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

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
nurses 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-afterpill-sues-california-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-everynurse-should-know-about-patientThe 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?