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Emily Collyer

on 7 February 2014

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Transcript of Abortion

Broad Overview
Topic: Abortion
Questions we will address:

1) Should abortion
remain legalized? Is
abortion an ethical

2) What are the nurses' roles as professionals throughout the abortion process?

3) What can you, as an individual & a nurse, do if this ethical issue causes you moral distress?
Abortion Defined
Spontaneous Abortion: Termination of a pregnancy by natural causes (Healthwise Staff, 2013).

Theraputic/Induced Abortion: The deliberate termination of a pregnancy (Healthwise Staff, 2013).

Medical: Termination of an early pregnancy (7-9 weeks) with medication (usually methotrexate and misoprostol) (Healthwise Staff, 2013).

Surgical: Termination of pregnancy with vacuum aspiration (Healthwise Staff, 2013).

Canadian Abortion Laws
1969: Abortion was permitted only under certain circumstance

1982: Enacted Charter of
Rights & Freedoms

1988: No laws in Canada restricting abortion
Over 90% before week 12
98% before week 16
Exploring the Ethical Issue of

Spencer, Nouman, Sophi, Christopher & Emily
By the end of our presentation you will be able to...
Learning Objectives
Define abortion & differentiate between the different types
Differentiate between the two main movements: Pro-life & Pro-choice
Understand what both Pro-life & Pro-choice argue
Understand how the CNA Code of Ethics, CARNA Nursing Practice Standards & nursing as a profession are relevant to the ethical issue of abortion
1989: Father has no legal right to say
a woman cannot have an abortion

1995: Abortion paid for by MediCare
in most provinces
Pro-Life Argument
Pro-life definition: advocating the legal protection of human embyos and fetuses, especially by favoring the outlawing of abortion on the ground that it is the taking of a human life.
Abortion is murdering a human being
Abortion is Murder of a Human Being
...When does human life begin?
1. Living things are highly organized.

2. All living things have an ability to acquire materials and energy.

3. All living things have an ability to respond to their environment.

4. All living things have an ability to reproduce.

5. All living things have an ability to adapt.
5 Criteria for human life:
Fertilization = LIFE
"By all the criteria of modern molecular biology, life is present from the moment of conception." Dr. Hymie Gordon, Chairman, Department of Genetics at the Mayo Clinic
Abortion is holistically damaging
Abortion can enhance quality of life

Dr. Diana Greene Foster stated that when a woman is denied the abortion she wants she is statistically more likely to wind up unemployed, on public assistance, and below the poverty line (ANSIRH, 2014).

¾ of women interviewed were on public assistance

67% were below the poverty line
Less than 50% held a full time job
(ANSIRH, 2014)
Abortion & Poverty
“Failing to finish school contributes mightily to poverty and education”

30% of girls name pregnancy or parenthood as the reason they left school.

51% of teen moms earn a high school diploma compared to 89% of female students who did not give birth as a teen.

61% of women who have children in community college do not finish their degree.

(The National Campaign to Prevent Teen and Unplanned Pregnancy, 2013).

Women have higher pressure to balance work and personal life (Betrand, Goldin, & Katz, 2009).
ANY career interruption greatly effects potential future earnings for employees (Bentrand et al., 2009).
Women with children work 24% fewer hours than the average male (Betrand et al., 2009).
Women without children work 3.3% less hours than the average male (Betrand et al., 2009).
“The presence of children is a main contributor to lesser job experience, greater career discontinuity, and shorter work hours” (Betrand et al., 2009, p. 230).


If pregnancy and children effect a woman’s future (career, education, poverty, and therefore empowerment) to such a great extent should the choice be taken away?
Should a woman be obligated to possibly quit school, receive less education, be at risk for poverty, maintain a primarily domestic role? Or should she have the right to choose her own life path?

Argument/ Reflection
Ethical endeavours viii. Nurses work to improve the quality of lives of people who are part of disadvantages and/or vulnerable groups and communities, and they take actions to overcome barriers to health care.
Illegal abortions compromise safety
Abortion options should be utilized in cases of rape
Rape: “the crime, typically committed by a man, of forcing another person to have sexual intercourse with the offender against their will:” (Oxford, 2014)

Incest: “sexual relations between people classed as being too closely related to marry each other.” (Oxford, 2014)

Definition of Rape and Incest as per Oxford Dictionary
Can lead to pregnancy. In 2012, it is estimated that 17,342 pregnancies were a result of rape. (RAINN, n.d.)

A very traumatizing experience for the woman. Negatively affects domains of functioning (DeAngelis, January 2013).
Effects of Rape & Pregnancy on Women
The Women That Do Not Want Pregnancy
A brochure put out by the pro-life action organization based in Chicago stated that half of the woman who aborted did it solely because of others demands. (Pro-Life Action, n.d.).
So, Good or Bad?
A lot of negative effects on women in all aspects of life.  

Abortion is not the necessary choice after a rape but it does leave the option open for the woman to reflect on her personal state of well-being and decide what would be best for her.

If made illegal, a raped woman would once again have no say in what happens to her body and be therefore forced to remain pregnant and possibly exacerbate the effects of rape along with the pregnancy.

Her autonomy is taken away.

In the health care setting, a patient has the right to choose and the ability to act on that choice according to autonomy under the code of ethics.
CNA Code of Ethics
CARNA Nursing Practice Standards
4.6 The nurse participates in quality improvement activities.
Safety & Abortion
Women wanted control over their fertility and were willing to go to great lengths to do so
Women would resort to dangerous remedies as a result of the laws against abortions
Some women would try taking tansy, quinine, pennyroyal, rue, black hellebore, ergot of rye, savin, or cotton root to induce miscarriage (Mclaren, 1978)
If those drugs failed women would try hot baths, violent exercises, bleedings, or consumption of large amounts of gin (Mclaren, 1978)
Finally as a last resort some women would attempt to dilate their cervix with slippery elm, a sponge tent, or a catheter (Mclaren, 1978)

Before abortion became legal...
In 1926-1947 4,000-6,000 Canadian women died from botched abortions (Pro Choice Action Network)

In 1915 a coroner Dr. Millen Cotton stated, “…there were between three and four hundred cases in the hospitals last year as a direct result of illegal operations, and in addition to these there were many cases in private houses which were not discovered.” (Mclaren, 1978
Illegal Abortion = Death
Since 1988 there have been no laws restricting abortion in Canada (National Abortion Federation, 2010)
In 1982 there were 75,071 abortions performed in Canada compared to 64,641 performed in 2010
Abortions Today
Nowadays Canada has one of the lowest maternal mortality rate in the world, 0.1 per 100,000 abortions (Pro Choice Action Network)

With the combination of the women’s sensible judgment and moral values along with a doctors professional and medical judgment, many believe that is all that is needed to regulate the process of abortion

3.2 The nurse protects and promotes a client's right to autonomy, respect, privacy, dignity and access to information.
CNA Code Of Ethics
CARNA Nursing Practice Standard
One year after being turned away from an abortion...
Psychological Impacts of Abortion
Emotional, Physical & Social
81% Increased chance of developing of a Mental Health Problem (Coleman, 2011)

Sadness or Depression (Speckhard, n.d.).

A sense of losing a child.

Feeling Regretful or Guilty (Speckhard, n.d.).

Emotional Impact of Abortions
Physical Risks of Abortion
Self-harm such as cutting, improper eating, and engaging in risky behaviours.

Sleep disturbances (Speckhard, n.d.).

Drug or Alcohol abuse (Speckhard, n.d.).

Suicidal tendencies (Speckhard, n.d.).

Social Impacts of Abortion
Worry of being judged by other people, such as family members.
Having avoidance behaviours (Speckhard, n.d.)

Partner/Spouse may not agree with the decision (Papworth, 2011).

CNA Code of Ethics
Promoting and Respecting Informed Decision-Making:
3: Nurses do not engage in any form of lying, punishment, or torture or any form of unusual treatment or action that is inhumane or degrading. They refuse to be complicit in such behaviors. They intervene, and they report such behaviors.
CARNA Nursing Practice Standards
Ethical Practice:
3.5: The registered nurse advocates for practice environments that have the organizational and human support systems, and the resource allocations necessary for safe, competent and ethical nursing care.

1. If something is growing, isn’t it alive?
2. If it has human parents, isn’t it human offspring?
Abortion= murdering a human
What is the difference between a one week old fetus
& week twenty week old fetus?
Nursing Perspective on Abortion
Very difficult to disconnect personal values (Natan & Melitz, 2010).

Factors influencing nursing perspectives:

Religious beliefs and the reason for abortion (most significant factors) (Natan & Melitz, 2010).
Socioeconomic status of the mother.
Age of fetus (Natan & Melitz, 2010).
Level of experience (Natan & Melitz, 2010).
Nursing schools do not always provide the necessary tools to achieve the objectivity required in preparation for the abortion. (Gmeiner, Van Wyk, Poggenpoel, & Myburgh 2000).
Number of children the nurse has (weak correlation) (Natan & Melitz, 2010).
More accepted reasons for abortion:
Malformation of infant
Compromised safety of mother
In the case of rape
(Natan & Melitz, 2010).

Nursing role:
The first contact (Natan & Melitz, 2010).
Educate patient about procedure (Natan & Melitz, 2010).
Educate about consequences (Natan & Melitz, 2010).
Participate in the best interests of primary patient. Support the patient and enhance/maintain dignity and safety (Natan & Melitz, 2010).

“The nursing profession requires nurses to be objective and to put aside their own perceptions, attitudes, and personal religious convictions” (Natan & Melitz, 2010, p.69).

Ethical dilemma and moral distress results when personal values conflict (especially in nursing students) (Natan & Melitz, 2010).
Nurses express “guilt, depression, and fear” as well as burnout .

Nursing Perspective on Abortion
Nursing Position Statements
Abortions should be prohibited:
Students: 57% Nurses: 43%

The government should prevent
late abortions:
Students: 18% Nurses: 14%

Fathers should have a say:
Students: 73% Nurses: 39%

(Natan & Melitz, 2010).

Students Versus Nurses...

• Safe, competent and ethical care: Nurses value the ability to provide safe, competent and ethical care that allows them to fulfill their ethical and professional obligations to NPS the people they serve.

3.2- The nurse protects and promotes a client’s right to autonomy, respect, privacy, dignity and access to information.

CARNA Nursing Practice Standards
2.7: The registered nurse supports, facilitates, or participates in research relevant to nurses.
CNA Code of Ethics
According to the principle of Non-Maleficence under the code of ethics, nurses as professionals are to do no harm

You are the nurse assigned to care for 19 year old Holly who is scheduled for a therapeutic abortion today. Holly enters the clinic looking scared and anxious. You perform a health history on Holly and receive the following information:
17 weeks pregnant
Her supports include parents and 1 best friend.
Scared and anxious. States “I don’t know what is going to happen to me”.
She has just started her first semester of college.
Currently on student loans. Depends on parents for financial support.

1. What are your initial thoughts and feelings about caring for Holly (Personal Values)?
2. What are your roles and responsibilities as a nurse when caring for Holly (Professional Values)?
3. What are your options if your personal values conflict with your professional values?
Over half of men involved with a abortion have experience difficulties with their relationship (Schelotto & Arcuri, 1986, as cited in Papworth, 2011).
In a survey with 905 men, 38% were interested in individual counseling and 55% were interested in counseling with their partner (Shostak, 2008, as cited in Papworth, 2011).
Abortion may also affect men
Pro choice does not mean pro abortion or anti life. People that argue pro choice believe that a woman should make their decision privately with her doctor. They defend the right of the woman to choose for herself what is best. Their mission is to:
Prevent unwanted pregnancy
reduce abortion
promote contraception, education, and resources.
Pro-Choice Physicians, 2014
Gray, 2013
(Development of a fetus)
(Photograph of pro-life rally)
(Keep abortion legal)
(My choice)
(Unborn baby)
(Prolife logo)
(When does life begin?)
(Where do you draw the line?)
(Abortion is forever)
(Pro-life vs pro-choice)
(Abortion law)
(Rape clipart)
What about the women that want abortion on their own will? Are we to not take into account their rights?
(Picture of crouched girl)
(Glass ceiling)
(Views of fetus in the womb)
CNA Code of Ethics
CARNA Nursing Practice Standard
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