Introduction
In my many years in the healthcare profession, I have found that an individual’s moral and ethical principles that guide their professional beliefs, attitudes and actions can oftentimes suffer due to unconscious bias, mine included.
Unconscious bias is shaped by our experiences and cultural norms. It allows us to filter information to make quick decisions, trusting our gut instinct. Sometimes however, this type of mental shortcut can take us off course, especially when it causes us to misjudge people or situations. Moreover, moral philosophic factors need to be taken into consideration as well as unconscious behaviors and attitudes that could have inferences to the way ethics is employed in decision making. (Why you need to check
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As someone who has had first-hand experience as being the medical decision maker for my mother, oftentimes social and spiritual values conflict, causing ethical dilemmas. The most common ethical debate in health care is withdrawal of nutrition and hydration (Legal and Ethical Issues Surrounding End of Life Decisions, n.d.) and this was the very issue faced by myself and my family when the time came to make the decision to end my mother’s tube feedings, ultimately leading to her death. I feel that this situation has definitely given me important insight (Virtue Approach) to the issues families face when honoring the wishes of the individual that are stated in an advance …show more content…
Inherently it is the medical professional’s and surrogate decision maker’s duty to honor the patient’s living will and this would certainly fall under autonomy - her right to autonomy of thought with regards to decisions regarding her healthcare that were stated in the living will; beneficence – the medical team involved has the knowledge needed when arriving at their decision based on the patient’s living will to discontinue ventilator support; justice – that removal of the ventilator is in align with the legal document (living will) and finally non-maleficence – the medical team ensures that removal of the ventilator does not harm the patient and before doing so, the spouse thoroughly understands the intent of the living will and that harm is minimized by pursuing a greater good for the patient. (Four fundamental principles of ethics. n.d.; Harris, 2014) My intent would be to adhere to these principles so that everyone involved can make an informed decision, a decision based on the facts and/or information. (Informed decision.
The main dilemma in this case study is that the patient wants her pacemaker shut off. She wants to stop the pacemaker as she believes this will end her life. She wants to end her life because she is miserable and feels she is making her family miserable. Although she believes this will end her life the cardiologist and primary care physician know that is not necessarily true. This could be a much longer process than she may think. Now the ethics consultant has been asked to meet with Dorthea and her family regarding the ethical/moral issues and medical rules about this dilemma.
In the medical profession, doctors and nurses run into ethical dilemmas every day whether it be a mother who wants to abort her baby or a patient who has decided they want to stop cancer treatment. It is important for the nurse to know where they stand with their own moral code, but to make sure they are not being biased when educating the patient. Nurses are patient advocates, it is in the job description, so although the nurse may not agree with the patient on their decisions, the nurse to needs to advocate for the patient regardless.
There are questions about transplant allocation in regards to the four major ethical principles in medical ethics: beneficence, autonomy, nonmaleficence and justice. Beneficence is the “obligation of healthcare providers to help people” that are in need, autonomy is the “right of patients to make choices” in regards to their healthcare, nonmaleficence, is the “duty of the healthcare providers to do no harm”, and justice is the “concept of treating everyone in a fair manner” ("Medical Ethics & the Rationing of Health Care: Introduction", n.d., p. 1).
Ethical principles in healthcare are significant to the building blocks of mortality. The principles are beneficence, autonomy, justice, and nonmaleficence. Although these principles can be certainly followed they can also be disregarded. Beneficence is a theory that assures each procedure given is entirely beneficial to that patient to help them advance within their own good. For example, There was a young girl, the age of 17. She had been being treated at a small private practice since she was born. She was recently diagnosed with lymphoma and was only given a few more years to live. Her doctors at the private practice who had been seeing her for years were very attached to her and wanted to grant this dying girl her every wish. They promised
As precious as life is to come in to this world, there is debate about whether life going out of this world should hold the same amount of pricelessness, happiness, and peace in cases of the terminally ill with no chance of long-term survival. This deliberation of whether physician assisted suicide should be permitted is a major medical ethical concern, however, as a future nurse, this argument does not have a place in modern medicine. In the following sections, the ethical principles of autonomy, beneficence, and nonmaleficence are discussed with regard to the patient’s best interest and the personal views and opinions of a prospective nurse.
Implicit and explicit biases are related mental constructs. For many years, even dating back to our great’s ancestor, people always have automatic judge people, places, and things. We were all given five senses, knowing how the brain works, we choose to use our conscious actions to judge. Without awareness, we usually act on those judgments. There are two types of judgments consciously and unconsciously.
Ethics is a branch of philosophy that deals with the moral principles and values that govern our behavior as human beings. It is important in the human experience that we are able to grasp the idea of our own ethical code in order to become the most sensible human beings. But in that process, can ethics be taught to us? Or later in a person’s life, can he or she teach ethics the way they learned it? It is a unique and challenging concept because it is difficult to attempt to answer that question objectively because everybody has his or her own sense of morality. And at the same time, another person could have a completely different set of morals. Depending on the state of the person’s life and how they have morally developed vary from one human
In my field of work, I have to make ethical decisions on a regular basis under the supervision of nurses and doctors but this particular time it involved the stopping of liquids and food to the patient. The patient was still alert and able to sit, talk and even walk for brief periods. A swallowing test revealed that this patient was not able to safely ingest by mouth liquids or food so I was to do mouth care only with a fairly dry sponge swab. This was the patient’s only means of mouth stimulation. Some family members felt for whatever reason that this was wrong to do no matter what. How can we stave someone to death? That was a distorted view of hospice and defeated the whole purpose of our mission. Yet they were entitled to their
Several ethical principles that are incorporated in the nursing care of patients on a daily basis are nonmalificence, autonomy, beneficence, justice, fidelity and paternalism. Nurses should strive to comply to as many of the principles as possible. In this case there are principles which support and conflict with the wishes of the patient. The first principle that supports the wish of the patient is autonomy. Autonomy means that competent patients have the right to make decisions for themselves and the delivery of the healthcare that they receive. Another factor that would support the patient’s wish to not be resuscitated is nonmalificence. Non maleficence means that nurses should not cause harm or injury to their patients. In this case the likelihood of injury after resuscitation was greater than if the patient were allowed to expire. A principle that could have negatively affected the outcome of the provision of ethical care was paternalism. Paternalism is when a healthcare provider feels that they know what is best for a patient, regardless of the patient’s desire for their own care. I demonstrated the principle of paternalism because I thought that I knew what was best for the patient without first consulting with the patient or family. This situation might have had some very negative consequences had the patient not have been competent. Practicing a paternalistic mindset might have caused a practitioner in the same instance to force their ideas about not resuscitating the loved one onto the family. This could have caused a sense of remorse and loss of control of care amongst the
Expression of Interest Topic At what point does the power of decision making (with regards to one’s health) shift from patient to family in Palliative care. Background This proposal arises as from observations made during nursing training placement done in a hospice that look after patients with serious illnesses such as cancer.
...ue to numerous medical errors. With the amount of medical errors that currently do occur which is a current health care issue it cost the health care billions of dollar each year to fix the mistakes that were made.
Heath care is a dynamic environment and one in which consumerism is expanding. Patients and families are more educated and involved in their care than ever before. The movement toward health consumerism has spawned additional ethical conundrums. The American Heart Association, American Association of Critical-Care Nurses, Emergency Nurses Association, and other health care entities have all addressed the topic of family presence during resuscitation and/or invasive procedures. Clinicians and researchers have cited a multitude of ethical principles when supporting arguments for or against family presence during resuscitation. On one hand family presence may be unhealthy for the family and cause untoward provider stress during an already tense situation. However, on the other hand do families have the right to attend these events and might it be beneficial for closure and education. Members of the health care team must evaluate both sides of the question.
Another huge ethical topic is the patient’s right to choose autonomy in the refusal of life-saving medicine or treatment. This issue affects a nurse’s standards of care and code of ethics. “The nurse owes the patient a duty of care and must act in accordance with this duty at all times, by respecting and supporting the patient’s right to accept or decline treatment” (Volinsky). In order for a patient to be able make these types of decisions they must first be deemed competent. While the choice of patient’s to refuse life-saving treatment may go against nursing ethical codes and beliefs to attempt and coerce them to get treatment is trespass and would conclude in legal action. “….then refusal of these interventions may be regarded as inappropriate, but in the case of a patient with capacity, the patient must have the ultimate authority to decide” (Volinsky). While my values of the worth of life and importance of action may be different than others, as a nurse I have to learn to set that aside and follow all codes of ethics whether I have a dilemma with them or not. Sometimes with ethics there is no right or wrong, but as a nurse we have to figure out where to draw the line in some cases.
What is unconscious bias? When asked this question, many people are hesitant to respond or they may not know the answer. But, it is quite simple. Unconscious bias can be defined as biases that we have but are not fully aware of. It becomes just “something we do,” essentially, it has been normalized and it is something rooted in our brains. Many times unconscious bias can also be referred to as implicit bias. There are many ways to define what this simple phrase means but, the best definition comes from the Kirwan Institute. The Kirwan Institute describes implicit/unconscious bias as “the attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner” (). Essentially, we may not know that we are being biased towards a certain person or group of people in our everyday lives. Many times this kind of behavior can find its way into the workplace and we being to make unconscious judgements about the employees that we work with on a day to day basis. With that being said, all members of society should work to defeat unconscious bias and I believe that starting with the workplace will help to make it a habit in our lives.
Health care has always been an interesting topic all over the world. Voltaire once said, “The art of medicine consists of amusing the patient while nature cures the disease.” It may seem like health care that nothing gets accomplished in different health care systems, but ultimately many trying to cures diseases and improve health care systems.