Leah L Curtin Archives - Protection of Conscience Project Library

The First Ten Principles for the Ethical Administration of Nursing Services

Leah L Curtin

Abstract
At the dawn of the 20th century, postmodern academics stressed the cultural differences among human beings. Philosophers predicated differing value systems based on these cultural differences, and conflicts have arisen among those who hold distinctly different religious traditions. Many people believe there can be no universal system to explain reality and thus form the basis for norms in human behavior. However, at the close of the 20th century scientists and philosophers had come full circle: physics quite literally became metaphysics, and ethical systems made sense. Rush Kidder interviewed two dozen “men and women of good conscience” from around the world and asked them if there is a single set of values that wise people use to make decisions. They answered with a resounding YES! Thus, in addition to the customary principles of beneficence, nonmalfeasance, honesty, and so forth, the author proposes a set of ethical principles based on those universal values, adapted to fit nursing administrators’ dual responsibilities. Ethical decision making and behavior, the author contends, help to reconcile perspectives and interests and to keep values and mission uppermost in one’s mind. In the process, ethical behavior establishes long-term relations of trust and cooperation, which in turn promote consistency and stability in an unstable world..

Curtin LL. The First Ten Principles for the Ethical Administration of Nursing Services. Nurs Adm Q. 2000 Fall;25(1):7-13.

Abortion: the limits of moral repugnance

Leah L Curtin

Abstract
A 28-year-old married woman, gravida 3 para 2002, was transferred to a tertiary care hospital at 27 2/7 weeks gestation for verification of gross fetal anomalies. Ultra-sonography studies showed the child she carried had a dramatic gastroschises, an enlarged heart, and small limb buds for arms. The patient was informed of her fetus’ condition and, after she discussed the situation with her husband, both parents asked that the pregnancy be terminated.

Using prostaglandin, the physician induced labor prematurely in a labor and delivery room suite. Both parents held the child until shortly before its death.

A voluntary abortion this late in pregnancy for nonlethal birth defects caused considerable concern and even distress among the nursing staff on this unit. As a matter of conscience, almost half of the nursing staff refused to care for any patients having elective abortions, and this case raised even more moral questions than usual. Moreover, this couple—and even their family members—received threatening phone calls and letters while the woman was still in the hospital, and the couple reported receiving even more after she returned home.

Curtin LL. Abortion: the limits of moral repugnance. Nurs Manag. 1994 Oct;25(10):22-25.

Conscience and Clinical Care

Leah L Curtin

Extract
If the state itself does not presume to order the consciences of its citizens, how can employers, physicians or hierarchical superiors assume such authority? For those in positions of power, it is all too easy to stifle the criticisms and consciences of subordinates by a summons to authority – or by an accusation of insubordination. The irony of it is that whether you succeed or fail in your attempts to force obedience through such tactics, you will have lost your most valuable asset – a man or woman of integrity. Within the ethical, professional and legal restraints to which all of us are subject, we can and must create a system that allows for respectful dissent and conscientious objection.

Curtin LL. Conscience and Clinical Care. Nurs Manag. 1993 Aug;24(8):26-28.

Creating Moral Space for Nurses

Leah L Curtin

Extract
(Lengthy 1983 editorial repeated verbatim in 1993 includes the following) “No nurse should be required to give any drug if (a) she is not competent to give it or (b) she has problems of conscience with regard to its administration. If, for these reasons, a nurse refuses to give a drug, another nurse may do so. The original nurse should receive inservice and/or counseling. If she still has conscientious objections, she should not be coerced. The patient’s right to have/refuse a drug should be protected by meticulous adherence to the principles and procedures of informed consent. However, his right to the drug is not greater than another human being’s (the nurse’s) obligation to practice with integrity. Therefore, if one nurse will not give the drug – the head nurse, coordinator or supervisor should give the drug.” If none of these nurses can, in conscience, administer the drug, then the physician who ordered it must give It himself or find another physician who will do it for him.

Curtin LL. Creating Moral Space for Nurses. Nurs Manag. 1993 Mar;24(3):18-19.

(Editorial) A Nurse’s Conscience

Leah L Curtin

(This lengthy editorial was repeated verbatim in 1993. It includes the following)
Extract
“No nurse should be required to give any drug if (a) she is not competent to give it or (b) she has problems of conscience with regard to its administration. If, for these reasons, a nurse refuses to give a drug, another nurse may do so. The original nurse should receive inservice and/or counseling. If she still has conscientious objections, she should not be coerced. The patient’s right to have/refuse a drug should be protected by meticulous adherence to the principles and procedures of informed consent. However, his right to the drug is not greater than another human being’s (the nurse’s) obligation to practice with integrity. Therefore, if one nurse will not give the drug – the head nurse, coordinator or supervisor should give the drug.” If none of these nurses can, in conscience, administer the drug, then the physician who ordered it must give It himself or find another physician who will do it for him..

Curtin LL. (Editorial) A Nurse’s Conscience. Nurs Manag. 1983 Feb;14(2):7-8