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A slippery moral high ground
Is it ever ethical for nurses to participate in abortions, executions or voluntary euthanasia?
Linda Shields interviewed by Patrick Avenell
Professor Linda Shields from Charles Sturt University is a specialist in nursing ethics. She has co-written a book on the role of nurses in Nazi Germany’ s forced euthanasia programs and recently authored an opinion paper on the role of nurses in the fulfilment of capital punishment, titled Nurse Participation in Legal Executions: An Ethics Round-Table Discussion, which was published in the journal Nursing Ethics.
“ This paper brings together the views of 12 senior nurses from Australia, the US and UK discussing the ethics of nurses being part of the process of executing a person condemned to die,” Shields says.“ Our intention is to highlight to the nursing world that this is occurring, to show a range of opinions and stances and to initiate discussion, argument and analysis of the topic.”
Campus Review speaks to Shields about the role of nurses in end-of-life situations, abortions and voluntary euthanasia.
CR: Can you start by giving us some background about this issue and your research?
LS: In the US, nurses who work in states where capital punishment is legal can become involved in preparing prisoners for their execution by putting in intravenous lines so that the doctors can deliver the lethal cocktail of drugs that will kill them. This goes against all the codes of conduct for nurses that are in place around the world by organisations like the International Council of Nurses, the American
Academy of Nursing, and certainly, here in Australia, the Australian College of Nursing. While it is legal for nurses to be involved, it is ethically and morally questionable that they do these things.
However, a radio interview was done a few years ago with one of the nurses who works in prisons and does this work. She described her actions as being similar to nurses who work in palliative care and end-of-life care. Her argument was that she was providing end-of-life care to someone who was going to die. Therefore, she saw it as no different to someone working in palliative care. She also argued that if she hadn’ t put the intravenous lines in, they would use unqualified people to do so, and the prisoner would suffer more.
Some of my research is about the role of nurses and midwives who worked in these so-called euthanasia programs of Nazi Germany. When Hitler came to power, nurses were as bombarded with propaganda as everybody else in Germany was at the time. Part of that propaganda was to propagate the idea that people who had a disability or a chronic illness were burdens on the state. They were called‘ useless feeders’ and‘ life unworthy of life’.
They were systematically killed in the hospitals which were supposed to be caring for them. Doctors were involved. They signed the forms for the killings to take place, but it was nurses that carried out the killings mostly. They would give children injections of pentobarbitone or they would starve them or they would put them out on the verandas in the middle of winter to let them die of hypothermia. No nurses were coerced into doing this. If they took part, they took part voluntarily. If they didn’ t want to be involved, they could say so and they would be moved to another ward or another hospital, so those who took part did so voluntarily.
Very few of the nurses after were ever tried. However, those who were gave the rationale that they became involved because they believed what they were doing was right. They also said that if they didn’ t do it kindly and gently, someone else would do it and they would hurt the patient. They also said that it was better for
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