Informed Consent for Medical Treatment Annotated Bibliography Ingravallo, F., Gilmore, E., Vignatelli, L., Dormi, A., Carosielli, G., Lanni, L., & Taddia, P. (2014). Factors associated with nurses’ opinions and practices regarding information and consent. Nursing Ethics, 21(3), 299-313 15p. doi:10.1177/0969733013495225 In this peer review journal article, based on a cross sectional survey conducted in a large Italian teaching hospital, the authors seek to examine nurses’ opinions and practices regarding information and consent and explore the possible influences such as gender, age, education, professional experience, and care setting. The results suggested that though nurses regularly informed patients about medications and invasive nursing procedures and asked for consent prior to invasive procedures, the main difficulties encountered in providing information were lack of time or opportunities and patients’ inability to comprehend information, and the care setting was a significant factor associated with nurses’ opinions and practices. The study is clear and well organized. The research and analyses methods are adequately explained and displayed and the authors provide a thorough literature review discussing previous knowledge on the topic. The results of the study are clearly shown and discussed regarding its implications. The researchers were aware of the study’s limitations and note them in the article. Limitations such as concerns regarding validity, reliability due to using an ad hoc survey, generalizability outside of the hospital setting, and the absence of a parallel study exploring patient experiences. Though it is suggested that further research is needed to confirm the findings for other care settings, this researc... ... middle of paper ... ...re shown by a clear and structured presentation of the combined themes that were identified in the data analysis of the interviews and discuss groups. Limitations of the study are discussed, such as the generalizability of the results due to the study being conducted in one setting. The report suggests further studies be conducted among larger populations in different settings and cultures and the explorations into the views of patients also. Overall, the research provides a respectable in depth look into the role of nurse’s in the informed consent process within a hierarchical and communal setting. The research is relevant to nursing especially in paternalistic settings, where nurses’ and doctors’ roles are not regarded as complementary, and/or when working with family orientated cultures, where the patient’s family has a strong influence on health care decisions.
Nurses are central to patient care and patient safety in hospitals. Their ability to speak up and be heard greatly impacts their own work satisfaction and patient outcomes. Open communication should have been encouraged within the healthcare team caring for Tyrell. Open communication cultures lead to better patient care, improved outcomes, and better staff satisfaction (Okuyama, 2014). Promoting autonomy for all members of the healthcare team, including the patient and his parents, may have caused the outcome to have been completely different. A focus on what is best for the patient rather than on risks clinicians may face when speaking up about potential patient harm is needed to achieve safe care in everyday clinical practice (Okuyama,
In the case study, Betty was adamant in refusing treatment, despite the risks of the illness progressing and potentially leading to death; under the laws of the medical treatment act (1988) any adult who exhibits competency has the right to refuse treatment, even if refusal of care increases the risk to their health, this right is based on autonomy (3). The information outlined suggests that Betty was capable of making a decision as she fulfils all the elements of consent; therefore she is competent and has the right to deny treatment. Betty acknowledges the risks of not receiving treatment and admits that not receiving treatment will make it difficult, demonstrating her sound understanding of the risk and benefits of the outcomes. For a patient to fulfil the element of understanding they must receive, process and incorporate the information they are provided with into their own personal values and Betty demonstrates this level of understanding by sticking to her values, her decision to stay home and by acknowledging the difficulties and risks of not receiving treatment (3). Once Betty received a diagnosis she was informed by the paramedic of the outcomes and potential risks of not receiving treatment for her condition, Betty was sufficiently informed with information and risks relevant to her situation, enabling her to make an informed decision (3). In order for consent to be considered voluntary, a patient must consent to treatment in an environment free of threat and pressure; if a patients decision is genuine they will also accept responsibility for the outcomes and understand the risks (3). Voluntary consent is a slightly grey area in Betty’s scenario, her son is potentially placing pressure on Betty with his demands, however, Betty expresses responsibility by admitting it will be difficult to and
In America, the legal age to sign off on any medical consent is 18 years of age. Seventeen year olds should be able to compose their own medical decisions, and sign off on their own medical consents. Power should land in their hands, accompanied by the professional advice of a doctor. It is your body, be compelled to fabricate a decision without having to have your parent’s signature.
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.
Thompson, I. E., Melia, K. M., & Boyd, K. M. (2006). Nursing Ethics: Churchill Livingstone Elsevier.
American Nurses Association. (2015, January 2015). Code of Ethics for Nurses With Interpretive Statements, 1-76. Retrieved from
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.
Consent is an issue of concern for all healthcare professional when coming in contact with patients either in a care environment or at their home. Consent must be given voluntary or freely, informed and the individual has the capacity to give or make decisions without fear or fraud (Mental Capacity Act, 2005 cited in NHS choice, 2010). The Mental Capacity Act perceives every adult competent unless proven otherwise as in the case of Freeman V Home Office, a prisoner who was injected by a doctor without consent because of behavioural disorder (Dimond, 2011). Consent serves as an agreement between the nurse and the patient, and allows any examination or treatment to be administered. Nevertheless, consent must be obtained in every occurrence of care as in the case of Mohr V William 1905 (Griffith and Tengrah, 2011), where a surgeon obtain consent to perform a procedure on a patient right ear. The surgeon found defect in the left ear of the patient and repaired it assuming he had obtained consent for both ear. The patient sued him and the court found the surgeon guilty of trespassing. Although there is no legal requirement that states how consent should be given, however, there are various ways a person in care of a nurse may give consent. This could be formal (written) form of consent or implied (oral or gesture) consent. An implied consent may be sufficient for taking observation or examination of patient, while written is more suitable for invasive procedure such as surgical operation (Dimond, 2011).
An ethical dilemma is defined as a mental state when the nurse has to make a choice between the options and choices that he or she has at her disposal. The choice is a crucial task as the opting of the step will subsequently determine the health status of the concerned patient, hence it requires a great deal of wisdom along with proper medical and health training before any such step is opted as it is a matter of life and death. Strong emphasis should therefore be on the acquisition of proper knowledge and skills so that nurses do posses the autonomy to interact with patients regarding ethical issues involved in health care affairs and address them efficiently. It is normally argued that nurses are not provided sufficient authority to consult and address their patients on a more communicative or interactive level as a result of which they are often trapped in predicaments where their treatments of action and their personal beliefs create a conflict with the health interests of the patient. (Timby, 2008)
Nurses need to consider the issues of confidentiality before deciding whether information disclosure is appropriate. The best practice is to obtain the consent of the patient unless their safety is at risk of harm or a serious crime committed. This log outlined some of the key issues of confidentiality and noted that confidentiality can be complex concept. Therefore, nurses must carefully balance the need to maintain confidentiality against the needs and welfare of individuals. I attended a full day trust induction before my placement and surprised that they did not discuss confidentiality and information sharing. In addition, we had our Information Governance training that we need to do before placement and learned the importance and our responsibility when it comes to confidentiality and handling patient’s informations. However, all student and registered nurses will benefit from ongoing confidential training and it will help them with
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
Filipova, A. A. (2009). Licensed nurses’ perceptions of ethical climates in skilled nursing facilities [Journal]. Nursing Ethics, 16(5), 574-588. doi: 10.1177/0969733009106650
As a nurse, it is within your role to safeguard the right to privacy for individuals. To ensure that nurses are adhering to this, ethical strategies have been proposed and implemented from a legal and regulatory body.
In conclusion, there are numerous legal and ethical issues apparent in the nursing practice. Nurses should study and be as informed as they can with ethics and legality within their field in order to ensure no mistakes occur. Ethical issues vary based on patient’s views, religion, and environment. Nurses are influenced by these same views, but most of the time they are not the same as the patients. As a nurse we must learn to put the care of our patients and their beliefs, rights, and wishes before our own personal
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.