ETHICS COMPONENT
1. Scenario 1:
In this scenario, the case of autonomy is the issue. Autonomy refers to a person’s independence, in this case the client’s independence. As a standard in ethics, autonomy represents an agreement to respect another’s right to determine a course of action. Based on this standard in ethics, the health care professionals should have respected the client’s decision as to what should be the next course of action. The health care team has no right to detain here and impose their decisions on her since in the first place the client is not found to be mentally incapacitated.
Respect for another’s autonomy is fundamental to the practice of health care. It serves to justify the inclusion of clients in all aspects of decision making regarding their health care. The decision to be discharged from the hospital may be at the hands of health care professionals but the client also has the right to voice out his or her opinions which should be respected by the health care professionals.
The agreement to respect autonomy involves the recognition that clients are in charge of their own destiny in matters of health and illness. Let us take for example the consent process required prior to surgery, this implies that a client may refuse treatment. In most cases the health care team must agree to follow the client’s wishes. Health care professionals agree to abide by a standard of respect for the client’s autonomy.
The nurse has of course a moral duty to prevent suicide. However, the client does not appear to be mentally ill and should be given her freedom and right to decide. If the client decides to go home, then she should be allowed to go home since in the first place she does not appear to be mentally ill and could make sound decisions and judgments. Unless the client is proven to be unable to make sound decisions and judgments, then the health care professionals and the family of the client could decide for the health care of the client.
2. Scenario 2:
The nurse in this scenario did not behave ethically. This could be discussed through the aspect of medical ethics which is beneficence. This refers to taking positive actions to help others. The practice of beneficence encourages the urge to do good for others. Commitment to beneficence helps to guide difficult decisions wherein the benefits of a treatment may be challenged by risks to the client’s well-being or dignity.
In the scenario, the nurse probably went against the doctor’s orders because she felt pity for the client. Given the fact that the client is terminally ill, the nurse could have felt that it was a little selfish and harsh for the doctor not to give the client anything to eat or even drink. Or the nurse could have thought that she owe it to the client to give him something to drink since he is dying anyway and the nurse just wants to grant a dying man’s wish. Thus, the nurse went against the doctor’s orders and gave the terminally ill man small sips of water. Although the nurse did this with good intentions in her mind, it is possible that it could have a bad effect on the client.
The nurse should have thought that the doctor’s orders may cause discomfort to the client, but the benefits, both for the individual and the society, outweigh the temporary discomfort. If the nurse has doubts of the doctor’s orders, she could have simply asked the doctor about it and why it should be done. The nurse should not act on her own without asking for advice, especially since this is a case wherein orders from a higher authority is given. The agreement to act with beneficence also requires that the best interests of the client remain more important than self-interest.
The nurse must remember that whatever she did on the client, she is accountable and responsible for. If what she did could harm the client, she could be blamed for it, and worse, she could be sued for malpractice. Depriving a client of something to eat and drink could sound harsh, but there are rationales for such actions. In ethics, such is done for the benefit for the client. No matter how terminally ill a client is, health care professionals must abide by what should be done clinically within the bounds of their established code of ethics.
3. Differentiate between legal, clinical and ethical dimensions of nursing practice. Give example of each to support your response.
Legal dimensions of nursing practice refer to legal boundaries within which nurses must function. There are certain legal guidelines that nurses must follow. An understanding of the implications of the law can protect nurses from liability and also protect their client’s rights. To illustrate, nursing malpractice which results when nursing care falls below the standard of care, is an example of a legal issue.
Clinical dimensions of nursing practice involve the nursing care itself that the nurse offers to the client. This also pertains to the skills of a nurse which are necessary to deliver a timely and effective care for the client. An example of clinical dimensions of nursing practice those that involve the complete assessment of a client’s condition that enables the nurse to make an accurate clinical decision as to the client’s needs and required nursing therapies.
Ethical dimensions of nursing practice include the ideals of right and wrong behavior. In professional practices including nursing, a code of ethics provides guideline for safe and compassionate care. A nurse’s commitment to the code of ethics guarantees the public that nurses adhere to professional nursing standards. An example of ethical dimensions of nursing practice includes the following scenario: A young woman is hospitalized in the final stages of cancer. The family of the young woman has expressed their thought for “no resuscitation” since everything has already been done and further treatment would be futile. The health care team caring for the young woman, especially the nurse faces an ethical dilemma.
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