[Solution]Health Policy, Law, Ethics Proposal

Introduction The purpose of this paper is to examine law, policy and ethical constraints that affect future solutions to abortion.  It demonstrates that a number…

Introduction

The purpose of this paper is to
examine law, policy and ethical constraints that affect future solutions to
abortion.  It demonstrates that a number
of ethical constraints, policy restrictions and convoluted laws make access to
safe abortion difficult and expensive.  This in turn has serious ramifications in
nursing practice. To make safe abortion a women right, there is need to study
policy, legal and ethical barriers and decide which ones are unfit.

Constraints

Lack of access to safe abortion is
the leading cause of maternal deaths and disability. Almost all maternal
disability and deaths occur in states where abortion is restricted in practice
and law. Health service delivery impediments may be codified in policies,
practices or laws (Kazemi Sharifi, Khazaeian, & Ramazankhani, 2017). These
codes restrict access to abortion services and information and thus prevent
women from seeking safe services. Even when abortion is legal, ethical and
policy barriers make safe abortion services unavailable to many women. Even
though courts and human rights agencies recommend abortion decriminalization
and abortion care provision, restrictions, poor implementation and
interpretation of abortion laws remain a big challenge. 

Lack of abortion clinics and
restrictive policies in most states limit access to safe abortion services for
many women. Despite abortion being legal in many states, restrictive policies
limit abortion to certain circumstances. In some jurisdictions, state laws and
policies may put in place time limits on duration of pregnancy for which
abortion should be conducted. Other restrictions include limiting the type of
facilities and healthcare providers that can provide abortion services,
mandating third-party authorization, restricting available abortion method
options, conscientious objection to make referral to abortion services and
excluding medical insurance for abortion services (Jerman, Frohwirth,
Kavanaugh, & Blades, 2017). Regulation of abortion facilities and providers
serves to reduce the availability of abortion services, forcing women to seek
these services in distant areas. These restrictive laws or policies can cause
the closure of abortion clinics and this influences where and how women can
have an abortion (Gerdts et al. 2016). Restrictive laws such as targeted
regulation of abortion provider and the hospital admitting privilege
requirement create constitutionally undue burden through the placement of
barriers in the way of women looking for an abortion. They cause providers to
shy away from providing abortion services to women in need. 

Legal restrictions limits access to abortion
services and increases the number of women seeking unsafe abortions by
unskilled providers. Criminalization of abortion poses a challenge of accessing
safe abortion care. Laws that criminalize abortion medical procedures, penalize
woman who go through abortion and punish providers who provide services
undermine women’s rights and health (Jerman, et al. 2017). While abortion is
legal, it is restricted to varying levels by some states.  In some penal or criminal codes, state laws
subject abortion to criminal regulation. Under such codes those providing safe
abortion services and those undergoing abortion are punished. In fact, abortion
accessibility and availability vary from one state to another

Many laws that ensure safe access to
abortion services also include a conscience objection clause. This clause
allows providers to opt out of performing abortion procedure on conscience
grounds (Nordberg, Skirbekk, & Magelssen, 2014). Some providers take
advantage of this clause to remove themselves from the provision of abortion
care on moral grounds, while not sending the service user to an abortion
provider. Conscientious objection by providers often delays abortion care for
women seeking safe abortion. Though the right to freedom of conscience is
constitutionally protected and provided for, international human rights
contends that freedom to express one’s beliefs or religion is subject to
controls required to protect others’ fundamental human rights.    

Nurses play a critical role in
promoting reproductive rights of women. But like other providers, nurses make
ethical and moral decisions about their patients, particularly when it comes to
the issue of abortion. Abortion remains a controversial issues with some nurses
refusing to take part in it. Constraints to safe abortion care can influence
the attitudes of nurses towards providing care. The legal responsibility and
obligation of nurses in legal abortion care is direct. Nurses can decide to
offer care to women seeking abortion or decline to provide care by invoking
conscientious objection clause. The law provides for respecting the nurses
right to decide their own ethical and moral participation to provide care to
patients seeking abortion. However, contention exists regarding the clashing
rights of nurses and patients. Nurses are supposed to respect the rights of
patients who want to undergo abortion. On the other hand, religious beliefs
affect the willingness and attitudes of nurses to provide care. Nurses who
oppose abortion are more likely to reject jobs where they are expected to
provide abortion care.

Nursing Process

A systematic approach supported by
Roper-Logan-Teirney model can be used to overcome these constraints in the
planning of care. This model provides a systematic guide to nursing care
(Holland et al. 2008). Nursing process focuses on four steps that involve
assessment, planning, implementation and evaluation. I will use the nursing
process to assess my religious values and beliefs and those of the client and
identify the ones that are important to nursing practice. I should seek a
compromise which accommodates women’s acknowledged reproductive rights and the
right to conscience objection when the two clash. The right of a nurse to
conscientiously decline to offer abortion services should be secondary to their
first duty- the patient. The right to refuse should be bounded by duties to
make sure the rights of patients are not violated. Nurses must be recognizant
of their role in assuring their patient’s rights.       

Conclusion

Legal, policy and ethical constraints
are rooted in nursing practice. Legal restrictions, conscientious objection and
policy constraints limit access to safe abortion by women seeking abortion
services. These restrictions have serious ramifications for nursing practice.   

References

Gerdts
C et al. (2016). Impact of clinic closures on women obtaining abortion services
after implementation of a restrictive law in Texas.
American Journal of Public Health, 106(5):857–864.

Holland,
K., Jenkins, J., Solomon, J., et al., 2008. Applying the Roper–Logan– Tierney
model in practice, 2nd ed. Churchill Livingstone, Edinburgh

Jerman,
J. Frohwirth, L., Kavanaugh, M., & Blades, N. (2017).Barriers to Abortion
Care and Their Consequences for Patients Traveling for Services: Qualitative
Findings from Two States. Perspectives on
Sexual and Reproductive Health, 49(2), 95 – 102

Kazemi
F. A., Sharifi, N., Khazaeian, S., & Ramazankhani, A.  (2017). Various aspects of abortion and related
policies in the world. Med Ethics
Journal, 11(39): 75-89.

Nordberg,
E. K.,  Skirbekk, H., & Magelssen, M.
(2014). Conscientious objection to referrals for abortion: pragmatic solution
or threat to women’s rights? BMC Med
Ethics, 15: 15-16
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