Ethics in Nursing
Discussion statement
Regarding an inpatient who was admitted through the ER complaining of fatigue and unable to get himself out of bed. After running blood test discover his blood counts were dangerously low, Hemoglobin and hematacrit. I don’t remember the exact numbers. The doctor informed him that he would need a blood transfusion. The patient refused for days. He is a Jehovah Witness and they do not believe in blood transfusion. The patient became sicker. Finally, the patient agreed to the transfusion if we placed a pillow case over the blood so he would not see the blood entering his body. The patient return to good health after a few blood transfusions and a few days later.
According to (1998), the pattern of ethical knowing encompasses descriptions of moral obligations, moral and nonmoral values, and desired ends. Ethical knowing, which constitutes the ethics of nursing, is generated by means of ethical inquiries that are focused on identification and analysis of the beliefs and values held by individuals and groups and the clarification of those beliefs and values. Ethical knowing is tested by means of ethical inquiries that focus on dialogue about beliefs and values and establishing justification for those beliefs and values.
Usually, ethical decision making is oftentimes difficult, it is a fundamental in caring for patients. It is necessary for nurses to be alert in recognizing ethical dilemmas and be prepared in taking action based on the code of ethics outlined by the American Nurses Association’s (ANA’s) Code of Ethics for Nurses with Interpretive Statements.
One of the ethical dilemmas in which nurses faces arises with objections that has to do with religion. As what the given situation above, a Jehovah’s Witness patient objected for blood transfusions. This would be a dilemma in terms of medical practice and with ethics if the patient needs blood transfusion. According to the Jehovah’s Witnesses’ belief, the reason they refuse for blood transfusion is because it has been a tenet to their faith. According to them, it is freely accepted covenant with God that can not be broken. In the (1985), it is shown that the party may lose eternal salvation and a place in the community if the covenant is severed.
In order to resolve these conflicts between in regards to religions, it is required that the patient together with their family members or religious counselors to participate in the decision making. In addition, it may also be necessary for the good of both sides to modify the planned intervention. In addition to hanging pillow case while transfusing blood on the patient, it may also be possible to have a bloodless surgery in which blood transfusion can be avoided. It may be the proper response to patients’ convictions, as well as a desire to avoid the transmission of bloodborne pathogens. Ethical dilemmas may cause challenging situation however it is the duty of nurses to be involve in resolving this challenges for the patient.
A clinical conflict that becomes a problem at the organizational level is the refusal of blood products by Jehovah’s Witnesses (JWs) ( 2005). Because the courts have consistently supported the right of adult patients to refuse blood on religious grounds, some hospitals have set up so-called “bloodless programs” that include blood-conservation techniques such as erythropoietin administration to reduce the need for blood transfusions.
Although patients who refuse transfusion therapy voluntarily assume a greater risk, the hospital can minimize that risk by becoming competent in blood-conservation techniques. Guided by the principle of caring with compassion, the hospital may feel compelled to establish a bloodless program.
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