nurses

No Naked Nurse Principle

/ Jack Marshall / 42 Comments

Naked Nurse

There is a Naked Teacher Principle, however. The Principle states that a secondary school teacher or administrator (or other role model for children) who allows pictures of himself or herself to be widely publicized, as on the web, showing the teacher naked or engaging in sexually provocative poses, cannot complain when he or she is dismissed by the school as a result. The Naked Teacher Principle and all of its variations have been explored exhaustively on Ethics Alarms, The last time it was discussed, nearly a year ago, was in the context of rebutting the argument that there are similar principles regarding police and firefighters.

The current controversy is similar. Allie Rae, shown above, was a competent and dedicated Boston-area ICU nurse (and a 37-year-old mother of three) until she was was forced out of her medical job after employers discovered her non-traditional sideline, an OnlyFans page with a current following of more than 69,000. She says she started being sexually provocative on the web to relieve pandemic lockdown stress as well as her reaction to being on the hospital’s front lines during the Wuhan peak, sometimes working 14-hour shifts. Actually, maybe nursing was the sideline. After all, Allie says she made over $8,000 in her first month on OnlyFans, and she was making only seven a month as a nurse.

Continue reading →

Comment(s) Of The Day: “Ethics Quiz And Poll: The Nurse Practitioner’s Dilemma”

/ Jack Marshall / 13 Comments

We have a rare two-headed Comment of the Day on “Ethics Quiz And Poll: The Nurse Practitioner’s Dilemma,”about the nurse practitioner’s dilemma when she was asked by a poor, unmarried, 16-year-old , unemployed high school drop-out to help her get pregnant. Taking a minority position among commenters (the post’s poll results overwhelmingly favored counseling the girl against pregnancy), commenter valkygrrl wrote,

“Assuming the local age of consent laws make the pairing lawful, I think we have our answer in regard to professional ethics:

(f) Not discriminate against patients who have difficult-to-treat conditions, whose infertility has multiple causes, or on the basis of race, socioeconomic status, or sexual orientation or gender identity.

Assuming the local age of consent laws make the pairing lawful, I think we have our answer in regard to professional ethics.”

Commenter Tony, a physician, added in his Comment of the Day #1, Continue reading →

Ethics Quiz And Poll: The Nurse Practitioner’s Dilemma

/ Jack Marshall / 58 Comments

Sure.

It is seldom that I strongly disagree with NYU philosophy professor Kwame Anthony Appiah, “The Ethicist” of the New York Times Magazine’s long-running advice column. A month ago I did, and emphatically so.

The question posed to him involved a professional ethics dilemma, and “The Ethicist” was so certain he had the correct answer that he was uncharacteristically terse about it. I’m pretty certain about the answer too, except that my certainty is that he’s wrong. But I have some doubts, based on my ethical positions in related situations.

The inquirer was a a nurse practitioner working at a primary care clinic for low-income patients. She said that a 16-year-old patient told her that she had stopped coming by the clinic to have her birth control pills replenished because she and her partner were trying to have a baby together. She had been having unprotected sex for  a while, and she was concerned that she might have some physical problem preventing her from conceiving. The nurse practitioner asked,  “Would it be ethical for me to steer her away from trying to get pregnant? …Or, as her health care provider, do I have an ethical duty to try to help her conceive?”

Appiah doesn’t see any wiggle room. He says,

“You’re her health care provider. You should certainly tell her about the medical consequences of pregnancy. But the social and economic consequences don’t fall within your professional competence. An intervention about her life choices may seem moralizing and intrusive to her, and it could drive her away; and then she’d be losing your guidance on the things you are trained to help her with.”

Really? Continue reading →

Gallup’s 2020 Trust In Occupations Poll

/ Jack Marshall / 4 Comments

I usually cover this interesting poll when it comes out in early January; somehow I missed it this year., and am getting it in right under the January wire. The results don’t change much from year to year, as you will see,  and this year was no different.

As the have for many years now, nurses, once again, top the list. Continue reading →

The Division Of Conscience And Religious Freedom Vs. Basic Workplace Ethics [UPDATED]

/ Jack Marshall / 60 Comments

In May, the Trump administration issued a new rule  that gives health care workers the power to refuse to provide services their religion disapproves of, such as abortion, sterilization or assisted suicide. A religious conviction isn’t even essential to trigger the rule; a matter of conscience is enough. The measure essentially revived a Bush rule that the Obama administration reversed.

It’s a bad rule, and an unethical rule, as Ethics Alarms has held before. If you can’t perform all the duties of a job, then don’t take the job. If an employee can get his or her employer to agree that he or she is exempt from certain duties, that’s freedom of contract. Fine.  The Trump rule, however, like the Bush rule before it, breaches a basic principle of the workplace, and common sense as well. It also leads inevitably to messes like this one:

The federal government has accused  the University of Vermont Medical Center in Burlington, Vermont of violating  federal law by forcing a nurse to participate in an abortion despite her objections. The hospital denies it.

The nurse, who is Catholic, filed a complaint with the Office for Civil Rights. It  alleges, that she was misled by supervisors to believe she was assisting in a procedure scheduled after a miscarriage. “After [she] confirmed that she was, in fact, being assigned to an abortion, [her employer] refused her request that other equally qualified and available personnel take her place,” the complaint reads. She then participated in the procedure and “has been haunted by nightmares ever since.”

Now the Office for Civil Rights at the Department of Health and Human Services has filed a notice of violation against the hospital, the  first since the Division of Conscience and Religious Freedom was added to HHS in  2018. Continue reading →

Morning Ethics Warm-Up: 1/13/2018: Dumb and Dumber

/ Jack Marshall / 24 Comments

GOOD MORNING!

(I really looked forward to Saturday mornings in those days…)

1 There has to be a special Ethics Alarms category for this…But what? Lizzie Dunn sprayed herself in the face with sulphuric acid, stumbled into a deli on Staten Island, and told horrified customers as her face was melting that a middle-aged black woman had attacked her when Dunn refused her demand cigarettes and money at a bus stop.  Local news outlets spread the frightening tale of the acid-spraying stranger before police questioned Dunn and she recanted.Apparently she has a history of hurting herself. I’d include the photo of what her face looks like now, but that’s no way to start a long weekend.

2. From the “This is getting ridiculous” Dept. Stan Lee, ta Marvel Comics icon and the creator of many comic book heroes,is 95 years old but still pretty spry s he enjoys late life celebrity. The NHL’s Arizona Coyotes invited hm to be its ceremonial pregame puck dropper for yesterday’s game, but cancelled its invitation after some of the nurses who had cared for Lee at his home accused him of sexual harassment. Lee not only denies the allegation from the company that employed the nurses that he has “spoken inappropriately” to some of them and had tried to “grope them,” he claims to be the victim of a shakedown. His lawyers have threatened to sue the company for defamation, and Lee’s current nurse providers say he is a “perfect gentleman.”

This is #MeToo bullying. As usual, we have no way to know who is telling the truth, but the Coyotes are cowardly and unfair to embarrass Lee publicly by behaving as if he is guilty when investigations so far have proven no wrongdoing. He deserves the benefit of the doubt, and the prospect of eldercare nurses being primed to cry sexual misconduct when some geezer engages in dubious but harmless behavior that he was raised to think was a privilege of old age is frankly frightening.  Lee is wealthy, famous, and at his age poses no physical threat to any caretaker nor creates a hostile work environment in a profession that routinely faces far worse daily indignities than a pat on the rear or a racy wisecrack. He would be easy prey for #MeToo extortion: all that would be needed is a group of nurses to agree to accuse him and split the pay-off.  Meanwhile, the Coyotes would hardly be regarded as enablers of sexual violence if they let the guy drop a puck. Continue reading →

Comment Of The Day (1): “Public Confidence And Trust (1): Observations On Gallup’s Trust In Occupations Poll”

/ Jack Marshall / 5 Comments

My post on the Gallup poll on public trust in various occupations and professions strayed into Charles Green’s wheelhouse, and the resulting home run comment enlightened us regarding why nurses keep “winning” the poll as the most trusted year after year after year.

Here is Charlie’s Comment of the Day on the post, Public Confidence And Trust (1): Observations On Gallup’s Trust In Occupations Poll:

Speaking just to the nursing angle: my work on trust has involved a diagnostic tool, the TQ (Trust Quotient), a self-assessment of the four components of trustworthiness in the Trust Equation:
(Credibilty + Reliability + Intimacy) / Self-Orientation.

70,000 people have taken it, and three results stand out above all others.

First, women are more trustworthy than men – a finding confirmed by informal polls in 397 out of 400 groups I’ve presented in front of.

Second, the most powerful factor of the four (defined as the highest coefficient in a regression equation) is Intimacy.

Third, the bulk of women’s outscoring men is their higher score on the Intimacy factor (again, intuitively true to the vast majority of groups I ask).

It’s in this context that I note the Gallup work (and other pollsters) finding of nursing at the top of the heap every year but 2002 (which was, not coincidentally, the year after 9/11 – and a year in which firemen, if only for that one year, took over the top spot.

Nursing is an 89% female profession. I ask my audiences, “Which of the four trustworthiness factors do you think nurses most embody: credibility, reliability, intimacy, or low self-orientation?” Most pick intimacy (with low self-orientation a frequent second).

Add ’em up: female, Intimacy, nursing – it’s a trifecta. Continue reading →

Public Confidence And Trust (1): Observations On Gallup’s Trust In Occupations Poll

/ Jack Marshall / 38 Comments

I’ve been following the Gallup organization’s yearly polls on public attitudes toward institutions and occupations for a long time. The results are in for 2017. I’ll discuss the ethics implication of the Gallup occupations poll first; Part 2 will cover the institutions.

The occupations poll tends to fluctuate more year to year, and is most interesting as viewed a competition. Who are most trusted and regarded as most honest? Who are least trusted? Nurses have been ranked #1 in public trust for 16 straight years. I guess this means not too many people watch “Nurse Jackie.” I assume the consistently high rating is because we tend to trust people we have to trust, thus confirmation bias, and because there haven’t been any major nursing scandals or “Angels of Death” in the news. As you will see from the chart, medical doctors are trusted much less. I think that’s the result of an illusion.

Only six professions rate as more than 50% “high” or “very high” for honesty and ethical standards: nurses, military officers, grade school teachers, medical doctors, police officers and pharmacists. The honesty rating of pharmacists dropped five points since 2016, however, and it an occupation that has sometimes finished right behind the nurses. Gallup guesses that the opioid crisis is to blame, and maybe that’s right, though I would think the doctors who prescribe the drugs are more to blame then the druggists who sell them.

Public views of the clergy have fallen like a Chinese space station. Before the Catholic Church child molesting scandal in 2001, the clergy was very trusted at the high 60% level. Now it is all the way down to 42%, though the total of high trust and average trust is still 85%. I think the film “Spotlight” hurt, as it should have.

Occupations that I would regard as having positive public trust include those whose high trust+average scores are higher than their low trust+average scores. That group, in addition to the occupations already named above, includes day care providers, judges, auto mechanics, nursing home operators and bankers. I think in all of these cases, the public has no real idea about how trustworthy these occupations really are. We just hope they are trustworthy, so again, we have a result that is polluted by wishful thinking. These people are entrusted with the welfare of our children, our cars, our parents and our money, plus the justice system. They better be trustworthy. Ignorance is bliss.

I confess amazement that Wells Fargo scandal didn’t result in lowered trust for bankers. Continue reading →

Morning Ethics Warm-Up, 11/29/2017: Featuring Vital Questions Such As: Will Women Now Try To Look Unattractive? Should A Hospital Employ A Nurse Who Hates White People? Is That Man Trying To Rape A Manniquin With An Ice Dildo?

/ Jack Marshall / 68 Comments

Good Morning!

1  Documented insanity. The New York Times has been on an extended binge of highlighting the suffering of deported illegal residents. I could probably post several more episodes of the Ethics Alarms “Good Illegal Immigrant ” series every week. The intellectual dishonesty of almost all of these Times stories, like the pro-illegal immigrant movement itself, is impressive. Essentially, they all can be reduced to, “Isn’t it terrible that these lawbreakers have to endure the consequences of their own actions?”

Complementing these stories are periodic opinion pieces like “ICE’s Courthouse Arrests Undercut Democracy,”‘ by César Cuauhtémoc García Hernández, an associate professor of law at the University of Denver. He writes a pro-illegal immigration blog, identifiable in motive by its habitual use of the cover word “migrant” to mean “illegal immigrants” and the deliberately misleading word “Immigration” to mean “illegal immigration.” Hernández’s op-ed’s argument follows as the night follows day:

“In El Paso, ICE arrested a woman moments after she requested a court’s help keeping away an abusive partner. Fear and uncertainty caused by this type of courthouse arrest are already keeping people away from the halls of justice. In Denver, the city prosecutor gave up on four domestic violence cases because the victims said they were too afraid of ICE to appear in court. In a nationwide survey conducted in April by the nonprofit Tahirih Justice Center, four out of 10 social service providers working with immigrant survivors of abuse said they had clients who had abandoned legal claims because of fear of what will happen if they call the police or go to court.”

Wait: why were these people afraid of ICE? By immigrant survivors, doesn’t Hernandez mean illegal immigrant survivors? If he does, why doesn’t he say so? His favorite terms are “unauthorized” immigrants, and here and there “undocumented” immigrants, poor things. Whatever happened to their documents?

It’s not a threat to democracy if illegal immigrants are afraid to come to court. They should be afraid to come to court. They should be afraid to take advantage of any aspect of  our government or American society. Underlying the professor’s claimed concern for democratic institutions is his contempt for the rule of law. He wants to blur the distinction between illegal and legal immigration to the vanishing point. He quotes the California chief justice as she writes that “the vast majority” of “undocumented immigrants” “pose no risk to public safety.” Is that the desired standard for law enforcement now? As long as a known law-breaker poses no risk to public safety, he or she should be immune from arrest when they turn up in court?

The Times is apparently committed to bombarding its readers with this unconscionable position in perpetuity: our monstrous government has decided to enforce its immigration laws, and the very fabric of our democracy is threatened as a result.

2. CNN Tales.   On a related note, this morning I saw a slick TV ad on CNN supporting “Dreamer” legislation. The terms “illegal,” and even the cover words “undocumented” or “unauthorized” were never used, as various Presidents were shown extolling “immigrants.” “Dreamers” were described as “immigrants” who came here as children.

An ethical broadcast news organization should not accept money to run ads that intentionally misinform its viewers.

But THIS is CNN!…and so is this:  A CNN spokesperson told Politico…
Continue reading →

The Legal Profession Appears To Have A Serious Character Standards Problem…

/ Jack Marshall / 15 Comments

I refer you, for context, to the recent post about Shon Hopwood, Georgetown Law Center’s former bank-robber, former federal prisoner professor, who was welcomed into membership in the D.C. bar…like me.

Now comes word that Tarra Simmons, a third-year law student, convicted felon and former drug addict, who in December won a Skadden Fellowship to help people recently released from prison, was told by the Washington State Bar Association that she did not possess the character to make her a trustworthy lawyer.

Tarra was a magna cum laude law school graduate, and co-chairs Washington’s Statewide Re-Entry Council.  She recently received a gubernatorial appointment to the state’s Public Defense Advisory Committee, and was selected by the dean of Seattle University School of Law to receive the school’s dean’s medal this year.

Nevertheless, the character and fitness board’s vote against Simmons was not even close, at 6-3.

A registered nurse for 11 years, Simmons became addicted to prescription drugs and methamphetamine after her father died, as she self-medicated for depression. In 2011, she was charged with felony theft, drug possession and gun possession, pleaded guilty, served 20 months in state prison. She says she  wants to assist former justice-involved individuals, as  a lawyer who has lived their experience, so they “can overcome barriers and rejoin society.”

But Tarra cannot cannot take the Washington Bar examination without getting a positive  character and fitness recommendation, and that looks unlikely. She’s appealing to the Washington Supreme Court, but traditionally that forum is tougher in assessing the  character and fitness of  potential admittees.

I think her course now is obvious: move to the District of Columbia. The bar there will surely see no reason to doubt her character.

After all, it’s not like she robbed a bank.

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Pointer: ABA Journal