RESUMO
There has been an increase in cases involving the maintenance of brain dead pregnant women on life support to allow for fetal growth toward viability and birth. This article provides an ethical analysis and discusses the critical care nursing needs of the maternal patient.
Assuntos
Morte Encefálica , Cuidados Críticos/ética , Viabilidade Fetal , Cuidados para Prolongar a Vida/ética , Gestantes , Atitude do Pessoal de Saúde , Morte Encefálica/fisiopatologia , Cesárea/ética , Cuidados Críticos/organização & administração , Tomada de Decisões/ética , Dissidências e Disputas , Análise Ética , Família , Feminino , Necessidades e Demandas de Serviços de Saúde/ética , Humanos , Cuidados para Prolongar a Vida/organização & administração , Enfermagem Materno-Infantil/ética , Modelos Organizacionais , Recursos Humanos de Enfermagem Hospitalar/ética , Recursos Humanos de Enfermagem Hospitalar/psicologia , Enfermagem Pediátrica/ética , Gravidez , Direito a Morrer/ética , Fatores de TempoRESUMO
This article is an exploratory effort meant to solicit and provoke dialog. Conscientious objection is proposed as a potential response to the moral distress experienced by neonatal nurses. The most commonly reported cause of distress for all nurses is following orders to support patients at the end of their lives with advanced technology when palliative or comfort care would be more humane. Nurses report that they feel they are harming patients or causing suffering when they could be comforting instead. We examined the literature on moral distress, futility, and the concept of conscientious objection from the perspective of the nurse's potential response to performing advanced technologic interventions for the dying patient. We created a small pilot study to engage in clinical verification of the use of our concept of conscientious objection. Data from 66 neonatal intensive care and pediatric intensive care unit nurses who responded in a one-month period are reported here. Interest in conscientious objection to care that causes harm or suffering was very high. This article reports the analysis of conscientious objection use in neonatal care.