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Ethical frameworks for consent in nursing
Ethical frameworks for consent in nursing
Importance of consent in health and social care
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The professional value that I have chosen to reflect upon is consent, which can be defined as a patient’s right to decline or accept treatment (Dougherty and Lister 2015). There are three types of consent and these are voluntary, informed and capacity consent. I will discuss the difference between these consents later in this reflective account.
Using Driscoll (2007) reflective model, which consist of three simple questions: What, So What, and Now What? I will reflect on my experience of working in the surgical ward and particularly on my involvement with a male patient. In order to maintain confidentiality, I will refer to this patient as Erick as the British Medical Association (BMA, 2016) suggests that all identifiable patient information,
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This legislation, among others, stresses the need for health professionals to involve the patient in their own treatments as well as promoting their right to give consent, or decline, any medical care.
According to Dimond (2010) consent, is a voluntary decision, which can be given, verbally, written or implied. The Professional Standards of Practice and Behaviour for Nurses and Midwives (NMC, 2015) suggest that health professionals need to ensure that consent is ascertained before carrying out any action. I have, therefore, demonstrated good practice in ascertaining Erick’s consent and by giving him sufficient time to reflect on the treatment I offered to him.
Obtaining consent, as suggested by Eyal (2012), also promotes patient’s trust in medical procedures that they are likely to receive as well as their likelihood to comply adequately with medical advice or participate in medical research. It is evident that obtaining a verbal consent from Erick was a testimony to his trust and willingness to comply with the medical advice, which I had given him such as keeping his wound dry and request painkillers if he were in
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
According to Terrence F. Ackerman, as of the 1980s the American Medical Association had to include the respect for a person’s autonomy as a principle of medical ethics (Ackerman 14, 1982). This includes having the physician provide all the medical information to the patient even if the information could cause negative implication onto the patient. The physician is also expected to withhold all information of the patient from 3rd parties (Ackerman 14, 1982). Although it is seen as standard in today’s world, in
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
In Amira’s case, an issue of consent is arisen that her GP has not explained to her much about the conditions she is suffering and the medication that he prescribed. Amira was left a little confused because she did not has the chance to ask questions. For obtaining consent, it must be informed and capacity which means that Amira must be given all of the information of the treatment and they understand the information provided by the doctor and they can use it to make a decision (13). Obtaining consent will lead to enhancement of the efficiency to the treatment because Amira is happy and showing agreement to the
In this context, new emphasis is being placed on the rights of patients. Recent federal legislation, for example, requires all health care facilities receiving Medicare or Medicaid monies to inform patients of their right to make medical treatment decisions. This includes the right to specify "advance directives," [1] which state what patients wish to be done in case they are no longer able to communicate adequately.
In America, the legal age to sign off on any medical consent is 18 years of age. Seventeen year olds should be able to compose their own medical decisions, and sign off on their own medical consents. Power should land in their hands, accompanied by the professional advice of a doctor. It is your body, be compelled to fabricate a decision without having to have your parent’s signature.
Patients are ultimately responsible for their own health and wellbeing and should be held responsible for the consequences of their decisions and actions. All people have the right to refuse treatment even where refusal may result in harm to themselves or in their own death and providers are legally bound to respect their decision. If patients cannot decide for themselves, but have previously decided to refuse treatment while still competent, their decision is legally binding. Where a patient's views are not known, the doctor has a responsibility to make a decision, but should consult other healthcare professionals and people close to the patient.
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.
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
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 ...
have the patient’s Bills of Rights which are the rights for a patient to participate in their care. The
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
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).
I have learned that informed consent is very important. It is the start to the therapeutic relationship. As a human service professional you are ethically bound to inform your client of informed consent. They have the right to know about the risks and benefits, financial consideration, limitations of confidentiality, mandating reporting, and my qualifications as a professional.
The article titled “Contemporary Ethical Analyses: A Shortfall in Scientific Knowledge” describes the ethics through the public’s eye. One of the major ethical issues brought up is informed consent.