In health care settings nurses are continuously dealing with various ethical problems and dilemmas. Ethical dilemma arises when there are equal moral obligations for or against two or more possible courses of action (College of Nurses of Ontario, 2008). Very often, there are not only simple ethical problems but rather complex issues involved many participants and multiple decisions. According to Wilson-Barnett (1986), nurses are more aware of its participation in decision making involving ethical issues. In ethical decision making, the nurse must be able to have the knowledge and skills about the entire scenario of a patient before making any possible interventions. Parker (2007) emphasized that the patients and their families along with other
Using relational ethics proposed by Bergum (1999) which includes principles of engaged interaction, mutual respect, embodiment and positive environment where freedom and choice are flourishing, and by considering patient’s vulnerability, a reasonable decision has to be made. Engaged interaction is when all participants are encouraged to share its thoughts and question on the impending decision. Mutual respect includes positive collaborative relationship, active listening and non-verbal behavior, confidentiality, prompt feedback and clear communication (Kaplan, Mestel & Feldman, 2010). Mutual respect is important not only for Adeline who can offer help in clarifying possible outcomes and providing emotional support but also for family members. Marcellus (2005) states that nurse must work towards respect of the others by trying to understand their circumstances. Difficult questions often arise when dealing with such a dilemma. How are the rights of Mr. Parma balanced with those of his children? Are nurse‘s moral values and believes allow her to suggest the course of action for this family? A reasonable decision cannot be reached if one key participant is not heard. All key participants here are vulnerable especially when faced with a hard decision, it is either they will stand firm or just move with the flow. At this point, the most vulnerable is Mr. Parma, not only physically but also emotionally. To entice the patient to express his doubts and concerns might help the nurse. In every ethical decision, everyone has a choice. This choice will either help the patient or not. A possible option for the patient, nurse, and family members is to meet on a common
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.
The first provision of the American Nurses Association’s (ANA) “Code of Ethics” states, “ The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.” The second provision states, “The nurse’s primary commitment is the patient, whether the patient is an individual, family, group, or community” (Fowler, 2010). As nurses we need to respect the autonomy and allow for the patient to express their choices and concerns. We also need to provide them with support by giving them knowledge and understanding so they
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.
During week 4, we became familiar with the application of ethics in the nursing practice settings. We learned about ethical theories and principles, which are crucial when practicing in any clinical settings during ethical decision-making and while facing one or multiple ethical dilemmas. Also, we were introduced to the MORAL model used in ethical decision – making progress. The MORAL model is the easiest model to use in the everyday clinical practice, for instance at bedside nursing. This model can be applyed in any clinical settings and its acronyms assist
Ethics has been a popular topic in nursing for a long time. Nurses are expected to demonstrate ethical decision-making as well as professionalism. I believe that in order to accomplish this, they need to use the ANA Code of Ethics as framework for their decision-making. It is also imperative for nurses to have a strong understanding of ethics, because they will be faced with many difficult ethical decisions that do not always have a straightforward solution.
This paper will focus on two BNUR leaner outcomes (University of Calgary, 2013) relevant to my learned understanding of nurses as ethical decision makers. I will outline the ways that I have seen ethics used and not used in practice, what I learned about ethics and its use in my theory courses and throughout my practicums, and I will reflect on how this understanding will translate into my professional practice moving forward.
Since ethical dilemmas are not always easily answered through the use of The Code of Ethics, ethical decision-making models are effective tools that can assist nurses in dealing with ethical issues. Ethical decision-making models provide a framework for working through difficult choices. They seek to define the limits of what is morally acceptable and help clarify the guidelines for making those difficult decisions. Ethical decision making models assist nurses in analyzing situations by focusing on understanding the patient needs, need for responsiveness to circumstantial considerations, and recognizing the uniqueness of each situation.
Healthcare provider’s perception and judgment in the patient’s well being as well as taking into account the right of the patient in every action is one of the key elements in nursing practice. International Council of Nurses (ICN), (2006) states “The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence” (p. 3). Furthermore, nursing action guided by theory and principles of moral and legal rights complements excellent nursing care. Nurse’s awareness in moral and legal codes helps them control the complicated scenario encountered and direct the nurses in the best possible action answerable by law (Lachman, 2006).
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)
Although nursing is universally practiced, not all nurses values and morals are the same. Nurses and nursing students are usually put in situations where they must operate within an ethical structure which is either unfamiliar to their cultural criterion or those of the patients for whom they are taking care of. The most prominent values and morals of nurses are based on human dignity and benevolence. Human dignity is the main component that branches off into other values under caring for health and well-being. Trust, integrity, autonomy, and privacy are one of the many sub-values that fall under human dignity. It is important for the nurses to respect and understand the culture and beliefs of the patient without being judgmental or confrontational. The wellbeing of the patient is priority and so the nurses must focus on gaining the patients trust first by tending to their needs and exhibiting
Nurses have a professional duty and legal obligation to provide ethical nursing care. There may be situations of contrasting values and beliefs between the client and the nurse about what actions are beneficial or harmful, which leads to an ethical dilemma. An ethical dilemma that challenges two or more values, “values that support diverging courses of action” and weighs individual judgment (CNO, 2009, p.5). The solution to the ethical dilemma often leads to dissatisfy either one or both ends of the nurse-client relationship. Regardless of the solution, the primary goal is to improve resident’s well being. As a nursing student, she should collaborate with experienced nurses; seek knowledge and guidance on how to handle an ethical dilemma.
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.
The four fundamental nursing responsibilities of promoting health, preventing illness, optimizing health and alleviating the ill are represented in the code of ethics. (Arnold & Boggs, 2016) One can say that the code of ethics are rules that a nurse needs to follow in order to effectively communicate and protect the patients. The American Nurse Association provided the code of ethics to guide nurses to ensure that patient’s care, safety, rights and health are well cared for and well managed. Models like Utilitarian, deontological, and the human rights-based all contribute in answering dilemmas that can arise with a patient. Thus, explaining what some of the code of ethics are, and how the code of ethics influence our responsibilities as a nurse will impact the overall care of the
In every nurse's career, he or she will face with legal and ethical dilemmas. One of the professional competencies for nursing states that nurses should "integrate knowledge of ethical and legal aspects of health care and professional values into nursing practice". It is important to know what types of dilemmas nurses may face
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