Ethics Component of Professional Studies - Essay Example

Ethics Component of Professional Studies I 26th October 2007 Total Number of Words 509 Q1 Define and differentiate between the ethical principles of deontology and teleology. Give clinical examples of each. Deontology is about the rightness or wrongness of a chosen action depending on the moral significance of the action. (Audi, 1999) ‘Deon’ from the word Deontology is a Greek word meaning ‘duty.’ Deontology, therefore, is a study of duty. (Seedhouse, 1988) The ethical principles of deontology is referring to positive actions that are committed by nurses based on the practice of what is acceptable in the nursing ethics and law. It means that every nurses must must not act on pure motive alone. Instead, nurses should consider what is logically right including the probable outcome and the actual outcome of an action when providing care to the patients. Basically, deontology emphasizes the importance of moral obligation and commitment to nursing duty. For example: when dressing the patient’s wound, it is the duty of nurses to protect the patient from possible internal and external harm. Therefore, in cases when the patients’ wound is severely big, nurses should consider that using a cheap type of dressing could inflict pain on the patient upon removal of the dressing due to the fact that cheap type of dressing could stick to the patient’s wound upon removal. Therefore, nurses think of the future consequences instead of being cost-conscious all the time. Eventhough the main intention of using a cheap dressing on the patient’s wound in terms of preventing possible wound infection is good, its consequences such that it could inflict pain on patient upon removal of the dressing remains a conflict between nurses’ two main duties. Teleology is about actions that could lead to ethically favourable or unfavourable consequences or possible outcomes of the actions. (Audi, 1999) The ethical principle of teleology is focused on the action’s consequences such that the end result of an action should always be for the greatest good of the patients. In other words, the end justifies the means. For example: in the case wherein nurses need to help patients and their families decide on a particular treatment such as the use of tube feeding devices, nurses should be able to draw from his/her past clinical experiences and relay its advantages and disadvantages to the patients and their families to help them decide on accepting the treatment or look for an alternative options. Possible benefits and danger that may occur out of using tube feeding devices has to be clear to the patients and their families. Q2 Scenario: A nurse was tending to a terminally ill man. The Doctor’s orders for this man included “Nil by mouth”. The nurse went against the orders and gave the man small sips of water. Did the nurse behave ethically? If so, what ethical principles was she upholding? If not, why not? Based on the ethical principles of deontology, the nurse behaved unethically due to the fact that he/she has violated the doctor’s order. Violating the doctor’s order is a clear sign of violating his/her duty to follow doctor’s order. In this particular case, the Doctor has a medical or treatment reasons for instructing that the man should go through the order of “nil by mouth.” Based on ethical principles of beneficence and non-maleficence, nurses should always ‘do good’ in terms of providing care for the patients and make decisions for the best interests of the patients. (Tuckett, 2005) Since nurses are the medical frontliner, the nurse should strictly and constantly monitor the patient whether he/she is showing signs of dehydration. In case there is an evident sign of dehydration, the nurse should immediately call the attention of the doctor and report the case of dehydration. In case the doctor is not available and there is a serious case of a potential dehydration; then it is okay to provide the patient with a small sip of water in order to avoid a potential case of death due to dehydration. Based on the ethical principles of teleology wherein the end justifies the means. Therefore, the nurse has accomplished the ethical principles of beneficence, non-maleficence, and justice for saving the life of the terminally ill patients from a possible death due to dehydration. Q3 Scenario: Mrs Carotid has had a large stroke, which has left her with a right sided paralysis. The treating doctor has told the primary nurse that the patient’s prognosis for a full recovery is very poor. The patient is keen to recover and exercises the limb very regularly. On one occasion when the nurse is attending to the patient, the patient asks, “Do you think I will gain full control of my limbs again if I keep exercising? Drawing on ethical principles how would you respond to this question? Outline your rationale. In the case of Mrs. Carotid, despite the fact that the doctor has told the primary nurse that the patient’s prognosis for a full recovery is poor, I would rather not tell her what I know. Instead, I would encourage her to continue with her regular exercises with the affected limb. The fact that there is a slim chance that the doctor’s prognosis on the patient’s recovery could be wrong and since the consequences of letting her know that her prognosis on full recovery is poor could deteriorate her willingness to fully recover will not do her any good, the action of letting her know the doctor’s prognosis could do more harm to the patient’s emotional welfare and her willingness to participate in any therapy or treatment to make her recover from paralysis. Considering the ethical principles of beneficence such that nurses should only do good actions which may contribute to the welfare of the patients and non-maleficence such that part of the nurses’ obligation is to avoid injuring the patients physically and emotionally (Bailey, 2007), it is justifiable not to let her know the doctor’s prognosis in her case. Weighing between telling her the truth and the consequences of letting her know the truth, I would rather not be the one to tell her what I know. Anyway, it is the doctor who should be the one to let her know the prognosis of her case. Q4 Differentiate between legal, clinical and ethical dimensions of nursing practice. Give examples of each to support your response. Legal, clinical, and ethical dimensions of nursing practice are all interrelated subjects. Basically, ethical dimensions of nursing practice forms the foundation of a universally accepted nursing practice in terms of moral issues. Violation of the ethical dimensions of the nursing practice could lead to legal issues related to the nursing profession. Therefore, it is crucial that all nurses should apply their knowledge in nursing ethics and its legality to the clinical nursing practice in order to avoid possible legal issues in the future. The common law in nursing is more or less based on the Human Rights Act 1998. Therefore, it is vital for all health care practitioners to be familiar with the said regulations especially with regards to ‘protection of rights to life’; ‘prohibition of torture, inhuman or degrading treatment or punishment’; and the ‘freedom of thought, conscience and religion’ among others. (Department of Health, 2001, p. 3) For example: it is ethically right to provide care to patients related to his/her personal hygiene and other physical interventions such as administration of drugs, providing assistance on dressing and/or other activities of daily living as part of the nursing duty. However, the common law or case law strongly considers that ‘touching a patient’ in the absent of a legal consent (autonomy) could result to a civil or criminal offence of battery. In the absence of a legal consent from the patient, in case the patient has been harmed from a care or treatment provided to them; it is possible for the patient to sue the health or social care practitioner for ‘negligence’. (Department of Health, 2001, p. 2) For this reason, it is advisable for nurses to keep themselves informed of any legal developments and nursing ethics related to their profession and apply the knowledge in their clinical practice. In case of any doubt with regards to a certain action regarding their profession, it is highly recommended to seek legal advices to avoid any legal problems that may occur in performing care and treatment for the patients. Q5 On our ward we have a 70 year old woman who was described as an alcoholic and had taken several overdoses over a period of 2 years. The staff feared that if she were to be discharged, she would return home to her alcoholic husband and sooner or later be found dead. However, when she was sober she appeared completely rational and demanded to be allowed home. Her compulsory detention in hospital seemed to me to be a complete violation of her freedom when there did not appear to be adequate evidence that she was mentally ill. What are the ethical issues associated with this scenario? Does the nurse have a moral duty to prevent suicide? Considering the ethical principles of beneficence and non-maleficence, nurses as public health professionals have a major role to play when it comes to preventing suicide attempts through educational campaigns, counselling and other support programs that changes people’s beliefs, attitudes, and values regarding suicidal acts. (Carter & Baume, 1999) In the process, patients’ emotional pain will be lessened. Patients should always have the right to freedom and right to decide on whether or not to take or accept medical services or treatment from the health care providers. (Department of Health, 2001) Since the 70-year old patient is still under the responsibility of the health care providers given that she is still confined in the hospital, the health care providers have the obligation to ensure that the patient is safe from any suicidal attempts or anything that could cause harm to the patient. Regarding the patient’s right to decide on whether to stay or leave the hospital should also be respected by health care providers. Considering the possibility that the patient may not be in the right frame of mind when she sobers, health care providers should allow the patient to calm down prior to making decisions. The health care providers especially the physician-in-charge of the patient should prove that she is in the right frame of mind and is emotionally fit at the time she makes the decision to go back to her home. The physician should make a good judgement with the help of psychiatrists regarding the case of the patient upon discharging her from the hospital. To determine the main cause of the old lady’s suicidal tendency and alcoholism over the past two years, physician should collaborate with a psychiatrist. Through a good clinical practice, management, and treatment over the patient, it is possible for the health care providers to prevent and minimize the risk of her suicidal attempts. *** End *** References: Audi, R. (1999). The Cambridge Dictionary of Philosophy. 2nd ed. UK: Cambridge University Press, p. 247. Bailey, G. (2007). NASW Standards for Social Work Practice in Palliative and End of Life Care. Retrieved October 16, 2007, from National Association of Social Workers: http://www.naswdc.org/practice/bereavement/standards/default.asp Carter, C., & Baume, P. (1999). Suicidal Prevention: A Public Health Approach. Australian and New Zealand Journal of Mental Health Nursing , 8: 45 - 50. Department of Health. (2001, March). Retrieved October 16, 2007, from Reference Guide to Consent for Examination or Treatment: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4019079.pdf Seedhouse, D. (1988). Ethics: The Heart of Health Care. Chichester: John Wiley & Sons Ltd. Tuckett, A. (2005). The Care Encounter: Pondering Caring, Honest Communication and Control. International Journal of Nursing Practice , 11(2): 77 - 84. Read More