“…the conscientious objection of a healthcare service provider based on his/her ethical or religious beliefs shall be respected; however, the conscientious objector shall immediately refer the person seeking such care and services to another healthcare service provider within the same facility or one which is conveniently accessible who is willing to provide the requisite information and services…" – HB 4244
The passage stated above is one of the most debatable parts
in the Reproductive health bill among health professionals. It requires every
medical professional (doctors, nurses, etc.) to refer a pregnant woman to
another professional if one cannot perform an act due to conflicting ethical
views. So to speak, medical professionals
can refuse, but they should provide a contact person to do it.
Some people argue that this is unethical especially when the
client asks the professional to do abortion. That by referring the patient,
you are already acting as an accomplice to the morally disturbing situation.
However, I believe that patient’s right to information should also be upheld
and health care services be extended to all, even those who choose to undergo
abortion.
For example, a patient asks about abortion, you as a health care professional can’t just
deny them of all information that they deserve as patients. Therefore, the responsibility
then of a doctor/nurse who is under ethical distress is to explain the risks, harm, and other ethico-legal issues to the patient.
When it comes to performing an abortion, the medical
professionals must set clear their values to determine what they would do in
such morally distressing circumstances and refuse to participate if it does not
conform with their beliefs. Medical professionals know what is good for their
patients however they should not impose their beliefs on them and not step on
their right to autonomy. It is the body of the patient thus they have the
authority to decide for themselves.
Should the patient
still persist to have abortion be done, referral to another medical professional is one good
way of ensuring that the abortion will at least be safe. Unsafe abortion as
defined by the WHO as ”a procedure for terminating
an unintended pregnancy either by individuals without the necessary skills or
in an environment that does not conform to minimum medical standards, or both.”
These women usually resort to self-induced abortions or receive it
from traditional healers whose credibility is questionable due to inadequate
medical training. (WHO, 2004) I am not saying that abortion is moral and that there is absolutely
no wrong with it since it has its own ethical issues and legal implications which are also conficting with my values. Although when you consider that an estimated
68,000 women die every year (eight women per hour) due to unsafe abortion (WHO, 2004),
you will realize how salient it is for them to receive adequate health care. This is also supported by the study of Juarez,
Cabigon, Singh, and Hussain (2005) where they recognized that policies and programs
on postabortion care in the Philippines needs improvement.
In a nutshell, patient’s decisions must be respected with
their autonomy valued. Nurses/doctors must assist the patient in coming up with an
ethical decision but should not force their beliefs on the patient. Should
client still pursue abortion, referral is needed to ensure that the procedure
will at least, be safe and free from complications.
Sources:
- Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associate mortality in 2000. 4th edition, Geneva, Switzerland: World Health Organization, 2004
- Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah Iqbal Unsafe abortion: the preventable pandemic. The Lancet Sexual and Reproductive Health Series, 2006
- Juarez F, Cabigon J, Singh S, and Hussain R The Incidence of Induced Abortion in the Philippines: Current Level and Recent Trends. International Family Planning Perspectives Volume 31, Number 3, September 2005
- https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhReAVkEFrhEBSQZVesAmZXBiiJ8h0twStwBjVV38dCxbES__oEsGsbjSmsPLARC8jeMbU-z99nVaCnB38GL7Z9L1BD08r_tyDzUqzZXziwTlLdWz3bDeuUz_sNFROCZjVEG3RWSsh3z4Yz/s1600/tb36injectables.jpg
