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A HISTORY OF NURSING ETHICS

The Nuremberg trials at the close of WWII offered disturbing questions. How can good people in traditionally honor-bound professions become complicit in some of the worst violations of humanity in history? What happens when individual professionals are not held to account by their peers, professions, and society as a whole? The trials showed how moral individuals within organizations can engage in morally wrong functions. I was just following orders, complicit healthcare providers, doctors, and nurses claimed.

Morality refers to principles that help determine what is right and what is wrong. Ethics is the related field that puts these principles to work to:

apply moral principles to choose right actions,

conduct relationships in an ethical manner, and

manage situations where a right action is clear but for some reason not possible.

Using what we have learned this week- read the ethical dilemma below and explain your response and actions:

Nurse Is Instructed to Have Patient with Low Literacy Level to Sign Consent for Treatment

Scenario: Nurse Gloria is instructed by the attending physician to have Mr. Isaacs sign a consent form before a scheduled colonoscopy. As Nurse Gloria goes over the form with the patient, she notices he seems confused and is unsure where or how to sign the paperwork.

Ethical Dilemma: It is common for nurses to be the ones to get signatures on consent forms, especially for procedures like the one described in this scenario. When faced with a situation like the one here when the nurse is not sure that the patient understands what he is being told or if he can read, the decision of whether to delay a busy schedule to have the doctor come back and talk to the patient or explain to the best of her knowledge and get the patient's signature may seem difficult to make.

Now that you have read the ethical dilemma below WHAT IS THIS PERSON FOCUSING ON EMOTIONALLY? What are the ASSOCIATED ETHICAL PRINCIPLEs AT PLAY IN THIS SCENARIO? WHAT ARE THE IMPLICATIONS OF THE NURSE'S ACTIONS? explain your responses and your current actions.

Full Answer Section

Associated Ethical Principles:

Several ethical principles are at play in this scenario:

Autonomy: The patient's right to self-determination and the ability to make informed decisions about their own healthcare.
Beneficence: The duty to do good and promote the well-being of the patient.
Non-maleficence: The duty to avoid causing harm.
Justice: The principle of fairness and equitable treatment.

Implications of the Nurse's Actions:

If the nurse proceeds with obtaining the patient's signature without ensuring full understanding, it could have serious ethical and legal implications. The patient's autonomy may be compromised, potentially leading to harm or adverse outcomes. Additionally, the nurse could be held liable for negligence if the patient experiences complications as a result of not fully understanding the procedure and its risks.

Recommended Course of Action:

Prioritize Patient Understanding: The nurse should prioritize ensuring that Mr. Isaacs fully understands the procedure, including the risks, benefits, and alternatives.
Seek Clarification: If the nurse is unsure about the patient's comprehension, she should seek clarification from the physician or another healthcare professional.
Involve a Medical Interpreter: If language barriers are present, a qualified medical interpreter should be involved to facilitate communication.
Document Thoroughly: The nurse should document all interactions with the patient, including any concerns or questions raised by the patient.
Advocate for the Patient: If necessary, the nurse should advocate for the patient's rights and interests, even if it means delaying the procedure.

By prioritizing patient autonomy, beneficence, and non-maleficence, the nurse can ensure that the patient's best interests are protected.

Sample Answer

Analyzing the Ethical Dilemma

Emotional Focus:

The nurse in this scenario appears to be focused on efficiency and task completion. The potential delay caused by having the doctor re-explain the procedure and obtain informed consent directly from the patient seems to be a primary concern. This focus on efficiency can overshadow the ethical imperative to ensure patient understanding and informed consent.