Abortion: a tangle of rights.

Management of abortion personnel within a hospital setting involves a number of rights: the patients rights to privacy and to the provision of competent compassionate and understanding nursing care; the right of nurses to refrain from abortion procedures due to conscience; and the right of hospitals to hire employees who will fulfill their contractual obligations. The US Supreme Court has held that the decision to abort is protected under the right to privacy; no one may interfere with a womans decision. Public institutions do not have an obligation to fund abortion. If the Court had made abortion a right then society would be obliged to provide abortion. The discussion of abortion rights focuses on the following topics: the legal duties of health professionals the legal and moral rights and obligations of nurses the legal rights and obligations of hospitals and the rights of abortion patients. A case study is provided of a head nurse and staff in the gynecology ward of a large metropolitan hospital in 1974 who objected to the performance of saline abortion on the ward to disposing of the fetuses and to the validity of patients consent. Their concern was for the health and safety of patients and the rights of patients to informed consent. The hospital did not have a right to force the nurses to comply with the directive on saline abortion procedures because the hospital did not have the right to violate the conscience of an individual citizen. In another example of a transfer of a nurse to another area of the hospital the hospital was exercising its prerogative to expect fulfillment of contractual obligations in a way that did not interfere with health care workers objections to abortion. Roe v. Wade and Doe v. Bolton were the 2 cases that established the existence of institutional conscience. Health care workers have an obligation to inform hospitals in writing if they have objections to participation in abortion procedures. Nurses have an obligation to respect the legal right to privacy in making or carrying out an abortion decision and to provide competent nursing care to all who receive their services. Nurses should not make judgments about their approval or disapproval of abortion or the patients reasons for abortion. Patients have a right to be protected from emotional and physical harm from objecting nurses; nurses may withdraw their services only if there are other qualified professionals available to provide care.