Neonaticide and Nursing 1

Ethical Decision Making

Kamrie Godfrey

Grand Canyon University: NSG-436

08/11/19
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Neonaticide and Nursing

Analysis and Justification

As a nurse, there are certain ethical dilemmas that you will run into more often than

others. One that has been an emotionally charged topic in both the medical and public health

world is abortion. Quality patient care is required from nurses for all patients regardless of their

race, religion, or moral standards. Nurses have an ethical obligation to care for clients without

judging them as right or wrong for their behavior and health care decisions. There is much

discussion about whether a nurse can hand off care to another nurse if he/she feels uncomfortable

assisting in neonaticide. Respecting the autonomy of each patient, practicing beneficence, and

maintaining justice in the health care setting is a part of the job and is extremely important.

Nurses should also have the right to choose when it comes down to protecting themselves

emotionally, physically or spiritually.

In most hospitals, because nurses are at a high risk for injury and abuse from patients, it

is policy that he/she can remove themselves from a harmful situation and hand off care to

another competent nurse. It should be the same in the case of abortion that a nurse can choose to

care for a different client if he/she feels that they would not be able to provide quality care.

Because nurses are responsible for administering medications, it is often their responsibility to

help potentiate the death of a fetus if the patient comes in requesting to abort her fetus. The

ability to have someone else take over care for the patient who can do so in a positive and

supportive manner would benefit everyone involved.

Ethical and Moral Standards

The very foundation of nursing is built on autonomy, beneficence, non-maleficence,

justice and fidelity (Reproductive Health Nursing, 2017). As of right now in our state, this is true
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even in the case where a mom comes in with the desire to abort her baby, and no matter her

reasoning. This does not mean that a nurse must condone or agree with an individual’s choices,

but simply that excellent care should still be provided for every individual who seeks it. While

you must recognize and incorporate a patient’s cultural and religious values into their plan of

care, these things must not be used to judge them. The ANA’s Code of Ethics writes, “A

fundamental principle is respect for the inherent dignity, worth, unique attributes, and human

rights of all individuals” (ANA, 2017).

The Nurse Leader’s Responsibility

The ANA’s Center for Ethics and Human Rights published, “Acts of conscientious

objection may be acts of moral courage and may not insulate nurses from formal or informal

consequences” (ANA, 2015). A nurse leader’s responsibility is to both the safety and benefit of

their nurses and their patients. They must find the balance between advocating for their staff and

supporting the patients on the unit. In the case that a unit is short-staffed, and it is not possible for

a nurse to hand off care to someone else, it is the nurse leader’s job to navigate finding a solution.

Some options would be to discuss the difficult circumstances with two nurses and allow them to

switch assignments, as long as the other nurse is willing to care for the patient requesting an

abortion. Ultimately, the charge nurse must create an open environment for their staff to feel

comfortable bringing them difficult moral dilemmas without receiving consequences for feeling

uncomfortable.

Ethical Decision Model

There are some excellent decision-making models for resolving ethical dilemmas, and

one of those is the DECIDE model. “D” stands for “defining the problem” and “E” is for

“establishing the criteria” (LaCharity, Kumagai, & Bartz, 2013). The problem in this situation is
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that a nurse does not feel comfortable assisting her patient in the death of her unborn child. There

are other nurses on the unit who will willingly switch assignments with her. “C” means to

consider other alternatives and “I” to identify the best alternative. Options for the nurse

originally assigned to the patient are to care for her anyways and to risk the emotions that might

follow after. She could also refuse to provide interventions for the client and risk losing her job if

the nursing leader is not supportive of that decision. “D” is for developing and implementing a

plan of action, which in this case would be to go to the charge nurse with concerns and get the

assignment switched. Finally, “E” stands for evaluating the outcome and is the final step in

making a controversial decision (LaCharity, et al., 2013). Going about this emotional situation

may be challenging but doing it in a professional and level-headed manner is crucial.

Leadership Styles

Each individual’s leadership style will drive the way that they make decisions and come

to solutions. The solution to this controversial issue is to approach the charge nurse, discuss

personal concern, and then step back from caring for the patient who is having an abortion. My

leadership style is both analytical and empathetic. This means that while I tend to internalize the

difficulty of handing off care to another nurse, I also understand the importance of caring for

myself. In being analytical, I know that each patient deserves quality care and that it is important

for another nurse to be assigned to her.

Conclusion

Nurses encounter unique situations every day that require emotional and physical

investment in their patient’s condition. For this reason, they must take care of themselves and

make decisions that others might not agree with. Refusing care for someone having an abortion

and handing off the patient to another nurse is a solution that will ultimately benefit the patient.
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Nurses have the right and even the responsibility to analyze moral obligations and to protect

themselves from emotional, physical or spiritual harm, as does anyone else.

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References

American Nurses Association (2017). American Nurses Association: Ethics and Human Rights

Statement. Retrieved from

https://www.nursingworld.org/~4aef79/globalassets/docs/ana/ethics/anastatement-

ethicshumanrights-january2017.pdf

American Nurses Association (2015). Risk and Responsibility in Providing Nursing Care.

Retrieved from

https://www.nursingworld.org/~4ad4a8/globalassets/docs/ana/riskandresponsibility.pdf

LaCharity, L. A., Kumagai, C. K., & Bartz, B. (2013). Prioritization, delegation, and

assignment: Practice exercises for the NCLEX examination (3rd ed.). St. Louis, MO:

Elsevier. ISBN-13: 9780323113434

Reproductive Health Nursing (2017). Professional Ethics in Unintended Pregnancy and

prevention Care. Retrieved from https://rhnursing.org/wp-

content/uploads/2017/01/Patient-Situation-1-Professional-Ethics-Module.pdf