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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.
them to do it because the patient knew and trusted them and they could provide good care up until the patient died. Now, to me, the rationale given by the nurse who killed the prisoners in executions a few years ago was very similar to the rationale given by those nurses in Nazi Germany who killed their patients.
My reason for studying this and bringing it to attention today is that we must learn from history. Nurses who are going to work in areas where ethical dilemmas abound; for example, in euthanasia, as euthanasia laws are becoming debated so strongly in Australia; [ and ] in prenatal screening, where fetuses are terminated before they … are born if they have a disability or an abnormality. I’ m not saying these things are right or wrong, but what I am saying is nurses and midwives who come across these ethical dilemmas, and who might work in areas where these are being carried out, should know the history so that they can make informed decisions about whether or not they want to work in those areas.
You spoke about four distinct types of dilemma in that description: pre-birth terminations, legal executions, euthanasia and programs of orchestrated homicide during Nazi Germany. Looking at those four issues, would you classify yourself as a moral relativist or a moral absolutist when discussing what nurses should and shouldn’ t do? I would have to go down a moral relativist line. I think that each situation should be judged individually, but I think nurses who are going to work in these areas – if they know the history, if they know what’ s gone before and the end result of that history – can make better informed decisions about what they want to do themselves, and that’ s why I think this is very important. I’ ve had people tell me that nurses would not do these things and, of course, we know that’ s patently untrue. I’ ve had people tell me that the work I’ m doing on the history of nurses and midwives in Nazi Germany is not relevant today, but this exemplar of nurses being involved in executions is a perfect example of why it is still very relevant to learn this history.
The paper you’ ve just published has the views of 12 senior nurses in Australia, the US and the UK. Can you provide more detail about what those nurses said? The 12 of us were either very senior academics or senior people working in clinical areas. [ We had ] directors of nursing, [ and ] we had many professors. Many of the nurses are researchers or study ethics, some don’ t. Some of them agreed that the comments made by the nurse in the radio interview in America that I cited, they agreed with her. They said that yes, if someone is going to die, it is a moral duty of a nurse to provide the best care possible for that person until they die, regardless of how they’ re dying. Others disagree. Others said that no, nurses should never be involved in execution or torture of any kind. So it was a certainly a divergence of opinions on what should happen.
Some of us, including me, cite the International Council of Nurses code of conduct that says nurses should never, under any circumstance, be involved in these things.
We must remember that these were the personal opinions of all these 12 people. But others called for a debate around the code of conduct to consider what is happening in reality and to consider whether the code of conduct should be reviewed to take account of these circumstances that are happening and the nurses’ involvement in things like executions.
On the flip side, say there’ d been a particularly heinous crime like a massacre and the accused perpetrator has been injured and has been taken to the hospital requiring medical attention. Do you feel that nurses have an obligation to treat the person who has committed the crime given that they’ ve killed several people, or do they have a right to refuse to provide medical care? I personally believe that they must provide the care to people regardless of who they are and what they did. Had it been my child who the person killed, I may well change my mind. That probably makes me the moral relativist you mentioned before.
The nurses who wrote the paper, would probably agree with me saying that. The difference is that when you have someone brought in for care who has done something terrible, they are still there for you to care for. If you have a prisoner in prison awaiting execution who’ s going to be killed by the state deliberately, then that puts a very different perspective on it. Everybody who wrote that paper disagreed with capital punishment, but they took the view that regardless of who the patient is, what the circumstances are, they must give the best care possible.
I would agree with that but I would not agree with nurses being actively involved in the killing of that patient, and that’ s the difference. If they had done some horrible murder and they come into you and you have to care for them, then you give the best care you can – but you cannot cross that line and actively kill them or be involved in their killing actively. That’ s the moral full stop for me. And the people who read the paper would agree with that. They would say that the nurse can’ t give the lethal injection itself, but they do believe that the nurse should give care to the patient who’ s going to get that lethal injection. My argument is that by being [ involved by ] cleaning the IV line so the injection can be given, you’ ve crossed that line. ■
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