Legal and Ethical Issues in Nursing
Introduction
This study examines the scenario surrounding legal and ethical issues in nursing concerning the event involving an 86-year-old woman with a pre-existing medical condition. She is transferred to the palliative care team for further assistance. Her daughter is pessimistic about her mother’s chances of survival. Healthcare services today are quite demanding. Ethical issues are bound to arise at any one given point. The question of whether an act is right or wrong underlies in the mind of the healthcare giver. Professional decision making is significant. The discussion studies a nurses’ duty to maintain ethical standards in their care while considering the legal implications.
Practice of Nursing
Nurses face different dilemmas in their role of practicing nursing. According to (Moodley, 2011) these ethical dilemmas encompass liberty versus control, truth versus lying, quality versus the amount, for choice versus for life and knowledge versus common belief. Ethical issues are a part of today’s healthcare environment (wood, 2014). This is characterized by several issues. Nurses are often challenged by these prevailing circumstances that have affected their delivery of quality services. It is becoming more difficult for nurses today as ethics has been incorporated in the practice of nursing (K¨alvemark et al., 2003)
Lack of standard policy that helps guide nurses in ensuring ethical standards are adhered to are insufficient (K¨alvemark et al., 2003) It is this that often affects the nurses’ decision to make proper judgments. The understanding of ethical issues is a daunting task for many health practitioners today. The guiding line is thin and wrong decisions can easily be made. Ethical standards have been raised a notch. Advancement in technology and the magnanimity of nursing requires them to be critical on care which they give to their patients to ensure their steady healing.helpsle for her actions. In this case, the nurse has to act by her subconscious. The nurse must understand that the patient’s life is dependent on the injections administered. The nurse should be able to maintain the health standards that are required by the patient.
Ethical Principles
The doctrine of principlism (Brent,2000) is significant in helping create informed decisions regarding a problem. These principles comprise autonomy, beneficence(non-maleficence), justice, and paternalism. When used together, they assist in making informed decisions that are ethical (Ambrosino & Goldstein, 2008)
Autonomy
Autonomy requires patients to make their own decisions regarding the type of treatment they prefer. Nurses are to respect patients’ rights to this principle. They have a right to decide on matters relating to medical procedures. These decisions are particularly important and cannot be ignored by the health practitioner even if its results are severe. The patient, in this case, has not made any claim or demand. Her decisions can only be made by another party. Patients have the right to make their own decisions. Nevertheless, they are required to have the mental capacity to do so.
Paternalism
The consent of a patient is important to any health practitioner. This principle involves the use of paternalism to discourage dishonesty, lack of choice, and anything that may harm the patient.in this scenario, the nurse id conversing with the daughter and not the patient. The decision taken by the nurse will be based on the information given to her by the daughter. The daughter has taken a paternalistic approach. However, the nurse is in the best position to make this decision because she is more informed. This decision will override the patient’s autonomy of right.
Beneficence or Non-maleficence
The act of kind-heartedness is fundamental in the provision of health care services. Beneficence is an obligation to do something nice and non-maleficence is a duty not to do bad (Rumbold, 2000). This provision is used by medical practitioners the avenue to decide on decisions made by patients. The dilemma arising is that a health practitioner will make a judgment that best suits at the expense of the patient’s own decision so a not to harm the patient. The 86-year-old woman is properly taken care of and is taken in by a palliative care team. This decision is made to safeguard her safety.
If a patient is not sufficiently notified of a procedure that is to be taken and something goes wrong, the medical practitioner will be at fault. A patient endured severe pain in the Bolam tests. This was after receiving electro-therapy. The doctor was not found guilty as he acted in conformity to the rules of conducting such a procedure. (Bolam vs Friern Barnet Management Committee, 1957).The nurse has to act on this principle by ensuring the patient gets proper medical attention.
Ethical theories
Utilitarianism
The concept here is to find a means of determining a method most viable for taking action. It identifies strategies to take when faced with different circumstances. Choices encompass making a person happy or sad. Some choices can be painful but worth it in the long run. In our case, the nurse has to decide on whether to continue administering the injections considering a patient is a person who is old. The action might look painful but helpful to the patient. If the nurse continues administering the injection she will have a reason that it helped in her recovery.
Mrs. Pretty had her autonomy rights withdrawn to safeguard her life (D.Pretty v The UK, 2002). The court found it paramount to protect her life. This theory has grown with time and it’s definition becoming much broader. Act utilitarianism requires a person to analyze the repercussions of the regions they are bound to make. This largely depends on the elements of the situation itself. The decision to have the patient transferred to a palliative care team because her health deteriorated is an act of utilitarianism.
However not all conditions of a prevailing problem need to be assessed. It is sometimes difficult or even inconceivable to evaluate a situation because of time or other constraints. This is referred to as rule utilitarianism. There are universal rules that nurses are expected to follow when in the hospital. For instance, they are required to be essential service providers acting in the best interest of their patients. Nurses are to save lives and help patients feel comfortable. Moreover, to benefit everyone involved they should make expedite decisions. The nurse in this scenario should be able to explain to the patient’s daughter the importance of life despite the constraints she undergoes to help in the recovery process.
Virtue Ethics
It is good to care for another person. The willingness to ensure the safety of other people is important. Though this mainly depends on individual character, some motivations can make a human being be forced to act kindly. The nurse shows concern by comforting the patient and her daughter. This positive personality is a virtue of ethics because the nurse has no prior experience of dealing with such a situation. Managing pain is part of palliative care and the nurse can show that to the patient by continuous administration of the patient’s medication.
Law
Common knowledge that defines what is true and false to which majority follow is the law. In our case; consent, capacity to make decisions, and the Human Rights Act are some of the law issues that merge.
Consent
Consent is the unwritten or written record to help guide a medical practitioner to make decisions. It simply means approving. Consent can be considered meaningless of the individual giving the consent does not comprehend their actions. The describing word ‘informed’ has to be used to make it more meaningful ( Tschudin, 1989). Consent does not need to be completely informed. Information given by a patient is at the control of the health practitioner. It is possible to be completely liable to an offense if a medical procedure is done to a patient without their consent.
Capacity to make Decisions (Mental Capacity Act, 2005)
In the face of the law, two scenarios define capacity; the ability to make or the inability to make decisions. This capacity offers a wide range of possibilities. In outlining the few in regards to our case, we can say capacity was compromised. Firstly because the law acknowledges all adults to have the capacity. This involves pragmatic thoughts that can help make informed decisions. Nevertheless, this capacity is further grouped. The other two divisions involve patients with prior capacity that is currently lacking and patients those with morals that can not be correctly verified. The patient in this scenario falls in the second instance. Considering her age, the patient may not be in a pole position to make decisions as before.
The best people to help make decisions are the patient and the palliative care team which in this case is the nurse. Underscoring the importance of autonomy in regards to capacity is essential. It, therefore, follows that the patients’ views are to be validated as a reflective indicator of their values. The law requires that these values are taken into consideration either directly from the patient or indirectly through other means that include people who are close to the patient. Whichever way, the patient’s values should be put into consideration.
Human Rights Act
This act is protected by the law and all National Health Services (NHS) must comply with this Act. The court when determining a case will base its ruling on the Act. It follows that the Act helps complement other laws that are already in place. Authorities must respect human rights when making decisions or policies. Concerning our case, there are several articles in the Act that approve of privacy and respect that are both fundamental in safeguarding the interests of the patient.
Conclusion
Legal and ethical matters are pertinent to decision-making activities. There is reason to believe that critical thinking is imperative when faced with such a predicament. Theories and principles help in forming the hallmark of making informed decisions. Autonomy is significant in determining patient choices but is not necessary. Decisions can be made on behalf of the patient mostly if they are not in the right capacity to do so. The law forms the blueprint of informed policies for any service provider. There is a need to further understand the societal influence in establishing accepted behavior in the medical field.