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

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

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

As I thought it might, the Ethics Quiz about “The Ethicist’s” position that a nurse practitioner was obligated to help an unemployed, unmarried, 16-year-old high school drop-out get pregnant provoked a lot of discussion. Here is how the poll results on the issue are running:

And here is Arthur in Maine’s Comment of the Day on the post, “Ethics Quiz And Poll: The Nurse Practitioner’s Dilemma”:

Yikes. I know you hold Appiah in high regard, and your previous posts about his work make clear why. But I agree with you – he’s very much in the wrong on this one.

Many years ago, I worked in a group home for adjudicated teenagers. We had several 15 and 16 year old girls who, like the girl in question, actually wanted to become pregnant (thank God none of them managed to achieve this goal on our watch).

I recognize that my sample size is small enough that this is nothing more than anecdotal – but as far as I’m concerned, well-adjusted 16-year-old girls may adore babies and kids but understand that now’s not the time. To desire pregnancy at that age requires one or more underlying pathologies. Continue reading

Ethics Quiz And Poll: The Nurse Practitioner’s Dilemma

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

Morning Ethics Warm-Up, 8/27/2018: Petards, Conflicts, And Bullshit Edition

Good Morning!

1. Oh no! Hoisted by my own petard! I’m pretty certain that Clinton fixer Lanny Davis has an unwaivable conflict of interest in his representation of Trump fixer Michael Cohen. The legal ethics establishment is soft-peddling the issue because most legal ethicists apparently hate President Trump more than they like ethical lawyering, but I’ve been wrestling over whether to file a disciplinary complaint. The problem is that any complaint that has even a tinge of political motivation won’t be touched by the Bar (if prior performance is any indicator), so a complaint by me would be the proverbial lonely tree falling in the forest. The remedy would be to issue a publicity release about the complaint, but I’ve criticized that tactic as unethical right here, on more than one occasion. Rats.

It might be just as well. After the mere hint that I was defending Donald Trump (I was not) on NPR appears to have gotten me blackballed there after many years as an ethics commentator, I probably should not criticize the lawyer for the most popular sleaze in D.C. these days.

2. Neil Simon Ethics. In an alternate universe, my still operating professional theater company, dedicated to keeping unfairly buried, forgotten or unfashionable American theater works of the past in front of audiences who deserve a chance to see them, is looking at a lot of Neil Simon productions. The works of the —by far—most successful writer of comedies in Broadway history are already sneered at as sexist and “outdated,” and I can vouch for the fact that all it takes is one militant female board member with a checkbook and a chip on her shoulder to kill a production. Remember S.N Behrman? Seen any Philip Barry plays lately? How about Kaufman and Hart? Simon just died, and he’s already heading to obscurity along with those guys, and most of their plays are still funny too.

3. Here’s another topic it’s dangerous to get intoFrom CBS:

A pregnant Washington state woman said she was fired via text message from a sub shop where worked, with a store manager telling her “it’s not a good time to have somebody who is leaving for maternity leave in several months anyway.” Kameisha Denton told CBS Seattle affiliate KIRO-TV that she had told the manager she was pregnant and due in December, asking for maternity leave.

Denton said she realized that she hadn’t been assigned shifts at Jersey Mike’s sub shop in Marysville, Washington, so she sent a text to her manager inquiring about the hours. The response she says she received was shocking.

When Denton asked for her “updated schedule” she received something a bit different. The store manager named only as “Marcos” in Denton’s phone responded, “I am sorry to inform you but it’s not going to work out with Jersey Mikes. It’s not a good time to have somebody who is leaving for maternity leave in several months anyways. You also failed to tell me this during your interview.”

Denton posted the exchange on Facebook in a post that had garnered over 1,000 shares in just two days.  

Denton told KIRO-TV,  “I was just like in shock, it took me a minute to face reality — I was like this is really happening.”

Continue reading

Ethics And The Broadway Star’s “Accidental” Pregnancy

In July, just four months after the show opened to rave reviews, producers closed the hit Broadway musical, “Shuffle Along, Or The Making of the Musical Sensation of 1921 and All That Followed.” “Shuffle Along,” with 10 Tony nominations this year, had the makings of a long-running bonanza, but producers decided that when its acclaimed star, multiple past Tony Award winner (six!) Audra McDonald, had to leave the cast due to a surprising pregnancy (the actress was 45), it was too risky to continue. As soon as a replacement was named, ticket sales plummeted.

The show, which was capitalized for up to $12 million, had purchased a $14 million insurance policy from Lloyd’s of London to cover any damages arising if McDonald “was unable to perform because of an accident or illness.” Now producers are asking Lloyd’s to pay up, covering losses created by the pre-mature closing of the musical and by the  effects on the production occasioned by other health issues related to McDonald’s pregnancy while she was still performing.  “Since the beginning of previews of the Show, Ms. McDonald was unable to appear in numerous performances of the Show due to circumstances related to illness, a knee injury, and her pregnancy,” a lawsuit says. Her role was a strenuous one, requiring, among other things, a lot of tap-dancing.

Why the lawsuit, you ask? Lloyd’s says that the policy’s terms haven’t been met, arguing that the actress’s pregnancy and the associated medical conditions were neither due to an ‘accident’ nor an ‘illness’ under the policies.” The show’s position, as articulated by a lawyer representing the show, is that”‘Shuffle Along’ bought an insurance policy to cover it in the event that Ms. McDonald was unable to perform, and she was unable to perform.”

I love this story! It has everything—cold-eyed insurance executives, a perhaps manipulative diva, the sanctity of pregnancy, buck-passing, Hail Marys, feminist taboos, and Broadway!
Continue reading

Kim Davis Musings: When Employment Discrimination Is Responsible And Ethical—But Still Illegal

Kim Davis

It’s Kim Davis Day, when we will find out whether the recalcitrant clerk will step aside, allow her deputies to do her job, obey the judge, and not interfere with American couples who want to get married in Kentucky, or, as many expect, will again take her marching orders from God, defy the Supreme Court, start speaking in tongues, or find some other way to make a public nuisance of herself. The latter, we can only hope, will send her back to jail, and give Mike Huckabee, Ted Cruz, Bobby Jindal and some other Republicans an opportunity to grandstand.

The issue this raises for me is: Why would any employer  hire someone who reveals themselves as a Davis-level religious zealot? Continue reading

The Unethical Opposition To Tennessee’s Fetal Drug Abuse Protection Law

200439961-001Tennessee is one of the most activist states that it comes to protecting children; for example, it has the among most stringent laws in the nation regarding the mandatory reporting of suspected child abuse. It also has a new law that just went into effect this month that allows officials to arrest mothers for assault who illegally use narcotics while they are pregnant if the child is born with symptoms indicating that the drug use impaired the child’s condition.

Predictable and tiresomely, the media and “war on women” scolds are attacking this is yet another incursion on the rights of women to have dominion over their own bodies. Think Progress, dishonestly, calls it a “pregnancy criminalization law.”  This is intentional misrepresentation, a TP specialty. The law doesn’t criminalize pregnancy in any way, by even the most distorted interpretation.  The knee-jerk opposition to the law highlights the problems of consistency and integrity that the women’s rights and pro-abortion forces have in all the areas relating to childbirth. Essentially, their position is that if conduct is related to child birth—or preventing it—in any way, anything they say, want or do must be accepted, and asserting otherwise, no matter what the justification, makes the government an oppressor of women. Continue reading

Of COURSE There’s An Unwed and Pregnant Catholic School Teacher Principle….Don’t Be Silly.

pregnant nunButte Central teacher Shaela Evenson says she is planning on suing the Montana Catholic middle school that fired her for getting pregnant without the benefit of a husband. Whatever it is she is thinking (and whatever it is her lawyer is encouraging to keep thinking), it’s unethical, and I doubt the law will have much sympathy with it either.

  • She signed a contract promising “to respect the moral and religious teachings of the Catholic Church in both her professional and personal life”—a bit broad for my tastes, but this episode was pretty obviously exactly the kind of thing such a clause was designed to forbid, and nobody forced her to agree to it.
  • As Patrick Haggarty, the superintendent of Catholic schools for the diocese, said,  Evenson “made a willful decision to violate the terms of her contract.” It’s hard to argue that getting pregnant before marriage isn’t a willful decision, if she wasn’t raped.

  • Haggarty also notes, “The Catholic moral teaching is that the sacrament of marriage is a holy union between a man and a woman.” That sounds about right. Continue reading

Ethics Hero: Journalist Harris Meyer

Harris Meyer is an Ethics Hero because he won’t let a bad lesson go unchallenged.

Meyer is an award-winning  freelance journalist and a former editor at the Yakima (Wash.) Herald Republic. That was the paper that first broke the story of Gaby Rodriguez last year, which I wrote about here. With the encouragement of her high school principal, Rodriguez, a senior, embarked on some amateur social science research that involved deceiving everyone in her life except her mother, one (of seven) siblings, her boyfriend, and the principal. She pretended that she was pregnant, suing padding. She faked the pregnancy for months, finally announcing the sham in a student assembly. This extended hoax was supposedly designed to expose how pregnant teenagers are treated by their peers and others. It was, by any rational standard, a despicable thing to do—a betrayal and exploitation of her friends,  her boyfriend’s family, her siblings and teachers. Deception on such a scale must be justified, if at all, by both need and necessity. Were there other, less destructive ways to investigate the treatment of pregnant teens? Sure there were; interviews come to mind. Collecting published journals and other accounts. But Gaby’s unethical stunt was in spiritual synchronicity with a reality show-obsessed culture, where fake is entertaining and collateral damage is of no concern.  I wrote: Continue reading

Comment of the Day: “Fake Pregnancy, Real Deception, Real Harm

Commenter Karl Penny expands on the original post with reflections on trust:

“…Ms. Rodriguez’s actions were just plain wrong. Society, a civilized one anyway, depends on trust if it is to function. I buy foods that I trust were processed in such a manner that they are still wholesome, for example. Not so long ago, my wife and I went to see a movie and, while still some distance from the ticket booths, noticed that a number of people had turned and started walking away from the line they’d been in. We asked a couple who’d headed off in our direction what the matter was. They said a particular movie (forgot which one, now), the one we had planned to see, was sold out. We thanked them and left. We believed them. We didn’t wonder if it was a stunt or practical joke of some kind. We didn’t think a competing theater chain was trying to undermine a competitor’s business in that way. We certainly didn’t wonder if some local students were conducting a study on the behavior of disappointed theater patrons. I don’t want to have to live in a society where it would have been necessary to check whether the theater was really out of tickets for that show. We have enough people already who have worked at undermining public trust, to the detriment of us all. Any more of them, we don’t need.”