Consent has been a fundamental part of nursing practice dating back as far as Hippocrates in ancient Greece. The Hippocratic Oath is an ancient form of guideline, devised for those who chose to enter the medical profession. Here these guidelines show physician-patient conversation were key components in healthcare, along with ensuring patients were kept informed on issues related to their health and the importance of gaining consent during the delivery of care (Miles, 2009). This assignment will discuss what consent is, and its importance in the modern world in adult nursing practice. It will also consider the differences and/or issues that may be faced looking at consent from an adult branch of nursing practice compared to a children’s branch, including possible barriers relating to diversity. Consent is defined in the Oxford dictionary as, ‘Permission for something to happen or agreement to do something’ (Oxford Dictionary, 214). In nursing practice this definition is more detailed and is defined by NHS choices as, ‘The principle that a person must give their permission before they receive any type of medical treatment. Consent is required from a patient regardless of the type of treatment being undertaken, to an organ donation’ (Advanced Nursing Practice Toolkit, 2014). As is very clear in these two definitions, the principle is very similar, if something is going to happen, permission must be obtained. But as we link this to nursing practice the concept becomes far more detailed than and as definite as can be to ensure there can be no misinterpretation as to what is meant. In nursing practice any adult consenting to any treatment or procedure must be believed to be mentally capable of making a decision. Consent must be given i... ... middle of paper ... ...ss common in relation to consent as every patient is treated the same regardless of their culture, beliefs or religion and every patient has the same choice as whether or not to consent to any form of procedure/treatment. The only factor that could really cause any issues are language barriers but in main they are overcome with implied consent, or if any treatments or procedures are being planned then discussion with family members who will then interpret this information and fed back to the practitioner. In conclusion as shown in the two cases discussed, consent is one of, if not the most important consideration in nursing practice. Patients have an ethical and more importantly, legal right to the choice of the care they receive. As practitioners we have the duty to ensure we are fully aware and work in line with the principles of consent to ensure best practice.
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
Consent is necessary from everyone, not only those who can verbalise his or her needs. It is important to find out the persons communication needs so that they can be involved in discussions around their needs and preferences. My duty of care is to ensure that choices are given, and that appropriate support is obtained where there is lack of capacity is the decision is complex and the individual cannot consent. This may be from families or next of kin or using advocates to ensure that the client’s best interests are maintained. There may be past events or requests that could indicate the client’s preferences, and these must be considered when choices have to be made by others. Any preferences should be recorded on care plans and shared with relevant others to be able to determine the best interests of the person. Decisions should also be put off until the client is able to make their own choices where possible and not taken on their behalf through assuming we know
Modern society has developed an understanding and recognised the morals regarding consent as individuals have a right and interest over their body (5). Consent enables protection against unauthorised invasion of an individual’s body and can be applied to numerous scenarios, including medical care (5). A paramedic must obtain consent before treating a patient, as consent has legal and ethical aspects that must be regarded (2). It is imperative for a paramedic to maintain ethical and legal competency to assess whether a patient is competent to deny or consent to treatment as presented in the case study (3). Paramedics attended Betty, a 78-year-old female, after her son called the ambulance service. Betty is provided
... event arises and it was due to lack of assessment of genuine comprehension. I think the best system of obtain consent would incorporate a regulated system that accommodated each institution and their requirements, but also equally weighed the importance of true understanding of facts and realization of the patient’s capacity to make decisions. But even if this was established as standard practice, there would still be the issue of how the assessment is made and how accurate it is due to other influences i.e. current injury status or medications needed for full psychological and or conceptual functioning. There could also be an issue of how to regulate such a subjective issue; each physician is going to have different ethical views and this will inevitably influence how he/she assess the patient and their ability to make the best decisions concerning their health.
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
Kuczewski, Mark. "Reconceiving the Family: the Process of Consent in Medical Decision Making." Hastings Center Report. March-April 1996: 32-37.
In this essay the author will rationalize the relevance of professional, ethical and legal regulations in the practice of nursing. The author will discuss and analyze the chosen scenario and critically review the action taken in the expense of the patient and the care workers. In addition, the author will also evaluates the strength and limitations of the scenario in a broader issue with reasonable judgement supported by theories and principles of ethical and legal standards.
The legal term of consent reflects a person’s agreement to something; while informed consent means that a patient has full knowledge of the possible consequences of the proposed treatment and has the right to accept or decline (Queensland Health, 2011). Informed consent is provided and gained during a conversation between a client and the treating health professional and is critical to providing patient-centred care (Freegard, Isted & Russell, 2012). This essay will aim to discuss the use of advance care directives (ACD) in healthcare using several ethical principles and theories such as respect for autonomy, beneficence verses maleficence and paternalism. It will also compare the professional and ethical frameworks of nurses and paramedics on the issue of ACD’s and informed consent.
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).
According to The Medical Protection Society (MPS 2015), consent it is needed for any treatment/intervention or care and this cannot be imposed by the healthcare team as ought be the expression of a patient 's wish and decision otherwise this is unethical and equally illegal. There are required elements in the process of informed consent. These include: Competence, disclosure, understanding, confidentiality, voluntariness and communication.
As health care providers, nurses strive to instill confidence in their patients and their loved ones. A nurse is respectful to their colleagues as well as their patients. Nurses promote patients’ independence, patients can be confident in the knowledge that a nurse will do what is best for them, respecting their privacy and dignity. This means that a nurse does not share the patient information for personal reasons nor does the nurse get involved in a patients personal relationship if it is not medically relevant (NCSBN, 2011).
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.
Another huge ethical topic is the patient’s right to choose autonomy in the refusal of life-saving medicine or treatment. This issue affects a nurse’s standards of care and code of ethics. “The nurse owes the patient a duty of care and must act in accordance with this duty at all times, by respecting and supporting the patient’s right to accept or decline treatment” (Volinsky). In order for a patient to be able make these types of decisions they must first be deemed competent. While the choice of patient’s to refuse life-saving treatment may go against nursing ethical codes and beliefs to attempt and coerce them to get treatment is trespass and would conclude in legal action. “….then refusal of these interventions may be regarded as inappropriate, but in the case of a patient with capacity, the patient must have the ultimate authority to decide” (Volinsky). While my values of the worth of life and importance of action may be different than others, as a nurse I have to learn to set that aside and follow all codes of ethics whether I have a dilemma with them or not. Sometimes with ethics there is no right or wrong, but as a nurse we have to figure out where to draw the line in some cases.
Health care providers are faced with bioethical issues every day when caring for a wide variety of patients. Bioethical principles are outlined in order to help these professionals provide the best possible care for their clients. The first principle focuses on the autonomy of individuals. This is the foundation of “informed consent” that is required before performing any medical care on a patient. The patient must completely understand the benefits and risks associated with any medical acts and make their own decision. The second principle states that no intentional harm or injury to the patient can result from the medical decision. This principle of nonmaleficence helps set standards of care to prevent wrongdoing. Beneficence is the third bioethical principle that states that it is the responsibility of the health care provider to benefit the patient. The fourth bioethical principle refers to justice and that each patient is treated with fairness. Every patient is entitled to impartial medical care to ensure the appropriate distribution of goods and services (McCormick, 2013). These bioethical principles help guide health care professionals when making difficult decisions related to controversial topics and practices.
Ethics is defined as the knowledge of the principles of good and evil. Sensitivity to ethical issues should be prerequisite for any profession that holds public trust. Nursing holds a public trust and therefore we must be aware of ethical concerns when dealing with patients (Barry, 2002). Ethical dilemmas such as consent force nurses to decide on possible actions to take. By discussing the ethical principles of autonomy, beneficence and non-maleficence and applying the ethical theories I hope to make it clear how nurses justify their actions.