ETHICAL ISSUES - Research Paper Example

In clinical standard, a consent for surgery had been secured, where it was clearly indicated that the client is to receive local anesthesia only by the nurse anesthetist. During intra-operative period, a mixed-up occurred, where monitored anesthesia had been administered, instead of local one. Expecting the latter, the client came to the hospital alone through his own vehicle. In institutional policy, clients should be admitted for at least a day as part of post-anesthesia monitoring if they received monitored anesthesia.

Post-operatively, the client was not admitted, and had no one to drive for him home. A nurse became aware of inconsistency with type of anesthesia indicated in consent form from the inducted one. The surgical team and nurse manager were informed of such mistakes, and the event was duly documented. Despite hospital protocols, the physician refused admittance for an outpatient procedure, leaving receiving nurses with no option but to look for a driver to bring the said client home. Clearly, a number of clinical and ethical discrepancies can be observed.

For one, the anesthesia indicated in the consent form had not been followed during actual surgery, giving undue risk to client who had no companion to drive him home during monitored anesthesia care. Another thing is the adamant refusal of the physician to admit the client overnight, despite the institutional policy to do so with such anesthetic category. Lastly, giving the burden of managing the aftermath of the error to nurse, conflicts the organizational accountability that all members of surgical team are obligated to resolve existing discrepancies during and after clinical service delivery.

The breach in consent form could have been prevented according to benchmarks indicated for surgical safety. A known surgical checklist divides the universal protocol in three sections: “sign-in, time-out, (and) sign-out.” In all parts, every opportunity is given to review pertinent things, from preparation of equipments, to detailed data in consent form, and relevant information on correct patient, surgical site, and procedure. Unfortunately, time-out process was disregarded, where the pause indicated to ascertain whether pre-operative details are followed and concerns with actual operation are addressed had been foregone (“Theatre,” 2008).

Through this, induction of wrong anesthetic technique, then, could have been avoided. The ethical parameters in consent form were neglected. More than legal safeguard, this represents professional respect for clients’ autonomic right to participate with clinical decision-making process. As emphasized by White and Baldwin (2003, p.762), informed consent should be specifically denote the “anesthetic techniques.which had been discussed and agreed by the patient.” As observed in the situation, patient autonomy is breached with the procedural error, and ethical dilemma begins.

This is even compounded by refusal of providing physician to admit the patient. The danger of monitored anesthesia induction ranges from respiratory depression to neurological dysfunction resulting to trauma (Bhananker, Posner, Cheney, Caplan, Lee, & Domino, 2006). As such, the practitioner is fully aware of client’