Two Significant Ethical Issues Relevant to the DNP

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Confusion in Professional Titling
While development and expansion of advanced nurse practice is greeted with enthusiasm it does not necessarily fall short of ethical and policy issues surrounding the actual practice. Questions has been raised whether it is in order to refer advanced nurse practitioners prepared at doctorate level ( DNPs) as “doctors” particularly in healthcare setting. Schierhorn (2010) point out the sentiments made by Dr. Yasso, the vice president and chair of the American Osteopathic Association (AOA) Bureau of State Government Affairs that DNPs deliver necessary care to patients and help reduce effects of worsening physician shortage. However, many physicians and other interested parties has questioned the validity and justification of referring DNPs as “doctors” in an environment that only physicians has traditionally referred by that title. Dr. Yasso contends “If nurses want to be doctors, they should go to medical school to prevent confusion among patients”. Nevertheless, Literature show no evidence that such initial confusion on the part of patients causes harm as long as patients are receiving high-quality care (Schierhorn, 2010).
Issue of Autonomy
Traditionally nurses have taken a subordinate role in making decisions regarding patient care. With increasing emergence of advanced nurse practice, ethical issues that relate to independence of practice arise. After years of legislative debate some states are trying to fill the primary care physician shortage with nurses who have advanced degrees in family medicine. There are currently 18 states in America that have allowed DNPs to practice without physician oversight (Vestal, 2013). While many state and federal legislations bear concerns about patient’s s...

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...erences
Fairman, J. A. (2011). Broadening the Scope of Nursing Practice. The New England journal of Medicine, 193-196.
Mundinger, M. O. (2008). American Board of Comprehensive Care Certification (ABCC): Too Close to Medicine. Clinical Scholars Review : JDNP, Volume 1( 2), 67-68.
Palermo, J. (2014, January 13). Physicians and Nurses At Odds Over NP Autonomy. Space Coast Daily . Retrieved from http://spacecoastdaily.com/2014/01/physicians-and-nurses-at-odds-over-np-autonomy/
Schierhorn, C. (2010, March 19). As NPs push for expanded practice rights, physicians push back. TheDO. Retrieved May 13, 2014, from http://thedo.osteopathic.org/?p=11501&page=2
Vestal, C. (2013, Jul 19). Nurse Practitioners Slowly Gain Autonomy. Kaiser Health News. Retrieved May 12, 2014, from http://www.kaiserhealthnews.org/stories/2013/july/19/stateline-nurse-practitioners-scope-of-practice.aspx

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