Before beginning nursing research, it is vitally important that professionals understand the morals and ethics to complete a study. Morals and ethics of nursing research can be divided into three primary principles: autonomy, beneficence/nonmaleficence, and justice. The first ethical principle, autonomy, is of utmost importance as it is the heart of a patient-centered practice. This paper will discuss the fundamentals of autonomy and its effect on nursing research.
As a nursing professional, respecting autonomy is a top priority when planning care for a patient whether in the hospital setting or in a research study. Respecting autonomy is defined as “give weight to autonomous persons' considered opinions and choices while refraining from
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The individual must educate himself or herself and not be afraid to ask questions to the nurse or researchers. Participants must evaluate risks, benefits, time commitment, and other factors that may be involved before committing to a particular study. From a researcher’s standpoint, it is important to respect the participant’s autonomy for liability reasons. The researcher should inform participants about the risks, benefits, side effects, etc. of the study so the patient fully understands the commitment before participating. Autonomy not only protects the individual’s rights, it also benefits the …show more content…
Terry Harnett (2014) explains informed consent as the following bullet points: “Explanation of how data are transmitted…Explanation of how data are maintained…Explanation of the data security plan” (p. 88). The purpose of a consent form is for the patient to confirm they have been educated in detail about the study, and they agree to participate voluntarily. Another factor that protects patient’s autonomy is the IRB. The IRB is a committee established to monitor activities, terminate any unsafe practice, observe participants, and evaluate finances of the study (Mayo Clinic, 2014, “Authority of the IRBs,” para. 1). The IRB allows the patient to feel confident that a medical professional team is concerned about their safety and will intervene if he or she is put in harm’s way. The board also establishes the foundation of a trusting relationship as it holds the researchers to a safety standard, so the participants know their best interest is of high concern. Lastly, if the patient feels uncomfortable or unsafe in the study they have the right to excuse themselves as a volunteer at any point without any coercion to stay or any consequences. Forced participation is not only illegal, but it invalidates all of the research’s
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
The IRB is an administrative body which has been established to make sure research participants' rights are protected. IRBs review all aspects of the researchers' project: the study design, the recruitment process, the participant population, the informed consent document and process, the risk/benefit ratio, privacy and confidentiality, data storage and protection, and safeguards for vulnerable participants (University of St. Francis, n.d.). In this way, participants' rights are protected because the effort is made even before the research begins. The review process ensures that participants are chosen fairly and informed adequately and the information collected during research is safeguarded through collection, use, and storage. Research using human participants is such an important part of medicine that it is imperative it is performed in a way that its intrigue is not compromised.
Truog, Robert D., Walter Robinson, Adrienne Randolph, and Alan Morris. "Is Informed Consent Always Necessary For Randomized, Controlled Trials?" The New England Journal of Medicine 340, (March 1999): 804-807.
Institutional Review Board (IRB) is a group of people established to evaluate and monitor all research involving human subject. This group have the authority to approve, require changes to obtain approval and disapprove research. The group review a crucial role to provide perfect protection of human research subject. The primary purpose of IRB is to protect people who participate in the study and to make sure the steps are right. Consent form is one of the important part in the IRB approval to be given to the person who will participate in the study. Also, explain the benefit and risk of the study.
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 ...
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.
Vice versa ethical principles clarify a nurse by eight factors which are autonomy, beneficence, confidentiality, fidelity, justice, non maleficence, and veracity. These virtues have hidden moral guidelines and the precepts to the nursing profession. Autonomy is defined as freedom to drive sound judgment in the clinical setting. Beneficence is my good in worth than the whole good for the patient care. Confidentiality is not exploiting information on the records and holds of the patient. Fidelity is the explicit and implicit oath of a person’s will. Justice is the strong force for what is righteous and morally disciplined. Non maleficence is doing no harm. Veracity is exact opposites which are truthful or deceive someone. These morals promote patient’s rights by promoting self governing, ensuring nurse, and act in a way that aids the patient, respecting a patient’s own info, and making faith filled and oaths. Also, a provision of appropriate, fair, and equal cares (Dohert & Purtilo, 2014).
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
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
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,
In conclusion, obtaining informed consent is a vital part of respect for the patient and safeguarding of self-determination. The consent to participate in research or treatment should be informed, comprehensible, and free of coercion. There is not a clear black and white answer because no matter what is done to assure informed consent there is always a moment of doubt on the end of the patient as to whether what is going to take place is fully understood and their true wishes honored.
Autonomy is a principle that allows a patient or authorizing agent to make decisions regarding healthcare decisions without any outside influence (Burkhardt & Nathanial, 2014, p.440) As the nurse, it is important to understand
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.
Theory development and research have provided a framework and body of knowledge for nursing to maintain autonomy and improve quality of care. As early as the 1800s, nursing and non-nursing theorists had developed theories and models which are continually applied to nursing practice (KEEP OR GET RID OF?). Nursing theorist Imogene King developed the theory of goal attainment which focused on interacting systems that affected a person’s ability to attain goals (Frey, Sieloff, & Norris, 2002). Psychologist Laurence Kohlberg created the theory of stages of moral development which places moral reasoning and ethical behavior into six identifiable stages based on a person’s response to moral dilemmas (Kohlberg, 1984). Although King and Kohlberg created theories in different fields, nurses can utilize both to improve patient care. The purpose of this paper is to analyze both theories based on major precepts, usefulness, and application to nursing practice.