Nursing and Biomedical Research

Nursing and Biomedical Research

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With unparalleled technological advancement, nursing and bio-medical research, and the present healthcare environment, nurses must be cognisant of their professional and personal views of ethics. Ethics are standards of behaviour, developed as a result of ones concept of right and wrong (Judson & Harrison, 2010), and are intended to influence the actions of healthcare professionals. Ethical principles help guide the decision-making process among healthcare workers in complicated situations. [Therefore] we cannot understand nursing unless we also understand ethics (Gallagher & Wainwright, 2005)
There are many different ethical theories which can mainly be divided into three groups. These are Duty based, Goal based and Rights based theories.
Deontology is a duty based ethical theory. This means that a moral person must always do their duty and must perform them “without exception, whatever the consequences” (Seedhouse, 2001). However, this theory has limitations and objections because it does not allow for conflict between duties, flexibility or compromises and these are all essential for health work. (Seedhouse, 2001)
Goal based theories such as Utilitarianism, believe that what is morally right is determined by the good that is produced as the consequence of the action. The acts that achieved this were defined as “good” and those that produce “pain” were bad. (Rumbold, 2000) An objection with Utilitarianism is that because it is only concerned with the consequences, then even if an action was taken that was intentionally bad, it would still be ethically right if the eventual consequences were favourable. (Seedhouse, 2001)
Dunbar (2003) states that there are four main ethical principles, these are beneficence, non-maleficence, justice and autonomy. The principle of beneficence is to do good for patients and to put their needs before your own (Rumbold, 1999 p217) and with beneficence comes the principle of non-maleficence meaning to do no harm. Rumbold (1999, p222) describes how in many nursing duties nurses have to “do harm” to our patients but only when it is alongside beneficence and the long-term goal is to do good by the patient. In not giving a patient assistance to eat their meals we are acting in a manner that these principles don’t support as there is no good that could arise from this. Beneficence is considered to be the caring ethic, as it guides us to work in the best interests of the patient but at the same time for the benefit of other patients, considering their rights to justice and fairness with their care (Kennedy, 2004).

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Justice can be about non-judgemental and non-discriminative nursing and nurses should do this by following a set standard of care and following this through with all patients, regardless of age, illness or dependence in this case. Thompson et al (2000, p19) explains that the principle of justice requires nurses to have a universal approach to care so that all patients are treated fairly. These patients are being left without any food, is that because nurses are busy feeding other people and have forgotten about them? This treatment illustrates that there is no universal standard of care and is therefore unjust. Autonomy is an important issue in relation to the given situation and as Jacelon (2004) states; an autonomous person is one who has the freedom and ability to act on their own behalf. Often patient’s autonomy is diminished when they are admitted to hospital as they lose control of their care to the routine of the hospital.

A dilemma, according to Thompson, Melia and Boyd (2004), highlights a specific state in which a choice has to be made between undesirable alternatives. As a result of cost containment and scarce resource allocation, nurses are presented with ethical challenges of justice in the present fiscal environment in healthcare. Sometimes providing adequate care and maintaining professional nursing practice is challenging in cost-constrained hospital environments (Ritter-Teitel, 2002). Nurses are expected to provide quality patient care based on the same or fewer resources (O’Connor, 1997). The progression of managed health care, with attention on cost containment and efficiency, has noticeably influenced patient care. Resource allocation and distribution along with rationing health care reflects a business, rather than patient care, focus. When one understands each individual theory, including its strengths and weaknesses, one can make the most informed decision when trying to achieve an ethically correct answer to a dilemma.

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