ETHICAL DILEMMA: Refusal To Provide Care Omar Perez-Sandoval Stacey Lacsina Daryl Apostol Izumi Suzuki Brianne Chinen

Refusing to Provide Care Any nurse who feels compelled to refuse to provide care for a particular type of patient faces an ethical dilemma. The reasons given for refusal range from a conflict of personal values to fear of personal risk of injury.

What would you do? Scenarios: ●You have been assigned to a patient that has active tuberculosis ●A patient is actively bleeding and is HIV positive. ●A patient is verbally abusive, uncooperative, and is threatening to physically harm you. ●A patient is admitted to the E.R. with flu like symptoms after a recent trip to Africa. ●You are a devout Christian who does not believe in abortion, but you have orders to administer the morning after pill to a patient.

Code of Ethics for Nurses Provision 1. “The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes or the nature of health problems.”

Nurses SHOULD NOT refuse to provide care

Why should nurses NOT refuse to provide care? ●Beneficence ●Professional Obligation ●Discrimination ●Patient abandonment & negligence ●Insubordination/dismissal

Statement of ANA Position The American Nurses Association (ANA) upholds that registered nurses – based on their professional and ethical responsibilities – have the professional right to accept, reject or object in writing to any patient assignment that puts patients or themselves at serious risk for harm. Registered nurses have the professional obligation to raise concerns regarding any patient assignment that puts patients or themselves at risk for harm.

Nurses CAN refuse to provide care

Why should nurses be able to refuse to provide care? ●Right to refuse care if the nurse believes it is unethical ●Right to refuse care if it goes against the nurse’s religious beliefs ●Right to refuse care if the nurse believes that it will place her or others in danger

Refusal of care ●Clear reasons ●Based on moral, ethical or religious reasons ●Maintain consistency

References Benjamin-Samuels, A. (2000, December 8). First Amendment Center. Retrieved March 16, 2015, from to-dispense-morning-after-pill-sues- california-county to-dispense-morning-after-pill-sues- california-county CNO (2009). Practice guideline: refusing assignments and discontinuing nursing services. Retrieved March 18, 2015 from: Johnstone, M. (1898). Law, Professional ethics and the problem of conflict with personal issues. International Journal of Nursing Studies, 25(2), Maryland Nurses Foundation (nd). Giving, acceptin, or rejecting a work assignment: a guide for nurses. Retrieved March 18, 2015 from: NurseTogether.com (2012). What nurses should know about patient care abandonment and negligence. Retrieved March 18, 2015 from: patient- The ICN Code of Ethics for Nurses. (2012, January 1). Retrieved March 16, 2015, from Title VII of the Civil Rights Act of 1964 | HR Topics for human resources. (2015, January 1). Retrieved March 17, 2015, from Waller-Wise, R. (2005). Conscious objection: Do nurses have the right to refuse care? AWHONN Lifelines, 9(4), Retrieved March 16, 2015, from