What Would You Do?
Posted on April 27th, 2005 by D. Bell
I have a friend, whom we will call Sally, who works as a nurse in a low-income urban area. Sally is Mormon. The other day she was paid a visit by a 16 year-old girl, whom we will call Maria, who recently discovered she is pregnant.
Maria informed Sally that she wants to have an abortion and requested that Sally refer her to an abortion clinic.
Sally feels quite strongly that abortion is wrong, and feels very conflicted about being involved with one, even though her participation is limited to providing Maria with a referral to an abortion clinic.
While Sally feels her professional obligation is clear — to provide Maria the information she needs to get an abortion — she also feels that given Maria’s youth and lack of family support she may be able to subtly and gently convince Maria not to have an abortion, which, of course, runs counter to her professional obligations. Essentially, we have a showdown between Sally’s religious and moral beliefs on the one hand and her professional duties on the other. Which should she follow? What course of action would you take? Would you:
1. Simply provide Maria the necessary information?
2. Provide Maria the information, but also subtly try to convince her not to have an abortion?
3. Mount a full-blown effort to convince Maria not to have an abortion? (Sally is certain that such a move would result in her dismissal.)
4. Withhold the information, forcing her to obtain it elsewhere? (This would also result in Sally being fired.)
5. Something else altogether?
I am curious to hear your opinions.
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I would give Maria the necessary information. I would ALSO give Maria alternative information.
“I know you are really overwhelmed with this situation and have asked for information. You do have choices in this situation. Here is the contact information you asked for about abortions. Here a pamphlet about a place that gives unwed mothers information/or counseling on ALL their choices if you want to talk to someone about what the options are. Here is a pamphlet about a place that gives unwed pregnant women specific information about adoption, to see if it is the right choice for you.”
I doubt you would get fired for passing out additional pamphlets, as long as you also provide the contact information about abortion.
It may take some investigation and research to find out about the other resources (governments, church, private), but worth the effort if you can help unwed mothers in the future find the right people to help them in this time.
I would not feel wrong about giving someone the address and phone number of a Planned Parenthood clinic. If that was wrong then you’d have to feel guilty if you worked for the phone book company.
When I was 16 I moved. 2 months later my one and only friend got an abortion. I was her one and only friend since she’d moved there at the same time. I could not talk her out of it. I was unsure of my obligation. I had a wonderful seminary teacher that I confided in. She said don’t drive her there, don’t participate, but you can’t stop it so don’t feel bad–it is her decision.
Ditto to JKS. That’s exactly what I would do.
I would ask my supervisor what my options are. If my conscience prohibited me from choosing any of them, I would find another job. But I don’t think that giving out a referral would violate my ethics.
BTW, does the church discipline doctors who perform abortions?
Will
Not that I know of. I am pretty sure that all doctors have to learn the procedure as part of their training (at least my dad did 25+ years ago). I am sure OBGYNs would have to learn it. I know my dad didn’t feel it was appropriate for him to perform them, so opted out of some rotations where he may have had to perform them.
I would think that the church would heavily discourage doctors from performing abortions not in line with church policy (endangering health/safety of mother, rape/incest).
But getting back on topic, I think Sally has an obligation to provide information about alternatives. IE the health risks of an abortion, opportunities for adoption.
Let’s remember that some abortions are not against church policy. So most OBs have at least learned to perform an abortion, even if they don’t do it in practice. Dilation & Curatage is a common procedure to abort a baby OR to “complete” a miscarriage. Its the exact same procedure.
I am strongly against abortion, but I agree with JKS’s first post. There is a limit to how much you should get involved with somebody else’s choices. Providing alternate information is about the only thing you can do without becoming a busy-body.
2-4, depending on the circumstances and what the spirit provides. Sometimes God needs us to make a firm and showy stand, at some cost to ourselves. Sometimes he doesn’t. His will be done.
This is a difficult circumstance and I’m not sure if the right answer is entirely clear. But if the nurse you are talking about feels abortion is wrong and wants to have no part in it whatsoever — perhaps the following scriptural pericope could be a source of principles that might be followed:
By the above, my conclusion is that the nurse has the right to disobey the hospital regulation and obey God, if that’s her perspective of the situation.
JKS is right on. I would add that I doubt that your friend is the first person to confront this situation in her job (not knowing any of the details). There may in fact be guidelines and precedents in place.
Leonard Pitts had a column on this subject, discussing recent legislation in some states that excuses pharmacists from dispensing contraceptives if it conflicts with their moral and religious beliefs.
Full article here (registration required)
An excerpt from the column:
I agree with this sentiment. Whether this situation is a forseeable part of your friend’s job, I don’t know, but if it is, she should either find a way to do her job in a way that satisifes her own sense of what is right, or she should find a new job.
Bryce, I guess I disagree with that take. I certainly understand your point, and I think people do need to consider these things in depth before choosing a profession. But I just think it goes too far to give up an entire career choice because of the possibility that sometime down the road you’ll be required to do something you object to, even though 99 percent of the job will be things you love or hold in esteem. I admit these are thorny problems, but it’s not self-evident to me that we should have to forego a good job based on some uncertain eventuality like this.
I believe in the covenants I made in the temple. That said, my profession comes after my obligation to the Lord. I also believe in the theory of “there are no accidents”.
Sally has been placed in the path of this young woman for a reason. She has a moral obligation, outside of her professional obligation, to provide Maria with enough information to make an informed decision. This obligation does not breech any professional obligation at all. In nursing you do not subscribe to “bandaid medicine”. When a patient in your care needs more than one treatment or course of action, it is your obligation to make sure all available options are explored.
Maria is a young girl. She is about to make a serious decision that can affect her in many different ways. Those being physically, emotionally/mentally, and spiritually. While the medical profession is not obligated on a spiritual level, it is obligated on the medical and psychological levels. This should give Sally all the permission she needs to pursue a course of education and counseling for her patient.
Ryan –
Your friend doesn’t have to find a new profession. She does need to find a situation where she will be allowed to perform her job in a way that satisfies her own sense of what is right. I imagine she should be able to work something out with her current employer.
To enter into a job with a clear knowledge of what that job entails, and a conviction that one will not perform certain aspects of that job due to one’s personal beliefs without informing the employer ahead of time is simply dishonest. I’m not saying that your friend is dishonest — perhaps she didn’t realize that she might be placed in such a situation. Now that she knows that this issue exists, she needs to either do her job as required or else come to an agreement with her employer.
Bryce, I agree with what you just said. I took you to mean that we are obligated to avoid these kinds of jobs entirely, rather than trying to work out details and specifics with the employer, which can often reap some benefits.
Anyway, having mulled this over, I think Sally has the obligation to share even-handed information with her patient. She’s got to give the requested info., but I think she’s morally obliged to share other info. in a non-assertive way, such as described above by JKS.
Yup, JKS, you are wise.
I used to be very pro abortion, in my much younger days. It seemed like babies born unloved and abused would have been better not born.
I’ve changed my mind, but I don’t think there’s ever a black and white solution here, too many emotions and moral issues involved. Very painful.
Yes, JKS, you really are wise.
She has a legal obligation to provide certain information, and so must provide it. To the extent that her job permits her to provide additional information (i.e., regarding adoption, etc.), she should do so. Otherwise, as a nurse she is not simply acting in her own capacity, but as a representative of her institution. She isn’t entitled to behave otherwise.
I’ve got a slightly tangential follow up posted at T & S, at http://www.timesandseasons.org/index.php?p=2215
Caught by the cookie monster.
“given Maria’s youth and lack of family support she may be able to subtly and gently convince Maria not to have an abortion”
Sally indeed has a dilemma about abortion counseling, and yet there’s another part of her dilemma that has yet to be touched on in this thread:
What about the morality of “subtly convincing” a young woman with “little family support” to carry a baby to term? What effect will that decision have on the health and safety of the mother and her baby? Will the young mother-to-be have a home to live in? Will she be in physical danger when her pregnancy becomes obvious? If there’s no family support, where will she find the physical and emotional strength to keep herself and her baby well-fed and healthy? Will she have the resources for adequate prenatal care? Will her family still accept her after the birth?
Pregnancy is not easy, and it takes a toll on healthy women with supportive husbands and close friends and relatives nearby to assist her throughout the gestational period. The decision to abort or complete a pregnancy is a very serious, life-changing one that should be made with careful thought, prayer and counseling.
Maria needs all the information she can get in order to make the decision, and she’ll need support both before and after her decision is made. Sally can be effective in providing complete information and in providing the support, no matter which decision Maria makes.
A comment on some of the comments: On physician training, I somehow doubt an OBGYN physician trained at a Catholic teaching hospital has been trained in optional abortions, a procedure obviously not offered/performed at a Catholic institution. In other words, I’m pretty sure there are OBGYN physicians that are 100% clean on this one. There was also a comment that seems to blur the distinction between a D&C after an incomplete miscarriage to assist healing and an early pregnancy D&C as an optional abortion. That said, I think the moral distinction between early pregnancy abortions and later abortions where the unborn child feels pain and death isn’t discussed enough. The former to me is an expensive version of simpler family planning techniques most of us use everyday w/o a second thought, and the State, in my view, has no compelling interest to prohibit the practice. The latter is barbarism that threatens civilization. Bear in mind we got Roe v. Wade as the law of the land because of the Griswold case where Connecticut tried to prohibit condom sales. Now we have to live with in your face barbarism because Connecticut overreached into an area that was none of its business, and we had a Supreme Court that thought it was its job to rescue Connecticut from its stupidity and invented Constitutional rights to do so. In effect, we can blame current US abortion law on moral zealots teamed with activist judges, how ironic. Now, I doubt any Supreme Court will even modify Roe just as they won’t touch the revision of the Interstate Commerce cause from the 1930s, etc.
I didn’t mean to imply that OBGYNs are trained in optional abortions. I meant to imply that there are abortions that are considered OK by the church. Therefore, an LDS doctor should feel comfortable performing an abortion in that case. I simply wanted to point that out before this thread started talking about church discipline for doctors. Since there is no way to truly know if a woman has been raped, and it is against the law for a doctor to reveal information, we have to be careful when we attempt to judge.
According to a friend, usually employers are sensitive to the fact that people have religious beliefs and they can often opt out of a procedure that they are morally opposed to.
I should have added in my list that Sally should discuss the options with her employer. It kind of depends on the individual employment situation. Is there a doctor in charge of Maria’s case? Or is Sally the person Maria goes to see. If Maria is Sally’s patient, Sally should have more autonomy that if Sally has a boss with a stronger claim to be in charge of Maria’s case.
If discussion was needed, I would first ask if there was any information handy about choices for a pregnant teenager and if there wasn’t, I would research it and then approach my employer with the resources I found. If my employer said I could not give out other information along with the abortion information, I would probably request that in these situations I refer the patient to another nurse to have them give the patient more specific information. Chances are the employer would say yes.
“decision to abort or complete a pregnancy is a very serious, life-changing one that should be made with careful thought, prayer and counseling.”
This is only true if the case of rape, incest, or serious threat to the mother’s health. Otherwise, having an abortion is a not an option and Miss Sally should feel no qualms about encouraging the young lady to have the child.
Also, though I do not belong to a faith that opposes contraceptions myself, I see no reason why pharmacists should be required to dispense them if they’re Catholic. If the company doesn’t like it, they can fire the person. If customers don’t like it, they can go elsewhere. Laws like that being discussed in Chicago, which would make it a regulatory crime for a pharmacist to refuse to dispense contraceptives, show no regard for the role of religion in life whatsoever.
If Sally encourages the mother to have the child and the mother’s father/boyfriend/uncle beats her to a pulp, does that count as a serious threat to the mother’s health?
“Will she have the resources for adequate prenatal care?”
Does that count?
Adequate resource for prenatal care are essential, for protecting the mother’s health, avoiding a premature birth, and protecting the child’s viability and freedom from birth defects. Prenatal care is more than just going in to the doctor to hear the heartbeat, have an ultrasound and get your uterus measured. The regular lab tests and exams address the mother’s physical, mental and emotional states, all of which are profoundly affected by a pregnancy (ask any pregnant woman if the experience didn’t change her life).
Medical professionals have the responsibility to “first, do no harm.” Sally should keep this in mind as she helps Maria determine the safest, healthiest course to take with regards to her pregnancy. Life is precious and it would be wonderful if Maria had all of the support she needs to be able to carry her baby to term. Sally and many of us would love for this to happen, but we can’t just look at the pregnancy without also examining the circumstances in which it is occurring.
If Maria truly does not have family support and will be completely alone in caring for herself and her baby throughout the pregnancy, Sally’s responsibility in advocating adoption also include teaching Maria how to find and take advantage of proper prenatal care to ensure that her baby is born at a healthy weight, free from the effects of drugs and alcohol, and safe from abuse and neglect. Sally must protect the mother if she wants to save the developing baby. She can’t just advocate adoption without addressing the mother’s life circumstances and high-risk pregnancy situation.
Sally must realize that Maria, as a teenage mother from a low-income neighborhood, is at risk for gestational diabetes and malnutrition at the least. Maria is still growing and maturing herself, and the way a woman’s body works, the baby gets the vitamins and minerals first; Maria needs to learn to compensate for that during her pregnancy. Inadequate vitamins and minerals can lead to severe birth defects. Contracting some diseases during pregnancy can also cause problems in fetuses. Taking some over-the-counter medications during pregnancy can also result in birth defects. Maria will need resources to find healthy food and vitamins, as well as treatment for common colds and other infections during the gestational period, and being in a low-income neighborhood with little family support, that may be difficult (though manageable).
Maria, is also in a higher risk group for pre-eclampsia as well, which can kill both mother and baby; if Maria doesn’t make and keep her prenatal appointments, early signs of pre-eclampsia can be missed and resulting seizures could be life-threatening.
Maria will need education as to the importance of prenatal care and will need a way to pay for and get to regular doctor’s visits. Does she have money for doctor payments? Can she make it to the free clinic between school and work responsibilities? Will she be able to complete her education? Statistically, Maria is likely to have been exposed to an STD or two which could affect both her health and the health of her baby, and prenatal care can minimize the effects of STD’s on her baby. Statistically, the chances that alcohol, smoking and drugs are part of her life are also high.
Sally should give Maria all the information available to her, both pro and con, as required by her employer, and Sally needs to help Maria understand the ramifications of whichever decision Maria makes. Hopefully, with complete information and proper care, Maria will make a decision which she will not regret and which Sally can live with.
One thing that hasn’t been mentioned is that Maria can easily find access to good adequate prenatal care through a wealth of state programs that were designed for people just like her, and she can go through them for free. If Sally feels like pointing out an abortion clinic is contrary to her beliefs, then I don’t think Sally should give her the information whether or not her job requires it. The reason is because Sally’s job is not worth her integrity.
the social services available to Maria include (but are not limited to) the following:
a case worker, free food, free prenatal, support groups of people going through more or less the same thing, counseling, adoption services, etc. Sally can introduce all of this to her, and after establishing a friendship, should help her realize that one choice is better than another.
Otherwise, the consequences are: Maria gets an abortion, and both she and Sally feel guilty forever.
Sister Mirth
It’s none of Sally business whether Maria gets an abortion.
So, Miranda, does this mean that we are no longer our brother’s (or sister’s) keeper?
Slip Maria the number for LDS Family Services and let her know that there are perople who pray for a child to raise.
The Mirth said: “The reason is because Sally’s job is not worth her integrity.”
This is an odd statement. I would think that fulfilling the terms of your employment agreement with your employer is acting with integrity, not deliberately refusing to perform some aspect of the job.
You say she works as a nurse, but you don’t say for what organization. She has an obligation to her employer which she can fulfill and still be true to herself, hopefully. Although if she is working for a place that advocates recommending abortion, she should quit.
If her employment is not an issue, I think she could state her opinion and let it go.
Bottom line, I agree with Miranda. It’s nobody’s business. I am now pro choice.