does: the use of the phrase within your sphere of responsibility' makes named practitioners and team leaders generally responsible, morally and professionally, for the standard of care given by those to whom they delegate it. Ethically, there- fore, they are obliged, obviously only in ways consistent with good working relationships, not only to make sure that other members of the team are appro- priately competent and fully and clearly informed and/or instructed, but also to maintain a check that standards of care are being maintained. The third area where moral duty goes beyond legal duty concerns unborn children. Midwives and other health professionals have no legal duty to care for unborn children, and are not liable for pre-natal injuries to the child provided they have cared properly for the mother. But ethically, it would seem that as long as the interests of mother and child are compatible the duty of nurse or midwife must be to both, so that whatever benefits the child should be done, even if it is of no direct benefit to the mother. )In any case, this would normallybenefit' the mother by
being strongly in accordance with her wishes.) There is a technical problem of
ethical language and ethical concepts here: it is a disputed matter whether a fetus/
unborn child is a kind of being to which duties can be owed. But this seems to be
genuinely a purely linguistic problem with no practical effects )unlike many issues
in ethics which seem linguistic but turn out to be substantive). One can simply
rephrase by saying that the legal duty of the nurse or midwife is to care for the
mother, but there is a moral duty also to care for the unborn child even if this goes
beyond caring for the mother. For example, if doing, or refraining from doing,
certain things will benefit the child but have no effect on the health of the mother,
there seems to be no legal duty on the nurse or midwife either to inform the mother
of this or to recommend it. But there seems to be a moral duty to do both.
6.11 Conflicts between law and ethics
So far, we have been dealing with various ways in which the moral duty to
`promote and safeguard the interests and well-being of patients and clients' goes
beyond the legal duty to avoid negligence, but is not incompatible with it. But there
are two areas in which there may be an actual conflict between legal and ethical
duty. One concerns the mother and unborn child: if the legal duty is to the mother,
but the moral duty is to both, then a conflict is at least possible. Very often, of
course, either the interests coincide or the mother strongly wants to put the child's
interests first. In the main instance where they do not, that in which the mother is
having an abortion, the law specifically allows a nurse with conscientious objec-
tions not to take part. One can conceive of a very determined opponent of abortion
raising the question whether it could be the duty of a nurse or midwife not merely
to refuse to take part but actually to try to sabotage the whole process; but I think
that, given that there seems to be no possible way of doing this successfully, to say
nothing of how ethically dubious it would be, one can dismiss this as not a serious
suggestion.
But a problem remains. It seems clear that it is possible, though hopefully rare in
practice, for a health care professional to consider on reasonable grounds when
faced with a situation in which the interests of the mother and the child are in
Negligence 95