Ethical and Legal Decision Making in the Context of Nursing

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Nurses can also benefit from surrounding themselves with experienced nurses as well as experienced nurse managers. You can count on the advice of caregivers when it comes to situations where they may not know how to deal with it. Nurses can create an educational environment where they regularly discuss ethical issues with nurses in their units. Through open dialogues on ethical issues, caregivers can learn from the mistakes of others and learn to address ethical issues and challenges. Every patient has the right to make their own decisions based on their own beliefs and values. [4]. This is called autonomy. A patient`s need for autonomy may conflict with guidelines or suggestions for care that nurses or other health care workers deem best. A person has the right to refuse medications, treatments, surgeries or any other medical intervention, regardless of the benefits that may result. If a patient chooses not to receive treatment that could potentially provide a benefit, the nurse must respect that decision. Rule 7.

The nurse promotes the profession in all roles and environments through research and scientific research, the development of professional standards, and the creation of nursing and health policies. Just as nurses have many ethical obligations to their patients, staff and communities, nurse instructors and nurse leaders have a duty to prioritize the training of nursing students on the importance of ethics in all aspects of nursing practice. Ethical issues faced by caregivers can increase work-related stress. For example, a nurse in the intensive care unit of Nurse.com describes the „moral distress“ that doctors and nurses feel when a patient`s wishes or refusal of treatment are incompatible with best medical practices and against the patient`s well-being. This nurse sees the ethics expressed in the goal of finding the solution that achieves the optimal result for the patient. The solution must also meet the patient`s wishes. The treatment of children is another area where ethical dilemmas can arise due to conflicting opinions. In the case of young children, parents have the right to determine the course of treatment and to refuse treatment on behalf of the child. However, caregivers have a duty to consider the well-being of the patient and not the parents when making decisions, and discussions about care decisions must therefore be detailed and sensitive. One of the most common ethical dilemmas in practice is differences in how the nurse and patient can see a clinical decision. Nurses have extensive training that gives them skills and knowledge about the disease and treatment – usually to a greater extent than the patient.

However, patients have the right to autonomy and ultimately have the final say in the treatment they undergo. When the nurse`s expertise suggests one treatment and the patient`s opinion dictates another, it can lead to a difficult clinical situation (Nursing and Midwifery Council, 2015). Vitale, E., Germini, F., Massaro, M. and Fortunato, R., 2019. How do patients and caregivers define nursing advocacy? An overview of the literature. Zeitschrift für Gesundheit, Medizin und Krankenpflege, 63, pp.64-69. Nurses have a responsibility to themselves, their profession and their patients to uphold the highest ethical principles. Many organizations have ethics committees to review ethical concerns. Nurses at all levels of practice should participate in the ethical review in their target area. It is important to advocate for patient care, patients` rights and ethical consideration of practice. Ethical inclusion should begin in nursing school and continue as long as the nurse practices. According to a 2019 Gallup survey of U.S.

citizens, 85 percent of respondents rated nurses` ethical standards and honesty as „very high“ or „high.“ This is the 18th consecutive year that caregivers have scored highest in the survey of consumer impressions of ethics in various professions. The next best professions for honesty and ethics were engineers (66%), doctors (65%) and pharmacists (64%). The American Nurses Association`s Code of Nursing Ethics serves as a guide for nurses to practice with competence and integrity. People`s ethics and morals influence their actions and decisions, as well as the perception of the consequences of those actions. In health care, ethics allow nurses and other professionals to identify moral dilemmas and apply good judgment to their decisions. Jack, K., Hampshire, C. and Chambers, A., 2017. The influence of role models in nursing education. Journal of Clinical Nursing, 26 (23-24), pp.4707-4715.

Barlow, N.A., Hargreaves, J. and Gillibrand, W.P., 2018. Nursing Ethics, 25(2), pp.230-242. In order to be the most useful aid in difficult situations, the Interpretative Statements of the Code provide specific guidelines for practice. The statements respond to the contemporary context of nursing and recognize the greater concern of nursing for the health of society. For Ms. Q, „the Policy on The Care of the Elderly (NMC, 2009) served as a framework for the Code to identify various principles that should be observed and followed by the student nurse when caring for this 60-year-old patient. The primary objective of this NMC Policy Code of Ethics (2009) is to preserve the anatomy and dignity of Ms. Q and other seniors in nursing and to respect the patient`s choice or rights of choice. The ANA Code of Ethics for Care also ensures that nurses comply with all regulations and guidelines that apply to their profession and employment.

The nine provisions of the Code guide nurses to act ethically in their day-to-day duties and responsibilities. The provisions are based on the four main principles of care ethics – non-malice, charity, autonomy and justice – as explained in the book Nursing Ethical Considerations. End-of-life care often begins when a person is healthy. Many people, including nurses, have specific ideas about the health care they want or don`t want at the end of life. Living wills are a way to allow people to convey their wishes for end-of-life care. This includes discussions with people who might be a backup decision-maker, as well as documents used to express preferences. Provision 4. The nurse has authority, accountability and responsibility for nursing practice; makes decisions; and takes action consistent with the commitment to optimal patient care.

The fourth, fifth and sixth principles of the Code of Ethics for Nursing address the boundaries that nurses must set in their work. Many circumstances are simply never considered ethical difficulties or challenges. After determining Ms. Q`s health problem, the assigned nurse must decide to establish the ethical dilemma in a simple and concise manner, taking into account all relevant elements of the situation (Beyk Mirza et al., 2019). Ms. Q suffers from mental instability and anxiety issues due to stroke and, as an older woman, the after-effects and mental shock after stroke are much deeper in her health. If the ethical dilemma does not conflict with principles, it is simply a good and bad problem and no ethical decision-making is necessary.