Brodtkorb, K., Skisland, A. V., Slettebø, Å., & Skaar, R. (2015). Ethical challenges in care for older patients who resist help. Nursing Ethics, 22(6), 631-641. doi:10.1177/0969733014542672 In this article it states, “Help should be given voluntarily and with consent.” This principle of a patient’s autonomy is used in professional ethics, clinical practice and health legislation. Health care professionals are sometimes unknowingly put into positions of paternalism or coercion. Autonomy and informed consent are stressful situations faced by nurses daily. In some cases the clinician made choices of action in personal hygiene, concealed medication, and detention in an institution. Findings show that decisions made against the patients will in …show more content…
Patients receiving end of life care can often be on mechanical ventilation. A ventilator is a machine that provides all ventilation and oxygenation needs a patient may need. Mechanical Ventilators are often used in acute care settings, such as surgery, drug overdose, or injury. However, many patients need a ventilator to survive long term and are often terminal. Respiratory therapists are trained to manage diseases of the pulmonary system and airway. Respiratory therapists are part of every aspect of healthcare. They manage patients on mechanical ventilation and the maintenance and operation of the ventilator. A Respiratory Therapist may find terminal weaning to be unethical whether the patient is conscious, brain dead, the patient’s preference, quality of life, or there may be family conflict involved. Terminal weaning goes against a Respiratory Therapists code of ethics of do no harm. Although, the therapist has broken no laws some feel as though they have broken the code of morality and religion. The work place must have a support system in place for the …show more content…
The Bipap however is usually not addressed when life support is discussed with the patient. Bipap is a noninvasive form of ventilation. Some doctors in this article believe that Bipap should not be used on DNR patients stating it is too invasive and would make the patient uncomfortable. Others however state it should be used due to the fact it is noninvasive and could get the patient over the hump. Some doctors in this article state that most patients using Bipap that are DNR’s are severe COPD patients. They have used Bipap many times in the past and it would make them comfortable. The article states there is no right or wrong answer when it comes to the initiation of Bipap on DNR patients. The physician will abide by the patient’s preference on whether or not they initiate the use of
This assignment will explore a case study on an episode of care where a patient with chronic pain was hoisted. This will be written from the perspective of the author, a student nurse. The purpose of this assignment is to underline the ethical, legal and professional issues surrounding the episode of care during nursing practice and how these issues influence the role of the nurse and their professional judgement in delivering holistic, person-centred care for the patient. The author will cover the complications on delivering care when healthcare professionals should consider and respect the patient’s decisions and personal preferences whether it may benefit the patient or not. Therefore, the author will argue the principles of the patient’s autonomy against the concerns for the patient’s health and well-being, considering what form of care is appropriate and what must be done and how the nurse can maintain their professional role in being an advocate. Moreover, this will consider the nurses’ approach in providing the best care possible by means of ethical, legal and professional values. Furthermore, this assignment will briefly show an awareness of the roles of other professionals involved in the care.
Nurses everywhere face problems and challenges in practice. Most of the challenges occur due to a struggle with the use of ethical principles in patient care. Ethical principles are “basic and obvious moral truths that guide deliberation and action,” (Burkhardt, Nathaniel, 2014). Ethical principles that are used in nursing practice include autonomy, beneficence, non-maleficence, veracity, confidentiality, justice, and fidelity. These challenges not only affect them, but the quality of care they provide as well. According to the article, some of the most frequently occurring and most stressful ethical issues were protecting patient rights, autonomy and informed consent to treatment, staffing problems, advanced care planning, and surrogate decision making (Ulrich et. al, 2013). The ethical issue of inadequate staffing conflicts with the principle of non-maleficence.
In this essay the author will rationalize the relevance of professional, ethical and legal regulations in the practice of nursing. The author will discuss and analyze the chosen scenario and critically review the action taken in the expense of the patient and the care workers. In addition, the author will also evaluates the strength and limitations of the scenario in a broader issue with reasonable judgement supported by theories and principles of ethical and legal standards.
The healthcare system can be difficult for clients to navigate and they are often unsure how to access information which puts them at the mercy of others and can lead to feelings of helplessness (Erlen, 2006). Nurses can provide resources to educate patients when they becomes dependent on a health care provider and no longer feel in control of their own body which can lead to fear, hopelessness, helplessness and loss of control (Cousley et al., 2014). The change in roles individuals face can further increase their stress and feelings of powerlessness (Scanlon & Lee, 2006). According to the CNA code of ethics, nurses are responsible for protecting patients from objective risks that place them in an increased level of vulnerability (Carel, 2009). They can do this by providing the resources necessary for patients to educate themselves and be better able to cope with the health challenges they
Recent developments in standard of care and professional relationship with patients have made law fundamental to the study and practice of nursing. At every stage of patients care, law helps bring up to date nursing practice and it is essential that nurses understand the legal and ethical implications of law in their nursing profession (Griffith and Tengrah, 2011). The purpose of this essay is to discuss the concept of consent in relation to the role of the nurse. This will aim at demonstrate ethical and legal implication of consent on nursing practice and professional working. In the Code (2008, cited in Griffith and Tengrah, 2011) the Nursing and Midwifery Council set standards for nursing professional to follow. Among the rules is the requirement of nurses to obtain consent before care is given.
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
Autonomy is identified as another professional value and one that the nurse must possess. Autonomy is the right to self-determination. Nurse’s respect the patient’s right to make a decision regarding their healthcare. Practical application includes, educating patients and their families on their choices, honoring their right to make their own decision and stay in control of their health, developing care plans in collaboration with the patient (Taylor, C. Lillis, C. LeMone, P. Lynn, P,
As nurses we owe a duty of care to our patients regardless of their race, status and age. In all our working life, we have to conduct our self in a way that is considered reasonable for someone in our position to do so. Reasonable conduct may be thought of as that which is acceptable, fair, honest, right and proper. However, this duty of care is questioned when it comes to dealing with preserving the autonomy of a person who is suffering from dementia in a nursing home. This research paper will focus on the ethical issues between duties of care vs. autonomy of dementia residents living in an aged care facility.
As nurses, it is important that we “be both empowered and competent enablers of patient empowerment.” (Burkhardt & Nathaniel, 2014, p. 493) We take an oath to follow an ethical code which requires us to act as our patient’s advocate while providing safe nursing care. Nevertheless, we cannot make any medical choice or decision on their behalf. We also cannot empower them, “because to do so removes the element of choice.”
Physician-assisted suicide refers to the physician acting indirectly in the death of the patient -- providing the means for death. The ethics of PAS is a continually debated topic. The range of arguments in support and opposition of PAS are vast. Justice, compassion, the moral irrelevance of the difference between killing and letting die, individual liberty are many arguments for PAS. The distinction between killing and letting die, sanctity of life, "do no harm" principle of medicine, and the potential for abuse are some of the arguments in favor of making PAS illegal. However, self-determination, and ultimately respect for autonomy are relied on heavily as principle arguments in the PAS issue.
A lot of information has been stipulated concerning how patients should be treated and the legal rights involved in the health care system. Different values are, therefore, involved. In the correctional setting, the patient entirely relies on the nursing service offered and various services are expected to be offered by a nurse. However, in the process of providing these services, a nurse has to uphold all ethics that dictate the profession (National Commission on Correctional Care, 2011). The legal ethics include right to autonomy where the patient’s view should be respected and incorporated in the provision of nursing care. A nurse should always tell the patient the truth according to how he or she is fairing on health wise. The principle of beneficence also allows a nurse to concentrate on provision of services that are beneficial to the patient. A registered nurse also ensures equitability and fairness in the provision of care to the patient (National Commission on Correctional Care, 2011). Another principle that a nurse understands is the principle of fidelity that allows a nurse to remain committed in the process of provision of care. The principles help a nurse in making ethical decisions in the process delivering nursing care to the patient. For instance, having in mind the principle autonomy, one can be able to appreciate an advance of health care directive that enables one to act as per the patient’s
All in all, the pros of life support are far outweighed by the cons. A sustained life may sound positive; however, when a patient is on life support, the sustained life is consumed in discomfort and the quality of it is belittled. Ethicists alike are appalled that an officially classified deceased individual may further be inappropriately tested on, and the costs underwent by both the patient(s) and close friends and family alone during the duration of the treatment surely would discourage anyone from attempting to put a loved one, or be put on by a loved one, any form of medical treatment used for life support. After looking at the entirety of life support and what it is and is not capable of, ask yourself one question. “When is life support really “life support”?
The American Nurses Association Code of Ethics for Nurses has five elements that pertain to the Principle of Autonomy. Each individual element applies to “respect individual persons” (Baillie, McGeehan, Garrett T, M., Garrett R. M., 2013, p.33). In Chapter 2 of the Health Care ethics: Principles and problems text, it discusses thouroghly the consent of an individual to make their own decisions regarding their health and future requests of care. As a nurse or within all heath care professions, we must treat each individual patient with care, respect, and to remain mindful to the patient regarding any aspect of their lives. In the ANA Code of Ethics for Nurses, it explains ways of maintaining the empathy required in the health field. It further discusses that the respect for human dignity must be a priority, relationships to patients must remain neutral, the severity of the situation, the right to self-rule, and the professionalism that must be upheld by the nurse and their associates.
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.
With the establishment of the DNR order, withholding CPR from an individual has reformed into standing as “ethically appropriate if the anticipated benefit outweighs the harm. However, since then, the literal meaning of DNR has not been clear, thus causing confusion that remains problematic in clinical practice” (Yen-Yuan 4). With the renovation of the DNR order, people and health care providers have worked to progress defining what the DNR order stands for along with people gaining autonomy in their choice of death. Additionally, associations and activists keep pushing forward in the refinement of the DNR order: “there has been increasing focus on promoting quality of care for the dying [. . .] However, the persistent problems with DNR orders suggest that physician behaviors toward communication with patients about goals of care and resuscitation decisions have not measurably changed in the past 20 years” (Yuen 7). Through the efforts of benefactors such as the American Heart Association and others, the DNR order will continue to increase in quality over time as improvements are made. The DNR order sprouted from the first incentives that people deserve a say in how they shall die and today has transformed into a necessity that functions to entitle people to their own choice of death or