External Influences on Ethics: Guarding the Guardians, Market Forces, Social Responsibility, and Technology - Essay Example

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EXTERNAL INFLUENCES ON NURSING ETHICS (A Personal Essay) Name of Student (author) Name of University (affiliation) STAGES OF TRUTH TELLING AND PATIENT AUTONOMY Autonomy, as it pertains to the patient in a health care situation, means self-rule or self-determination…
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External Influences on Ethics: Guarding the Guardians, Market Forces, Social Responsibility, and Technology
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Download file to see previous pages The patient is given unconditional worth and utmost respect (Morrison, 2011, p. 28). Truth telling is an ethical imperative; however, there are situations where absolutely telling the truth can be harmful, creating an adverse reaction from patient and his family. Truth can be told in stages, or in installments. Morrison mentions that Kant requires truth telling as a categorical imperative but utilitarianism on the other hand, requires the health care provider to weigh the benefits of truth telling against a possible harm if truth is told all at once. Fidelity can be done in installments, if the situation warrants it (ibid. p. 34), and out of compassion. A similar situation which I had encountered concerned patients who are diagnosed with Alzheimer's disease. It presents an ethical predicament for a need to communicate honestly and a need to keep it secret at first due to reluctance of family members to disclose to the patient that he is suffering from an irreversible, incurable and eventually hopeless, diagnosis. Silence may be conflicted with patient autonomy as at its early stages, an Alzheimer's patient can still decide. Staff within a health care system are hired based on their initial competence, and then must undergo regular evaluations based on demonstrated continuing competence (JCAHO, 2002, p. 12) to create an ethos of continuous learning. A good competence assessment program must be systematic, objective, and measurable, done by a series review of performance data (Smith & Pelletier, 2009, p. 21) and attendance in continuing medical education (CME) programs. NON-MALFEASANCE AND WORKPLACE BULLYING There are definitely a number of situations where the nurse is exposed to certain acts of bullying, from the head nurse, the supervisor nurse, the nurse manager, or even worse, the attending physician who acts in a menacing manner to see if instructions are followed. This situation puts the nurse in a compromising situation where the nurse can be torn between a tendency to uphold nursing ethics or comply with a directive. One of the foremost principles in the nursing profession is to do no harm (non-malfeasance) but there are certain times when nurse has to choose between complying with orders or following his or her conscience with regards to patient treatment. Bullying cases arise from work-related pressures and against medical ethics. Workplace bullying where the nurse is threatened with suspension or termination if she does not follow orders can have a demoralizing effect. This can cause the resignations of those who are well-qualified nurses, who may not take it lightly to do things against their conscience. It is the entire community that will eventually suffer as it loses its good and competent nurses. It is the job of health care executives to see this situation does not develop or is even tolerated. Executives must be vigilant and investigate complaints of bullying by a supervisor that compromise patient safety and overall quality of health care. It is imperative that a culture of ethical conduct pervades throughout the institution or organization. American College of Healthcare Executives (ACHE) regularly conducts its continuing education programs through its foundation (ACHE, 2012, p. 1) and has an institute of leadership to instill the importance of acting ethically (Owen, 1990, p. 155). Staff who were proven incompetent, even physicians, will lose their privileges and credentials, even cause their removal from the list of accredited practitioners ...Download file to see next pagesRead More
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