Nursing Code of Ethics Stands with Human Rights and So Do I

  

I am writing today to express support for all of the nurses who advocate for the rights of all human beings.  I am Liz Stokes, a Senior Policy Advisor for the ANA Center for Ethics and Human Rights, and have been a nurse for many years.  I spend each day informing, elevating, and advancing nursing ethics and human rights.  I stand with nurses in the fight for human rights with two things in my arsenal: (1) my stethoscope (because nurses do wear stethoscopes) and (2) the Code of Ethics for Nurses with Interpretive Statements (the Code).   When I became a nurse, I took an oath to commit to the tenets of the profession, including the Code.   “Nurses must always stress human rights protection with particular attention to preserving the human rights of vulnerable groups such as the poor, the homeless, the elderly, the mentally ill, prisoners, refugees, women, children, and socially stigmatized groups.” Interpretive Statement 8.4

What this blog is not:

  • A post about my political affiliation
  • My personal perspective on religious affiliation

This post is a reminder to my fellow nurses that we have an ethical obligation not only to stress human rights protection, but also to care for all.  We do not get to choose who we care for.  The word “patient” does not include identifying factors such as race, ethnicity, status, economic worth, criminal history, sexual orientation, gender, gender identity, immigration status, physical appearance, spiritual belief, disability, mental health, culture, or any other measure.  When a patient is in need, we answer the call of duty that we all were trained for.  We do so with compassion and respect and without bias or discrimination (intentional or unintentional).  This means that we have to be aware of our own biases in order to overcome them.  Take this opportunity to self-reflect.  What are your implicit biases? Take this moment to refresh yourselves with the Code that binds us and affirms, “A fundamental principle that underlies all nursing practice is respect for the inherent dignity, worth, unique attributes, and human rights of all individuals.” Interpretive Statement 1.1

Our profession is incredible.  We are the most trusted profession.  The power and influence we have on our patients, communities, and the world is profound.  Even when our personal perspectives vary- and they undoubtedly will- we must live up to our ethical obligations and be unified in our fight for equality in the treatment of all patients and zealous protection of human rights.

Over the last few weeks, many nurses across the world have expressed fear, uncertainty, sorrow, anger, and powerlessness on behalf of their patients and themselves.  Journaling, blogging, and other forms of written expression can be effective and therapeutic methods of dealing with intense emotions.  Please feel free to comment below and share your stories of advocacy and protection of our primary commitment- our patients.

 

President Trump Nominates Judge Neil Gorsuch (10th Circuit) to the Supreme Court

  

Last night, President Trump tapped federal appeals court Judge Neil Gorsuch to fill the empty seat on the Supreme Court.

Gorsuch is a right-leaning judge who once clerked for Justice Anthony Kennedy.  Gorsuch, 49, is among youngest of recent Supreme Court nominees (Justice Clarence Thomas was 43 when nominated, and Chief Justice John Roberts and Justice Elena Kagan were both 50.)

In 2013, he was part of the lower court that sided with Hobby Lobby. That’s the private company that successfully argued that Obamacare violated its religious beliefs by requiring it to cover birth control for its employees. Gorsuch is considered an “originalist” – meaning he believes the Constitution should be interpreted exactly how the Founding Fathers wrote it. If approved, he’d be filling the seat of another originalist, Justice Antonin Scalia, who died almost exactly a year ago.

Under the Constitution, the President nominates a Justice and the Senate has to approve. Last Congress, the Republican Party argued that they didn’t think President Obama should fill the seat in an election year. Obama went ahead and picked centrist federal appeals court Judge Merrick Garland but since the GOP controlled Congress, it blocked Garland all year. Dems were less than pleased.

Supporters say this is exactly what they wanted: a right-leaning justice who’ll keep the Supremes to the right. Critics remember Trump’s campaign promise to appoint someone who’d overturn Roe v Wade – and worry Gorsuch could help make that happen.

What’s next? Gorsuch now has a job interview with the Senate. And since the Dems aren’t super thrilled to be interviewing Gorsuch, they’ll be giving him extra scrutiny. They may even choose to filibuster (read: block) his confirmation. If that happens, the GOP could ‘go nuclear’ – aka change the rules so they wouldn’t need the Dems to approve Trump’s pick at all.

Freedom of Religion: In Hobby Lobby Stores vs. Sebelius, Gorsuch wrote a concurring opinion siding with the craft store and its owners arguing the courts should accept one’s interpretation of their faith’s requirements and that they were likely to succeed in claiming the ACA contraception mandate infringed on their freedom of religion.

Regulations:  Gorsuch has also questioned the constitutionality of the current volume of federal regulations Caring Hearts Personal Home Services vs Burwell.

Guns: While not a Second Amendment question, Gorsuch has indicated disagreement with some convictions for a felon’s knowing possession of a firearm, suggesting that prosecutors must prove that the defendant both knew he or she was a felon and knew that he or she was in possession of the firearm (rather than just knowingly possessing a firearm being sufficient for conviction). In one such case, Gorsuch did note that “gun possession is often lawful and sometimes even protected as a matter of constitutional right,” but it was still settled on statutory rather than Second Amendment grounds.  These cases are less an indication of Gorsuch’s views on gun rights, and rather evidence that — like Scalia — Gorsuch is an advocate for the rule of lenity. Conservative outlet American Thinker criticized Gorsuch for joining the majority opinion in U.S. v. Rodriguez, where the court cited Terry v. Ohio to uphold the legality of the search of a man who was found to be in possession of an illegal handgun. American Thinker wrote the case “causes us to have some concern about his understanding of the relationship between the government and an armed citizenry,” while acknowledging that the ruling was on Fourth Amendment grounds, not Second Amendment grounds.

 

GOP Meets for ACA Strategy Session and Senate Alternatives

  

Last week, there was flurry of activity and chatter on Capitol Hill surrounding the ACA’s repeal-and-replace. Much of the focus surrounded Congressional Republican’s three-day retreat in Philadelphia, where House and Senate Republicans were expected to plot their legislative agenda for the 115th Congress.

Congressional leaders held a special session on Thursday morning to try to reach a consensus on how to move forward on an ACA repeal and replacement strategy; unfortunately, no consensus was reached, which seemed to suggest that House and Senate Republicans were more divided on how to move forward than previously thought.

In the House, Speaker Ryan (R-WI) suggested on Thursday a more piecemeal approach towards health reform that’s focused on a “repeal and repair” of the system. Chairman Greg Walden (R-OR), a close Ryan ally, later this week will consider four separate bills that affect changes to the individual market in the House Energy and Commerce Committee. The changes would permit insurers to tighten enrollment periods, an attempt to try to ensure coverage for pre-existing conditions, and consideration on a measure to allow insurers to charge seniors higher rates. The committee will also examine potential reforms to the Medicaid program.

In the Senate, Senators Cassidy (R-LA) and Collins (R-ME) introduced the Patient Freedom Act. Hoping to chart a path that gives states options for reform, the bill would allow states to either 1) keep the ACA as is, 2) switch to a different insurance expansion plan that auto-enrolls individuals into a subsidized catastrophic plan, or 3) move forward with a repeal and no coverage expansion (meaning states would lose federal Medicaid expansion funds).

Senator Rand Paul (R-KY), also introduced his own bill. His legislation primarily focused on repealing the ACA’s employer and individual mandates, which includes a repeal of the ban on pre-existing conditions. The plan includes a two-year open enrollment period in which individuals with pre-existing conditions cannot be denied, but by and large the bill emphasizes tax credits and a more deregulated health market as an alternative to the ACA.

Stay tuned for more activity on Capitol Hill this week on the healthcare reform front.