There are some circumstances where health care professionals may not respect their patient 's wishes or decisions and justifies a need for paternalism. In the health care context, paternalism is an ethical concept or idea where a health care professional makes a medical decision on behalf of their patient, for their own good (Buchanan, 2008). Grill (2012), describes paternalism as “benevolent interference with a person’s liberty or autonomy”. Grill (2012) also explains that “benevolent because it aims at promoting or protecting a person’s good, and interference because it restricts a person’s liberty without his consent”. Paternalism can be justified when a person is incapable of making their own decisions, for instance, if a patient is suffering …show more content…
An example of where a patient may require an advocate could be where a patient is in excruciating pain and has informed the nurse that they require additional pain relief. The nurse informs the Doctor of the situation and asks for the dose to be increased; however, the Doctor dismisses the nurses concerns and states that the patients dose is adequate. In this situation, the nurse would act in beneficence and step forward as the patients advocate and inform the physician that they are not abiding by their duty of care to put the patients best interests first (Day, 2006). In the situation where a patients life support needs to be turned off, and the patient has stated in their advance care …show more content…
To assist the nurse to make ethical and moral decisions, Beauchamp & Childress (2001) explain that the four primary principles, non-maleficence, beneficence, autonomy, justice and privacy and confidentiality, could be an effective ethical framework. The Code of ethics for nurses in Australia may also be beneficial as it outlines the standards and values in addition to the policies and procedures the nurse must adhere to (Nursing and Midwifery Board of Australia, 2008). In conclusion, health care professionals will be faced with many ethical and moral dilemmas in relation to consent and patient choices throughout their career. In some situations they may need to take a paternalistic approach and in others they made need to act as an advocate. With the knowledge and understanding of health care ethical and moral frameworks, this will not only enable the health care professionals to work within their scope of practice, but to respond to these ethical dilemmas in a way that puts the best interests of the patient
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
The main reason paternalism is even debated revolves around one primary question: Is it beneficial to the patient? This one question has, and will continue to evoke strong responses from those who hold viewpoints across the spectrum. The spectrum varies from those who are in favor of paternalism, to those who think it should only be allowed if certain criteria are met, to those who strongly oppose it in any form at any time, but may consent to a few, rare occasions when it would be deemed acceptable. One such person who strongly opposes paternalism is Alan Goldman, and he presents his argument in an article entitled, “The Refutation of Medical Paternalism.”
A code of ethics provides a standard by which nurses conduct themselves and their practice, observing ethical obligations of the profession and providing quality care. To achieve its purpose, a code of ethics must be understood, internalized, and used by nurses in all aspects of their work” (Aliakvari, 2015, p. 494).
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.
“Ethics is a systematic study of principles of right and wrong conduct” (Taylor, Lillis, Lynn, & LeMone, 2015, p. 96). The American Nurses Association Code of Ethics has nine provisions to it. All nine are important to the nursing field in their own way. There are two provisions that I find most important in helping my career as a nurse. Provision one, The nurse, in all professional relationships, practices with compassion and respect of 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. Secondly provision two, the nurse’s primary commitment is to the patient whether an individual, family, group, or community.
Within public health, the issue of paternalism has become a controversial topic. Questions about the ethics of public health are being asked. The role of ethics in medical practice is now receiving close scrutiny, so it is timely that ethical concepts, such as autonomy and paternalism, be re-examined in their applied context (Med J Aust. 1994). Clinically, patients are treated on a one on one basis, but public health’s obligation is toward the protection and promotion of an entire population’s health. So, based on this difference, the gaping questions targeting public health now becomes, under what conditions is it right to intervene and override an individuals’ autonomy?
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.
Not all cases is patient autonomy the most important thing to respect and honor. There will always be situations where Medical paternalism is justified. Justifiable paternalism in a medical perspective is prolonging patients’ lives allowing them to exercise their autonomy. Failing to respect a patient’s treatment requests or denials is a violation of the autonomy at that point in time during their illness. While the previous statement is true, the medical professional is violating a patient’s future autonomy. For this reason, medical professionals have the right to act paternalistically, therefore medical paternalism is justified by means of future autonomy and obligations to promote patient
The Code of Ethics for Nurses was created to be a guide for nurses to perform their duties in a way that is abiding with the ethical responsibilities of the nursing profession and quality in nursing care. The Code of Ethics has excellent guidelines for how nurses should behave, however; these parameters are not specific. They do not identify what is right and wrong, leaving nurses having to ultimately make that decision. Ethics in nursing involves individual interpretation based on personal morals and values. Nursing professionals have the ethical accountability to be altruistic, meaning a nurse who cares for patients without self-interest. This results in a nurse functioning as a patient advocate, making decisions that are in the best interest of the patient and practicing sound nursing ethics.
The medical Profession recognizes that patients have a number of basic rights. These include but are not limited to the following: the right to reasonable response to his or her requests and need and needs for treatment within the hospital's capacity. The right to considerate, respectful care focused on the patient's individual needs. The right of the patient to make health care decisions, including the right to refuse treatment. The right to formulate advance directives. The right to be provided with information regarding treatment that enables the patient to make treatment decisions that reflect his or her wishes. The right to be provided upon admission to a health care facility with information about the health care provider's policies regarding advance directives, patient rights, and patient complaints. The right to participate in ethical decision making that may arise in the course of treatment. The right to be notified of any medical research or educational projects that may affect the patient's care. The right to privacy and confid...
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)
In his essay, “The Refutation of Medical Paternalism,” Alan Goldman discusses his argument against differentiation in the roles between physicians and patients. He says the physician may act against a patient’s will in order treat the patient in their best interest. Goldman makes his whole argument around the assumption that a person’s right to decide his or her future is the most important and fundamental right, saying, “the autonomous individual is the source of those other goods he enjoys, and so is not to be sacrificed for the sake of them.” His claim is that most people agree that they are the best judges of their own self-interest and there is an innate value in the freedom to determine their own future. On these principles, Goldman starts by discussing conditions under which paternalism may be justified.
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
In the code of ethics, the very first ethical principles that nurses are expected to uphold in order to exemplify that they are competent professionals are autonomy, beneficence, and nonmaleficence. That is, nurses as professionals are expected to advocate for their patients while preserving their respect and dignity and
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