Twelve New Jersey nurses working on the same-day services (SDS) unit of the University Hospital in Newark, New Jersey, filed suit on October 31, 2011, against the University of Medicine and Dentistry of New Jersey (UMDNJ), alleging that the institution's officials demanded that the nurses assist in abortions, despite their religious and moral objections, or their employment would be terminated. In what was to be a public hearing of oral arguments and rebuttals for both sides on December 22, 2011, the attorneys instead reached a settlement in New Jersey's U.S. District Court.
The initial complaint accused the defendants of being in “blatant violation of federal and state laws,” namely 1974's Public Law 93-348, which protects health care personnel who work in agencies receiving grants or contracts for research programs from the U.S. Secretary of Health, Education, and Welfare from being discriminated against for refusing to perform or assist in activities that would be “contrary to [their] religious beliefs or moral convictions.” In a formal statement, the UMDNJ maintained that it was in “full compliance with all applicable state and federal laws and is confident that its position will be vindicated.”
Legal counsel Matt Bowman, with the Alliance Defense Fund (ADF), said at a press conference on November 14, 2011, that UMDNJ attorneys told him that the nurses still had to “assist in abortion cases” even after the suit was filed, forcing Bowman to obtain an emergency temporary restraining order.
On November 17, Theresa Rejrat, vice president of patient care services and chief nursing officer at the UMDNJ, sent a letter to at least one defendant, inviting her “again” to discuss “reasonable accommodations” to her objections regarding performing certain “current job duties.” In response, Demetrios K. Stratis, an attorney with the ADF and local counsel in the case, filed a motion the next day for another restraining order that also included a request that the defendants be held “in civil contempt.”
A brief filed by the UMDNJ on November 22, however, disputed that the plaintiffs were told they would be fired, claiming instead that they were told several times they could discuss possible accommodations to their beliefs. The brief also stated that “the routine, peripheral care that plaintiffs are now expected to provide to TOP [termination of pregnancy] patients is the same care they provide to other SDS patients, and cannot reasonably be construed as assisting in the performance of abortions.” It adds that the University Hospital nurses “are not forced and will not be forced to assist in the performance of abortions.” The UMDNJ also maintained that the plaintiffs were “objecting to particular patients as opposed to pre- and postoperative procedures.” On at least one occasion, the brief states, a “plaintiff refused, in front of a TOP patient, to provide any care to her because of her status as a TOP patient.”
Despite the volley of legal briefs and replies filed in the case, both sides seemed pleased with the settlement; the nurses do not have to assist in any way with TOP patients, but the SDS staff can make an exception in a medical emergency. In a press release the day afterward, the ADF called it a victory for the nurses.
Responding to a request for comments, the UMDNJ told AJN, “We are pleased that we have reached an agreement that is in the best interests of the patients we serve and respects the beliefs of our nurses. The hiring of additional nurses, which we announced several weeks ago, enables us to address both concerns.”
American Nurses Association (ANA) president Karen Daley points out that the issue of moral objections to providing care “has become more and more polarizing in the health care system and in the legislative system.”
Echoing the ANA's Code of Ethics for Nurses with Interpretive Statements, Daley said that when nurses find a particular treatment intervention or practice to be morally objectionable, they're justified in withdrawing from participation on moral grounds. However, she added, nurses cannot abandon the patient—they are still obliged to provide for the patient's safety. When it comes to conscientious objections made on moral grounds, Daley believes, they aren't made casually and “nurses reflect long and hard on these decisions.” A key component in such considerations, Daley told AJN, is knowing that “the best medical care is not given by nurses who are reluctant to give it.” —Gail M. Pfeifer, MA, RN, news director