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
http://www.firstamendmentcenter.org/nurse-fired-after-refusing- to-dispense-morning-after-pill-suescalifornia-county
CNO (2009). Practice guideline: refusing assignments and discontinuing nursing services.
Retrieved March 18, 2015 from:
http://www.cno.org/Global/docs/prac/41070_refusing.pdf
Johnstone, M. (1898). Law, Professional ethics and the problem of conflict with personal issues.
International Journal of Nursing Studies, 25(2), 147-157.
Maryland Nurses Foundation (nd). Giving, acceptin, or rejecting a work assignment: a guide for nurses.
Retrieved March 18, 2015 from: http://www.mbon.org/practice/assignments.pdf
NurseTogether.com (2012). What nurses should know about patient care abandonment and negligence.
Retrieved March 18, 2015 from: http://www.nursetogether.com/what-every-nurse-should-know-aboutpatientThe ICN Code of Ethics for Nurses. (2012, January 1). Retrieved March 16, 2015, from
http://www.icn.ch/about-icn/code-of-ethics-for-nurses/
Title VII of the Civil Rights Act of 1964 | HR Topics for human resources. (2015, January 1). Retrieved
March 17, 2015, from http://topics.hrhero.com/title-vii-of-the-civil-rights-act-of-1964/
Waller-Wise, R. (2005). Conscious objection: Do nurses have the right to refuse care? AWHONN
Lifelines, 9(4), 283-286. Retrieved March 16, 2015, from
http://onlinelibrary.wiley.com/doi/10.1177/1091592305280872/epdf