Refusal to Treat

Refusal to treat is an issue that arises when a patient’s care requires a nurse to do something that conflicts with his or her personal moral beliefs. A typical example of this dilemma involves assisting in or caring for a woman having an abortion. There is a legal right to abortion, but this does not establish whether abortion is morally right or wrong. If the nurse has a strong moral or religious belief regarding abortion, these concerns must be communicated with the appropriate supervisor. Do not abandon the patient; instead, ask for another assignment. Remember that the right to disqualify oneself from assisting with an abortion does not extend to the complete ability to avoid caring for the patient after the abortion. Disagreement with care decisions made by patients does not allow the nurse to refuse to care for them.

Patient diagnoses and lifestyles do not allow the nurse the legal right to refuse to care for a person. Examples include an infectious disease, such as HIV, or sexual orientation. The rationale is that the need for standard precautions (infection control measures) applies to every patient, and therefore, the nurse is at no greater risk for infection from one patient than from another. The ethical principle of respect for all people without discrimination underlies this issue. The patient has the right to receive care, and the nurse has the responsibility to provide nursing interventions.