This assignment addresses the implications relating to an ethical dilemma encountered in practice using an appropriate model of reflection. The assignment will highlight ethical theories and four guiding ethical principles, such as autonomy, beneficence, paternalism and non-malificence. The two main principles that will be discussed in depth will be autonomy and beneficence and how they impact on practice. I will use Bortons (1970) reflective model, which was taken from Jasper (2003).
An incident, which occurred on practice placement, involved a patient’s decision to withdraw from active treatment. It is hoped that by exploring the incident in depth, a greater understanding of moral and ethical principles will be gained. All names that will be used within the text are pseudonyms. This is to ensure confidentiality, as stated by the Nursing and Midwifery Council (NMC 2004).
Health care professionals have a legal and moral obligation to care. They have to respect the patient’s decision even though they themselves find it difficult (Butts and Rich 2005). Decisions are not unproblematic. They have to be rationalised, as there are many dividing thoughts, which must be acknowledged.
The dilemma occurred whilst on practice placement with District Nurses (DN) in the community. It involved a 72-year-old female whom we shall refer to as Clare, who made a utilitarian decision to forego active treatment. It was an autonomous decision and the DN and I had to respect her choice but we were concerned with the practicalities associated with her judgment. Attempting to relieve pain and suffering is a primary responsibility for the nurse (Butts and Rich 2005).
Clare was extremely weak and she was not able to take the sta...
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...nsent 1: concepts and definitions. British Journal of Nursing, 12(1), 43-47.
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Tadd, W. (1998). Ethical issues in nursing and midwifery practice. Houndmills: Macmillan Press.
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Thompson, R., Melia, K., & Boyd, K. (2004.). Nursing Ethics. (4th ed.). Edinburgh: Churchill Livingstone.
Wilkinson, J. (1997). Developing a concept analysis of autonomy in nursing practice. British Journal of Nursing, 6(12), 703-707.
Wilmot, S. (2003). Ethics, power and policy: The future of nursing in the NHS. Basingstoke: Palgrave.
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
Winland-Brown, J. L. (2015). The New "Code of Ethics for Nursing With Interpretive Statements". Practical Clinical Applications Part I. MEDSURG Nursing 24(4),
Sim, J (1997). Ethical Decision Making in Therapy Practice. Oxford: Reed Educational and Professional Publishing Ltd. p.16.
The classical term for the word ethics is, moral philosophies that rule an individual’s or group behavior or action. The American Nurses Association used ethics to write the Code of Ethics for Nurses with these values and visions in mind: “(1) As a statement of the ethical obligations and duties of every person who chooses to enter the profession of nursing. (2) To act as the nonnegotiable standard of ethics. (3) To serve as an expression of the understanding on nursing’s commitment to society.” (Nurses Code of Ethics, 2015). With our ever-changing society and healthcare, also comes changes to the American Nurses Association’s
A nurse’s role in decision making is minimal depending on the place of work residence. Authors Shoni Davis, Vivian Schrader, and Marcia J. Belcheir’s opinion on Ethical decision making in nursing is “a process that involves making an ethical consideration of a patient care situation” (738-749). It seems like nurses can just cite immediately or take a hunch of what is wrong with a patient, but doctors are the ones that actually do the direct diagnosing. There have been many decision making processes and theories. Each has its own unique concepts and terminology, but all have similar components. It identifies good nur...
This paper explores the legal, ethical and moral issues of three healthcare colleagues by applying the D-E-C-I-D-E model as a foundation of decision making as found in Thompson, Melia, and Boyd (2006). Issues explored will be those of the actions of registered nurse (RN) John, his fiancé and also registered nurse (RN) Jane and the Director of Nursing (DON) Ms Day. Specific areas for discussion include the five moral frameworks, autonomy, beneficence, Non – maleficence, justice and veracity in relation with each person involved as supported by Arnold and Boggs (2013) and McPherson (2011). An identification and review of the breached code of ethics and the breached code of conduct in reference with the Nursing, Council, and Federation (2008) will be addressed. Lastly a brief discussion on how the three schools of thought deontology, teleology and virtue had effects on each colleague (McPherson, 2011) .
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.
Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics & issues in contemporary nursing (4th ed.). Stephan Helbra.
Barnett, Wilson J.(1986). Ethical Dilemmas in Nursing. Journal of Medical Ethics. Retrieved on 12th July 2010 from
Nurses are responsible for their own practice and the care that their patients receive (Badzek, 2010). Nursing practice includes acts of delegation, research, teaching, and management. (ANA, 2010). The nurse is responsible for the following standards of care in all practice (Badzek, 2010). The individual nurse is also responsible for assessing their own competence and keeping their practice within the standards of the current standards of care for the specialty which they are practicing and the state nursing practice acts (ANA, 2010). As the roles of nursing change, nurses are faced with more complex decisions regarding delegation and management of care (Badzek,
A Bunch C, Woolnough B, Hope T. (2001). Clinical Ethics Support in the UK: A review of the current position and likely development. The Nuffield Trust, London: p. 22.
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,
Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics & issues in contemporary nursing (4th ed.). Stamford, CT: Cengage Learning.
Ethics asses the values, morals, and principles of nurses. Legal codes or laws are rules established by our government. It’s important that nurses have a clear and comprehensive understanding of ethical and legal codes within their career. The understanding of these codes is essential for nurses to safely practice and to protect their patients. Nurses must abide by these principles or face the consequences of legal action. These principles include autonomy, utilitarianism, confidentiality, and many others. Autonomy is the agreement to respect ones right to determine a course of action, while utilitarianism is what is best for most people as defined in American Nurses Association. In order to give you a
The American Nurses Association created guidelines for the profession including, a set clear rules to be followed by individuals within the profession, Code of Ethics for Nurses. Written in 1893, by Lystra Gretter, and adopted by the ANA in 1926, The Code of Ethics for Nurses details the role metaethics, normative ethics, and applied ethics have within the field (ANA, 2015). Moral obligation for an individual differs within professions than it does within an individual’s personal life, so the code of ethics was written to establish rules within the profession. The moral obligation to provide quality care include the fundamental principles of respect for persons, integrity, autonomy, advocacy, accountability, beneficence, and non-maleficence. The document itself contains nine provisions with subtext, all of which cannot be addressed within this paper however, core principals related to the ethical responsibilities nurses have will be