In any circumstances, an ethical dilemma takes place where an option must be made between disagreeable alternatives. It can happen where one may want to give up something good and suffers from something bad no matter the route of action taken. Ethical dilemmas often oblige one to make choices that may break or contradict some moral norm and value. There is a broad range of issues of ethical and legal affecting the system of health care. In the essay, it focuses on the case study of Residential Aged Care Family (RAC) who had received an old patient Elsie Lee aged 88 years. The stake holders and the health care professionals in this study are the Nurse Manager, Registered Nurses (RN), Staff caring and the paramedics.
Difference Between Legal and Ethical Conflicts
In this scenario, an ethical and legal conflict arises between the wish of the patient and the ethics of registered nurses (RN) on saving the life of the patient. RN had to make a decision on taking Elsie to hospital after she had developed a severe pain and paramedics had to resuscitate her so as to improve her health condition. Although making that choice was for the best of Elsie health, it was contrary to Elsie since earlier on she had made it clear not be given any aggressive treatment and not to be resuscitated. Nurses when participating in study have to manage three value schemes; a society that values the rights of a human: nursing which is cultured grounded on the moral of helpful and the value of investigator which is about the scientific inquiry. Johnstone (2016) affirms that this value may conflict with the subject value and the entire society thus creating tensions and dilemmas in nursing.
Dignity and Rights of Stakeholders
The responsibility of nurses is to care for the patients, offer the best treatment to them and enhance their good being. However, this is bringing a conflict when it comes to the individual and social right or the negative and positive right. Negative rights are the individual rights that inhibit state of action and have a right to be let alone. The positive rights are the one that requires active government intervention to be accomplished. The RN nurses in the Residential Aged Care facility (RAC) made a decision to offer the best treatment by taking Elsie to the hospital, but this resulted in adverse consequences for the patient. Utilitarianism in the theory of teleological points out that the results produced depend on the rightness or wrongness of the action. According to Beauchamp and Childress, " consequences is the moral theory that actions are right or wrong according to their consequences rather than any intrinsic features they may have, such as truthfulness or fidelity" (2015). Even with rights of patients, practitioners should weigh the consequences first when directing the appropriate course of action.
Nurses have to compact with the system of hierarchical and bureaucratic of organization that demands faithfulness to assistants of the institution even if they have a task of caring and being trustworthy to the patient. In a higher status professional of a case of the incompetent researcher, nurses are obliged to show loyalty though it is conflicting with the commitment of patients (Freegarld, 2012). As a result, they may feel that their patients are vulnerable, but they cannot prevent it since they don't have the power and the voice to resist.
Nurses have a right in creating an environment that can support and facilitate ethical practice and also an environment that is safe for themselves and others. They are responsible for providing services that maintain the esteem for human dignity and embrace the uniqueness nature of patient with their health problems (Marianna, 2011). However, their rights and responsibilities are threatened when the decisions of the patient contradict their role resulting in legal and ethical conflicts that are beyond their measure. They are forced to take randomized control trials where they have to make a decision even though it contradicts so as to save human life (Kerridge, Lowe & Stewart, 2013). A primary role of nurses is to give information to patients. However, a conflict may also arise where they have to decide whether to give out certain information and participate in them or not do so.
Principles and Virtues of Health Care Ethics
Health professionals have an ethical requirement to care for their patients. Moral principles and virtues give direction to practitioners about the entailment of obligations. When approached with a moral dilemma, they should first regard as whether morals rules are appropriate and helpful and if not, they should determine the course of action so as to move to the ethical principle level for guidance.
This principle states that the liberty of option, action, and thought of an individual should not be interfered with. "Autonomy has been used to refer to a set of diverse notions including self-governance, liberty rights, privacy, personal choice, freedom to follow one's will, causing one's behavior, and one's person" (Morrison, Eileen, Furlong & Elizabeth, 2014). Autonomy in health care is thought as an individual's right to make a decision about what will happen to their bodies for instance whether to carry out treatment or not. To the principle of autonomy, there are two ethically justifiable exceptions one being weak paternalism and the other being harmed principle (Fisher, 2011). Medical paternalism proposes that due to education and training of medical physicians, then they know the best for their patients. The nurses in our case know the right way to the better health of the patient, but the autonomy conflicts with the decision of the patient of not taking aggressive treatment.
Autonomy principle is a significant constituent for informed approval. For instance, when one gives informed consent to a person concerning the participation of a trial of clinical research, one respects that right of a person to make a self-governing decision. This principle of informed approval guides the patients on a fully informed about the payback and risks of involving in a clinical trial and medication. According to Beauchamp and Childress (2015), autonomy is the capability for independence in action according to an individual plan. Informed consent incorporates the autonomous individual rights through self-rule. In my scenario, informed consent will seek in preventing assults on the truthfulness of the patient and shield personal liberty and authenticity.
The ethical principle is of benefit and cannot harm. Beauchamp and Childress propose that "the principle of beneficence includes the professional mandate to do practical and significant research so as to serve better and promote the welfare of our constituents" (2015). A conflict in health care may arise in qualitative research and thus can create immense ethical considerations, particularly for the nurses. In this case, Beneficence can be used when including deterrence of harm and elimination of harmful state in Elsie condition so as to bring the benefit of better health in the patient. A conflict may occur when the patient is not willing to be taken care of.
Fidelity and Justice
This principle requires professional of health act in a way to reveal fidelity to their patients. When there is a link between the medical professionals and the patient, the relation places the weight to a practitioner to act in the best awareness of the patient (Banks & Gallagher, 2011). Justice principle distributes a fair share of benefits; it does what the law says, and claim claims the human rights. All these are important in the case in giving the medication to the patient in the right way.
Kind, Compassion and Honest
These are virtues that enable the practitioners to show love to the patients of all types no matter the age or status. When practitioners are honest, they cannot give any false information in the field regarding the patient; rather they will be open and offer respect to them.
Codes of Professional Conduct
Principles of ethics such as autonomy that relate to medical perform and research has long served as a ground for an ethical conduct code. Moral codes give professional of health care standards to guide their practice. However, they cannot provide them with solutions to every ethical question that may occur in the course of their training (Tonti-Filipini, 2011)). In health care, ethical issues entail making decisions that are usually in precise situations. The aim of such values and codes is to offer medical professionals a framework to use when approached with moral questions and not provide them with the right and wrong answers. "The formulation of an oath or ethical code does not remove the moral choices and the need to consider each situation carefully and the alternatives actions or decisions that can be made" (Townsend & Luck, 2013), but it is to enable them to make the right choices in the situations.
The code of moral sustains that one must place the truthfulness of the profession and concentration of clients above your interest. One is to preserve and develop competence in the profession so as to be able to increase their personal and professional development (Occupational Therapy, 2014).
The code of ethics requires members to release their roles and responsibilities throughout in a way that professionally and ethically does not compromise any individual whom they have in contact with despite the position or condition of that person.
National codes of ethics enable nurses to be insightful to the moral challenges and do their best to accomplish their ethical duties and roles. It elucidates that nurses should communicate with the ethics committee of the hospital when it comes to making of decision especially when confronted with moral cases (Berglund, 2012). Also, the conduct of ANA code claims that nurses should protect the client and the public from the unprincipled or illegal practice of any individual. This is important in offering security to the patient and other people.
There is a conflict between the rights of the patients and the responsibility of the practitioners. Thus an ethical resolution must be looked so as to solve this dispute (Pozgar, 2014). The professionals of health care should presume an approach that is individualistic and takes an illegal but yet moral action for their patients regardless of the legal results asking them to idealistically sub-judge their interest to those of their patients.
In a situation of ethical decision making, medical practitioners can ensure that all facets are known about the case by having the knowledge of all facts in a given circumstances. They are to know what the patient wants and how to keep some confidential information to them. The practitioners can also apply the moral rule on the confidentiality. If the dilemma still exists, they may opt to apply certain principles such as autonomy, beneficence so as to solve the issue.
In a situation where there is a conflict of two or more rules or moral principles, then a moral theory should be applied. Ozolins and Grainger (2015), affirms that the ultimate arbiter of ethical dilemmas is the ethical principles. Also, managers and other directors should positively influence employees in health care to behave ethically. A manager can promote moral values and norms in the field since they act as a figurehead and personifies in the ethical position of the organization.
In preventing exploitation of humans, ethics committees should be introduced. The achievement of any ethics committee will rely on the obligation and member's moral competency. The committee is not to have a personal interest and academic prestige on their own only rather they should share everything with the nurses so as they are both able to deal with dilemmas occurring in the research (Dawson, 2011). To deal with difficulty cases, nurses require a greater convenience to committees and a claim of multidisciplinary combination. Also, boards should not be harsh and strict so as not to stop the development of knowledge in nursing.
Any person can be faced with an ethical dilemma like in our case study of the nurses, but all depend on the choice made based on moral and legal grounds. Ethical principles and codes help in solving some moral dilemma that one may be faced with in any field. Ethical theories and principles, moral values may not at all time contribute to give a clear direction for professionals of health care but may assist in providing a framework within which a decision can be made.
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