it is argued that a fetus may not be considered a human, all who have seen an unborn child can recognize how similar a child that was born is to that of an unborn fetus, structurally speaking. The issue of abortion effects nurses so severely because to many it is not simply tissue matter; many, especially to those who are deeply religious, think it of as the body of a lost life. All nurses who participate in the process of abortion admit to having doubts and guilt on the matter. Disregarding the stance a nurse takes on the matter of abortion, the process places a great weight on his or her conscience eventually, if not immediately.
Works Cited
Davis, Anne J, Marsha D Fowler, and Mila Ann Aroskar. Ethical Dilemmas & Nursing Practice. 5th ed. 2010. Upper Saddle River: Pearson Education, 2010. Print.
Gallagher, Katie, Davina Porock, and Alison Edgley. “The Concept of ‘Nursing’ in the Abortion Services.” Journal of Advanced Nursing (Oct. 2009): 849-857. CINAHL. Web. 12 Apr. 2011.
Kane, Roslyn. “Conscientious Objection to Termination of Pregnancy: The Competing Rights of Patients and Nurses.” Journal of Nursing Management 17 (2009): 907-912. CINAHL. Web. 12 Apr. 2011.
Lipp, Allyson. “Challenges in Abortion Care for Practice Nurses.” Clinical Focus 19.7 (2008): 326-329. CINAHL. Web. 12 Apr. 2011.
Morrison, Eileen E. Health Care Ethics. 2nd ed. 2009. Sudbury: Jones and Barlett, 2009. Print. Critical Issues for the 21st Century.
P, Dolores. “Ask an Abortion Provider.” The Hairpin. N.p., 3 Mar. 2011. Web. 13 Apr. 2011. .
Yarbrough, Catherine Jean. Personal interview. 20 Apr. 2011.