The article addressed a controversial issue, Informed consent. When is it required? Should informed consent be repeated for identical procedures? Who can give informed consent? Having worked on a Telemetry and PACU unit, I can confer importance of informed consent is often overlooked during the busyness associated with health care settings. Also, it is often unclear what procedures are covered under a single informed consent. In addition, when patients are incapable of signing consent, usually a legal power of attorney can sign on their behalf. Essentially the POA is deciding for the patient. If the patient is incapable it is difficult to determine if these are current wishes, it is not uncommon for wishes and ethical views to change. Although, …show more content…
Policy of Health care organization should reflect these recommendations with written policy governing the length of time each consent is valid for and other variables. Especially, when there’s a change in patient condition. Changes in patient’s condition may reflect changes in medical directives. Requiring reassessment of patients' understanding of procedures and the associated risks. It is the role of the nurse to be the Patients advocate. Also, to verify that valid consent is on the chart. Failure to do so can yield legal implications. Since often perioperative nurse is required to confirm and document that valid consent is on the chart. It is and ethical obligation to all patients to be informed of procedures performed on their body. Although nurses are not legally able to receive consent. It’s still part of our responsibility to oversee that legal communication between the physician and patient occurs. In summary during this discussion, both the patient, doctor and sometimes POA are present. The Physician should explain the implicated risks and benefit of procedures. Also, review alternative to having a procedure performed. If the patient chooses to accept these risks, and thoroughly understands the significance of the procedure, only then should consent be …show more content…
References Menendez, J. B. (2013). Informed consent: Essential legal and ethical principles for nurses. JONA's Healthcare Law, Ethics, and Regulation, 15(4), 140-144. Woods, K. D. (2012). Clinical Issues—December 2012. AORN Journal, 96(6), 658-664. doi:10.1016/j.aorn.2012.09.008 Baldwin, K. M. (2010). Moral distress and ethical decision making. Nursing Made Incredibly Easy!, 8(6), 5. Clusmann H, Schaller C, Schramm J Clusmann, H. (2001). Fixed and dilated pupils after trauma, stroke, and previous intracranial surgery: Management and outcome. Journal of Neurology, Neurosurgery & Psychiatry, 71(2), 175-181. doi:10.1136/jnnp.71.2.175 2001;71:175-181.doi:10.1097/01.nme.0000388524.64122.41 Baldwin, K. M. (2010). Fixed and dilated pupils after trauma, stroke, and previous intracranial surgery: Management and outcome. Nursing Made Incredibly Easy!, 8(6), 5. doi:10.1097/01.nme.0000388524.64122.41 Ober, V. (n.d.)(2015). Legal Implications and Ethical Considerations of "Do Not Resuscitate". Retrieved April 03, 2018, from
The only result from the testing consistent with a brain injury was the abnormal pupil response of the right eye (constriction) (Traumatic brain injury, 2015). The physical effects that could have pointed to a brain injury were the laceration to the right side of the gentleman’s head and the amount of blood loss. The complaints from the patient that may have insisted a brain injury included a severe headache, dizziness, and nausea (Traumatic brain injury, 2015).
Do not resuscitate (DNR) is an order written by a doctor or written in an Advance Directive initiated by a patient. The self-determination act of 1990 established the right of a patient to in certain situations where they may be unable to make crucial medical decisions because of incapacitation(Geppert, 2010). Orders given by the patient instruct medical personnel not to perform life saving measures such as cardiopulmonary resuscitation. A DNR order may also be specific to a medical facility depending on state law a patient may be able to choose what type of DNR order they would like to have. Many patients have these orders decided well before the need for them, due to the fact that the patient must be of sound mind to make these decisions. ("Comfort care," 1995-2013)
By gaining consent Jean's autonomy will be respected and maintained. It is important that all nurses and other health care professions uphold the professional standard when providing direct care to individual, community and groups. Gallagher and Hodge (2012) states reinforce a person's right to exercise choice in relation to personal and bodily integrity and to have that choice respected. Before administrating the medication to Jean the nurse and student nurse made sure that she was given a choice by obtaining consent from Jean first. According to the NMC Code (2015) make sure that you get properly informed consent and document it before carrying out any action.
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.
Informed consent is the basis for all legal and moral aspects of a patient’s autonomy. Implied consent is when you and your physician interact in which the consent is assumed, such as in a physical exam by your doctor. Written consent is a more extensive form in which it mostly applies when there is testing or experiments involved over a period of time. The long process is making sure the patient properly understands the risk and benefits that could possible happen during and after the treatment. As a physician, he must respect the patient’s autonomy. For a patient to be an autonomous agent, he must have legitimate moral values. The patient has all the rights to his medical health and conditions that arise. When considering informed consent, the patient must be aware and should be able to give a voluntary consent for the treatment and testing without being coerced, even if coercion is very little. Being coerced into giving consent is not voluntary because others people’s opinions account for part of his decision. Prisoners and the poor population are two areas where coercion is found the most when giving consent. Terminally ill patients also give consent in hope of recovering from their illness. Although the possibilities are slim of having a successful recovery, they proceed with the research with the expectation of having a positive outcome. As stated by Raab, “informed consent process flows naturally from the ‘partnership’ between physician and patient” (Raab). Despite the fact that informed consent is supposed to educate the patients, it is now more of an avoidance of liability for physicians (Raab). Although the physician provides adequate information to his patient, how can he ensure that his patient properly ...
Burkhardt, M. A., & Nathaniel, A. K. (2007). Ethics & issues in contemporary nursing (3rd ed.). Clifton Park, NY: Cengage Learning.
A consent can be either written or verbal and must be given by the patient authorizing that a procedure be done on them. Every patient has the right to agree or refuse any healthcare treatment that they may be offered. The consent can not be forced and must
Fowler, M. D., & American Nurses Association (2008). Guide to the code of ethics for nurses: Interpretation and application. Silver Spring, MD: American Nurses Association.
Professional standards of practice and behaviour for nurses and midwives’ (2015) which states that obtaining patient’s informed consent is an act in their best interest and that nurses and midwives are required to respect individual’s right to accept or refuse treatment, moreover, support and document their decision, give evidence-based information, use clear language, cooperate with patients to help them with making the decision and be aware of the current legislations. This includes ‘Mental Capacity Act 2005’, ‘Mental Health Act 1983‘and ‘Human Rights Act 1998’. From a healthcare perspective vital articles are those which set out the rules for accessing patient’s capacity to make a decision, clarify who makes decisions for those who lack capacity and how this should be done, likewise those that regulate how to treat and protect patients without their consent but also those that specify basic human rights: to life, privacy, receiving information and other such as right to be free from discrimination or inhuman, degrading treatment. Other regulations to consider are ‘Human Tissue Act 2004’, ‘Human Fertilisation and Embryology Act 1990’ (GMC, 2015). Professionals should also consider common criminal
The Doctor and Patient relationship aspect of Medicine has changed drastically in the last twenty years. It has evolved from paternalism (the doctor makes the decision for the patient) to shared decision making where the patient is considered an equal partner in his/her own health related decisions. Informed consent is the cornerstone for this view. When a patient or a research subject makes an autonomous decision after understanding, the risks and benefits involved with the decision is Informed consent. Complete Informed consent covers the following components: competency, disclosure, comprehension and voluntary. Competency refers to the requirement for the individual to be of legal age and be mentally competent to understand the process. Disclosure relates to knowledge of the relevant risks and comprehension means fully understanding the pertinent and factual risks before consent. Voluntary is when the decision is without coercion or duress. (Colston, 2004)
NSNA (2003). Code of ethics for nursing students Part I: Code of professional conduct. Retrieved June26, 2011, from: http//www.nsnsa.orgpdf/pubs_CodeofProfessionalConduct.pdf
Potter, P., & Perry, A. (2009). Fundamentals of Nursing. Ethics and Values (7th ed.) St.
However, informed consent has many flawed elements in the concept. In order to support this belief, the following issues must be addressed include the following: disclosure of pertinent medical facts and alternative course of treatment, including refusal, ensuring absence of coercion and manipulation, and ensuring patient intellectual capacity to understand the medical information.
Paramedics are frequently presented with neurological emergencies in the pre-hospital environment. Neurological emergencies include conditions such as, strokes, head or spinal injuries. To ensure the effective management of neurological emergencies an appropriate and timely neurological assessment is essential. Several factors are associated with the effectiveness and appropriateness of neurological assessments within the pre-hospital setting. Some examples include, variable clinical presentations, difficulty undertaking investigations, and the requirement for rapid management and transportation decisions (Lima & Maranhão-Filho, 2012; Middleton et al., 2012; Minardi & Crocco, 2009; Stocchetti et al., 2004; Yanagawa & Miyawaki, 2012). Through a review of current literature, the applicability and transferability of a neurological assessment within the pre-hospital clinical environment is critiqued. Blumenfeld (2010) describes the neurological assessment as an important analytical tool that evaluates the functionality of an individual’s nervous system. Blumenfeld (2010) dissected and evaluated the neurological assessment into six functional components, mental status, cranial nerves, motor exam, reflexes, co-ordination and gait, and a sensory examination.
2) Oral consent should be obtained in the presence of a neutral third party, like hospital staff or nursing