ABSTRACT
Ethical issues are something that is a reality in modern medicine. This is certainly true when it comes to religious, spiritual and philosophical belief systems. Sometimes these strongly held beliefs are on the part of patients, but there are times when beliefs are held by healthcare workers. There are ethical codes in place that protect a patient’s right to refuse treatments, like blood transfusions, if they ethically or morally feel that are not what they wish to do. There are also options available for healthcare workers who feel that they cannot ethically be involved in certain treatments or procedures if they find it ethically wrong, like elective abortion procedures; these are called “conscience clauses” and “unconscionable clauses.” Ultimately, the goal is to continue to find means to develop policies and ethical compromise that respect all beliefs, both those of patients and healthcare workers, without infringement on any of those same rights.
INTRODUCTION
Today the healthcare industry is an ever-advancing, ever-innovating industry. The means that how patients can be treated has changed a great deal throughout the years. Modern medicine has been at the center of a great deal of controversy that occurs when healthcare collides with long-held religious beliefs and ideologies. There have been many instances where healthcare staff, very often nurses, is confronted with patients whose beliefs systems will not allow them to received life-saving treatments, which can weigh heavily on nurses. There are, also, instances where it is the nurse who is conflicted between providing medical treatments they find personally contradictive to their belief system. That being said there are cases everyday that pose such ethical concerns for nurses and all healthcare professionals within the realm of medicine. After reviewing the available sources it becomes clear that professional ethics and religious beliefs are a serious ethical dilemma for nurses that is deserving of greater research and study.
BACKGROUND
In the earliest forms of healthcare and nursing the types of treatments of given to patients were rather simple; sew up a wound, treat a fever or splint a broken bone. However, as medical knowledge advances it now allows life to be extended via artificial equipment, people can receive blood transfusions and, even, receive organs from donors. Unfortunately, many of the modern advancements are not accepted by all Americans from many different racial, cultural and religious perspectives. There are branches of Christianity that disapprove of any kind of donated tissues, including blood, to be administered. There are branches that believe that prayer is better than medicine at treating life-threatening conditions and will refuse any sort of treatments. There are also members of the healthcare industry who possess very strong religious believes themselves face a reverse form of the ethical issues (Swartz, 2013). They do not feel comfortable with the patients or hospitals views.
DISCUSSION
The reality is that these sorts of ethical dilemmas are faced by nurses every single day somewhere in the world. Reconciling professional ethics and procedures with personal beliefs and religious ideologies can be nearly impossible on occasions, both for patients and healthcare staff. What is more important is once these ethical problems are identified is to address the problem (Zahedi, Sanjari & et. al, 2013). How such situations are handled and are resolved is incredibly important to the stakeholders of the healthcare industry, from all facets. Patients must be able to trust healthcare professionals. The hospitals do not want to face legal allegations that their personal beliefs of a patient were not respected; this can be costly issue. At the same time the hospital and investors also must make certain than employees that have a celebrated faith or belief system are acknowledged. Unfortunately, the overall goal is ultimately more about money; doing things ethically is simply more cost effective.
Religious Patients and Healthcare Ethics Issue: As mentioned one of the many ethical issues that nursing staff may face, including situations where they have a patient who has or whose loved ones have refused treatment. For many modern nurses it can be ethically difficult to understand how such individuals could refuse even the most basic of treatments, like antibiotics for an infection, which are life saving could be denied because of religious tenants that are not shared by everyone. However, as a healthcare professional it can be an ethical conundrum (Zahedi, Sanjari & et. al., 2013). There are many nurses that wish they could defy such orders and treat the patient anyway. Unfortunately, that would be unethical in the healthcare setting, hence the issue for many nurses and healthcare staff. A prime example of this is seen in scenarios involving children. Parents bring their ill child to the hospital hoping that it is just the flu. However, after the doctor’s complete their tests it shows that the child has a more serious condition, where a blood transfusion is imperative to save his life. Unfortunately, the parents are from a devout religious sect that does not allow blood transfusions of any kind; the parents will not authorize such a procedure. For healthcare staff and nurses the refusal to treat a sick child, who does not have choice in the matter, it can be difficult for many healthcare workers to maintain their professional ethics, but as professionals they must comply.
Patients and the Religious Beliefs of Healthcare Staffs:
As previously mentioned, it is not always the patient’s belief system that is in conflict of medical procedures. There are many healthcare professionals who possess very dedicated and heartfelt personal and religious beliefs that they feel it would be ethically unjust to force them to comply with anything that they believe to be wrong (Swartz, 2013). A perfect example of this situation can be seen in the fields of women’s reproductive health. Abortion has been and remains one of the most heavily debated issues in the United States and in many parts of the world. The two sides of this issue struggle to find common ground. For healthcare professional, particularly nurses who are often expected to assist on such procedures, like abortion, it can place an ethical burden on those healthcare professional who consider such procedures to be antithetical to their personal and religious beliefs (Husseini, 2011).In a diverse society it is necessarily for healthcare professionals to have the same and equal rights to the patients they treat.
So what policies or initiatives are in place that protects both the patients and the healthcare professional's personal and religious beliefs, while maintaining an equally ethical solution for all parties. Well there are a few different approaches that can be taken in such situations. For patients who refuse treatment; the medical staff may attempt to talk them out of their decisions, but ultimately those patients’ rights to deny care must be respected. Many nurses surveyed determined that more than 60% of the stress nurses experiences during their workday are those related to ethical issues (Ulrich, Taylor & et, al., 2010). However, in certain cases where healthcare professionals feel that those rights are not superseding the ethical rights of another, there is another option, designed to make certain that ethical treatment is given to all involved.
As in the example previously given if parents refuse care for their child based on religious beliefs, many healthcare professionals may feel that the ethical rights of the child are not be acknowledged, just those of his parents. In such cases, healthcare professionals and facilities can legally petition the court to override the parent’s decision and treat the child regardless. Another good example of ethical dilemmas that are taken to the court system. People who are surviving purely on life support system, like coma patients, where loved ones argue about whether to “pull the plug” on the patient (Husseini, 2011). For healthcare professionals it can be difficult because they may have personal beliefs that favor one side of the argument or the other, regardless they must remain neutral and tolerant regardless of how they feel. Again, these sorts of issues can be settled in a court of law, taking the decision making out of the hands of patient, families or healthcare professionals.
In cases where it is the healthcare professional, again very often nurses, are caught in an ethical conundrum due to the nature of the procedure and treatments that patients may receive, there are also alternatives that exist (Zahedi, Sanjari & et. al, 2013) First the “conscience clause” allow healthcare professionals at all levels, to have the right to refuse to participate in any medical procedure or practice that one finds to be wrong, unethical or immoral. Again, abortion procedures are ethically questionable to many people and if a healthcare professionals cannot in good conscience participate in the procedure and they cannot be forced to do so. The “unconscionable clause” is similar in that it is intended to discourage any healthcare professional from having to participate in certain procedures or practices. The use of unconscionable clause applies to arbitration in ethical argued issues. If the healthcare professional is forced into a contract where their ethical rights are violated through coercions or duress, forcing them to feel “bullied” to comply against their conscience, then the healthcare worker can be freed from legal or occupational consequences (Swartz, 2013).
Ideally, healthcare workers are dedicated to saving lives, regardless of their personal beliefs, and work very hard to make certain that all patients receive fair, just and ethical treatments. However, there are instances where healthcare workers, be it nurses, physicians or other staff, are faced with ethical issues that are contrary to the policies, procedures and treatments considered in a given situation. Fortunately, when that happens there are avenues to address them; either policies that allow employees to opt out or the standard policies that place an individual’s treatment primarily in the hands of the patient, where they cannot be forced into treatments that they clearly do not want (Swartz, 2013). The goal appears to be an attempt to find agreeable compromise among those involved or, at least, tolerance of belief systems other than what may celebrate. Finding equitable compromise really is the most ethical of policies.
CONCLUSION
The healthcare professionals here in the United States and around the world see gruesome injuries, watch the symptoms of terrible diseases and deal with people from all walks of life, from those whose conditions are terminal and others whose ailment is easily treated and, even, cured. When a situation arises where life saving treatment is refused it may not make sense to healthcare staff, but it must be respected. In the same vain many healthcare workers are faced with people who are receiving a procedure that is disagreeable to their personal perspective, but can opt out and eliminate themselves from that situation. For healthcare professional making difficult decisions is part of the day-to-day reality of the occupations; there needs to always be avenues for both patients and professionals to be heard, respected and allowed to maintain their ethical position and standards.
REFERENCES
Husseini, D.I. (2011). The implications of religious beliefs on medical and patient care.
Swartz, M.S. (2013). "Conscience clauses" or "unconscionable clauses:" Personal beliefs versus
professional responsibilities. Yale Journal of Health Policy, Law and Ethics. 6(2). 269-352
Ulrich, C,M,, Taylor, C. and et, al. (2010). Everyday ethics: Ethical issues and stress in nursing
practice. Journal of Advanced Nursing. 66(11). 1-15
Zahedi, F., Sanjari, M. and et. al. (2013). The code of ethics for nurses. Iranian Journal of Public
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