Under Fire: A time of trial and testing

UNDER FIRE

"A TIME OF TRIAL AND TESTING"

by Fr Jim Whalen

1998, Issue 1

Some years ago, Fr. Joseph Gravel, a teacher at Ottawa University School of Nursing related to his students an account which occurred at the Sudbury General Hospital. An operating room nurse, Cecile Rivet, was expected to take part in a 'Dilatation and Curettage procedure.' (D & C). When she found out it was an abortion, she refused. The doctor threatened to have her removed permanently from her work if she did not assist him. She reported it immediately to her administrator. The doctor was reprimanded. This nurse displayed the characteristics of an alert and courageous healthcare worker with strong Christian moral values.

Today many of our healthcare workers are facing the same problem, having to make choices between conscience and career, as recently reported in the Catholic Register regarding Bishop Frederick Henry's letter accusing the Thunder Bay Regional Hospital of riding "Roughshod over ethical considerations 'for the sake of administrative convenience." (July 28, 1997). No one should take part or be forced to assist in abortions. The health care profession is meant to be "An unflinching affirmation of Life"... "Absolute respect for every innocent human life also requires the exercise of conscientious objection in relation to procured abortion and euthanasia". (Evangelium Vitae #89)

Part of the dilemma revolves around providing adequate health care, while at the same time allowing for personal values and moral beliefs. In 1988, the Registered Nurses Association of Ontario (RNAO) approved the following excerpt from the Canadian Nurses Association Code of Ethics (though this code has been changed since 1988, to the best of our knowledge this section remains unchanged): "A nurse is not ethically obliged to provide requested care when compliance would involve a violation of her or his moral beliefs when that request falls within recognized forms of health care. However, the client should be referred to a more appropriate healthcare practitioner. Nurses who have or are likely to encounter such situations are morally obliged to seek to arrange conditions of employment so that the care of clients is not jeopardized."

The ethical framework for nursing in Ontario has represented in their magazine: "All nurses have their own personal values which must not interfere with client's right to receive care. Clients' values however are of primary consideration when planning care...When a client's wish conflicts with a nurse's personal values, and the nurse believe that she or he cannot provide care, the nurse needs to arrange for another caregiver and withdraw from the situation. If no other caregiver can be arranged, the nurse must provide the immediate care required. If no other solution can be found, the nurse may have to leave a particular place of employment in order to adhere to her or his moral values." (College Communique, Feb. 1995, #20)

Various solutions have been proposed to resolve this situation of participating in duties that conflict with healthcare workers' personal values or moral codes. In the United States, state legislatures protect healthcare workers with exemption statutes, which individuals must claim in writing, with no resulting penalties or disciplinary action, with accommodation for moral or religious beliefs. In emergency medical situations the health care worker is required to assist, as the individual's right to life overrides the right to a particular lifestyle. In Canada, the long-term solution would be to have conscience clauses enacted at the provincial and federal levels. This approach is supported by the Charter of Rights and Freedoms: (Section 2, Freedom of Conscience and Freedom of Religion). Immediate action would entail appealing to the Workers Union, the Provincial Labour Board, and the Human Rights Board. At present Campaign Life Coalition is preparing to introduce 'Conscience Legislation' into Canada. Senator S. Haidasz has drafted a bill to amend the Criminal Code to prevent coercion of healthcare workers or offend personal values or moral standards and religious beliefs.

Pope John Paul II points out that: "For Hippocratic ethics, as for Christian Morality, the life of each human being is a value which cannot be called into question...it must be defended and watched over. In a word, it must be served. If this imperative applies to everybody, it must apply first and foremost and above all else to health care workers." (The Charter for Health Care Workers: A synthesis of Hippocratic Ethics and a Christian Morality, Vatican City, 1995) The principal aim of the charter is to guarantee the ethical faithfulness of healthcare workers so they can build through their choices and behavior a civilization of love and life, without which society loses its human meaning.

Healthcare workers are challenged to uphold the right of man to life and to his dignity. In order to carry out their preventive and therapeutic stewarding and promotion of health and the improvement of the lives of people, medical faculties should allot more time to the study of the Church's social teaching through appropriate research and interdisciplinary studies. This would enable students to acquire: "An integrated social vision of the medical profession, making it possible for them to exercise appropriate discernment of the requests for medical intervention, making the right decision and if necessary, being spurred even to the point of conscientious objection." (Faith Offers Integral Vision of Health Care, Pope John Paul II, to Italian Catholic Doctors, Nov. 25, 1995) ¤