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Sometimes, medical workers are confronted with moral dilemmas when treating patients. Kuczewski and Blair (2021) presented a case of a health professional coming to conflict with the ethnic perspective of their employer. A private healthcare company recruits personnel to deliver medical services to prison detainees. One of the requirements is participation in the execution of convicted criminals. The authors comment that there is a medical obligation to respect patients’ human rights regardless of work instructions. My position on the conflict between moral values and employer’s healthcare requirements is that human health and basic decency come first.
The authors of the case follow the viewpoint that all health professionals ought to place morality before duty, giving three ethical arguments. The first one is that medical workers “can, in no way, be agents of punishment, either by directly or indirectly facilitating neglect or inadequate care” (Kuczewski & Blair, 2021, p. 13). The second argument is that the person at the focus of the case should have the ability to send a patient to the hospital despite the demands of the administration. Finally, all health professionals should be vigilant for immoral conduct and refrain from cooperating. All these points are ethically valid because they follow the principle of prioritizing morality above the employer’s instructions.
The authors also refer to international law for appropriate legal reasoning. Kuczewski and Blair (2021) quote the twenty-fourth session of the UN Commission on Crime Prevention and Criminal Justice, which explicitly obliges physicians to “advocate for their [patients’] health-related needs and basic human rights” (p. 13). It is also a point of a professional code conflict. Whereas capital punishment is legal in the United States, health professionals are prohibited from participation in the execution (Kuczewski & Blair, 2021). However, if the employer assigns such a person to alleviate the suffering of the patient, a conflict emerges since it is their responsibility to deliver healthcare services indiscriminately.
This particular case involves a physician facing this dilemma, yet such a scenario also applies to my role as the nurse practitioner as I may be employed and requested to engage in unethical behavior as well. In my opinion, health professionals should be allowed to work in a facility that administrates lethal doses to convicted criminals. Yet, they should be removed from the actual process of execution. If the employer compels them to participate, they should have the right to refuse.
My position is supported by legal, ethical, and professional evidence. The legal evidence is that the employer’s actions would contradict the Constitution by forcing the nurse to perform a cruel punishment, which is prohibited by the Eight Amendment (Henry, 2018). The ethical evidence stems from the AMA Code of Medical Ethics, which deems participation in the execution of the patient as the betrayal of trust (AMA, n.d.). The professional evidence concerns examples of nurses who refused to be recruited to participate in executions while referencing the aforementioned code (Shields et al., 2017). As a result, a nurse practitioner should have the opportunity to refuse to comply.
The strategy for resolving this issue is allowing health professionals to refrain from executions. The solution is obliging the employer to explicitly highlight this right in the contract. However, legally enabling nurses to abstain from contributing to execution might also raise an ethical issue of patients who do not want to be resuscitated. This can be viewed as passive murder, which is similar to capital punishment as it requires a nurse to comply and do nothing to save the patient’s life. Subsequently, allowing nurse practitioners to refuse to participate in the execution may encourage them to decide not to comply with the do-not-resuscitate order.
References
AMA (n.d.). Code of medical ethics: Professional self-regulation. Web.
Henry, T. A. (2018). AMA to Supreme Court: Doctor participation in executions unethical. AMA. Web.
Kuczewski, M. G., & Blair, A. (2021). How should history of physician involvement in the Holocaust inform how physicians approach employers? AMA Journal of Ethics, 23(1), 12-17.
Shields, L., Watson, R., Darbyshire, P., McKenna, H., Williams, G., Hungerford, C., Stanley, D., Ben-Sefer, E., Benedict, S., Goodman, B., Draper, P., & Anderson, J. (2017). Nurse participation in legal executions: An ethics round-table discussion.Nursing Ethics, 25(7), 841-854. Web.
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