Recently the 40th anniversary of the 1967 Abortion Act was marked by much debate. I’m not going to focus on the details but I want to consider how we, as nurses, make our ethical decisions.
In a way, the side of the fence that you sit on is less important than what has led up to you choosing your side. As nurses, there are several issues that we have to consider when faced with a tough ethical dilemma – we mustn’t break the law, we have to stick to our professional code of conduct, we must act within trust guidelines. Get the picture? It’s very serious. I don’t want to freak people out but having to make decisions that affect someone’s health and future is a big deal.
So it’s worth considering where the bottom line is for you. For example, there are nurses who refuse to assist with procedures that terminate pregnancies because they believe terminations to be fundamentally wrong.
In mental health settings, nurses speak out during the process of assessment prior to people being placed on a section. I have voiced my dissent in some situations to ensure my patients’ needs are put first. It’s vital to do this. Disagreeing with colleagues may not make you popular but as long as you are acting within the guidelines and in the best interests of your patient, this is the call you will have to make.
It’s not OK to think that, as long as you stay within professional and legal guidelines, you don’t actually have to know what you personally think about difficult issues. As professionals, we are accountable for our own actions and may be called upon to explain them. And I’m sure that most of us have a firm moral code on which we base our behaviour and decision-making. So ask yourself the difficult questions: a patient who is terminally ill wants you to help her die; you know that a young patient is bringing drugs on to the ward; you suspect that someone in your care is being abused; an exhausted mother is pregnant and doesn’t want another child – she wants a termination but doesn’t want her husband to know.
I could go on and I’m sure many of you come across these scenarios daily. What do you do? And why do you choose that course of action? To what extent does the care you show reflect your profession and to what extent does it reflect who you are? Think about where you stand now, because in the heat of the moment, it can be hard to decide which side of the fence is for you.
Alison Gadsby is a mental health nurse in Cambridge