Beneficence Nursing Essays Text

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All civilization has faced health challenges from ancient times to the present. In traditional practice, ethicist usually used casuistry case based approach as a method of analysis for centuries in jewish medical ethics. Therapeutic paternalism assumed as usual practice by most health care pros and their patient's believed that whatever done by health care team will be better for them. Hence, the queries of medical ethics have been argued since the early development of western medicine. Ethics is a philosophical approach that covers entire associations of belongings and involved with good and bad, moral duty, obligations and values lindberg, j.b. Potter and perry, 2010 present that it is a human fundamental right and moral decisions in health care should be practiced by four principles. In this rapidly changing world, healthcare professionals face multiple challenges encircling ethical dilemmas.

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There is a conflict between the healthcare professionals and patients regarding the best choice. The nurse is often the person who can act as an advocate and resource to the patient. One of the best tools which healthcare professionals especially nurses rely upon in these challenging situations is the ethical decision making process. The four principles of healthcare ethics namely autonomy, beneficence, non maleficence, and justice presented by beauchamp and childress, 2001 provide us a direction to estimate the significance of the ethical decision in clinical setting. It is important to note here that the application of these ethical principles may vary according to the situation.

It also depends on the laws governing to the principle and the conditions applied. In the paper to follow, i will discuss the implications of these four ethical principles in regard to the scenario in which a nurse is asked by the family members to withhold the information about the poor prognosis of the disease from a patient who is diagnosed with an inoperable tumor. The paper will also provide a compare and contrast of the application of these ethical principles in the given situation followed by the best possible solution.

Critical analysis of the situation looking at the scenario, the question that arises is whether the harm in not telling the patient about poor prognosis of the disease greater than the harm from telling the patient about the poor prognosis. As part of the nursing curriculum, nurses are inculcated a habit of truth telling and honesty. The ideology and core values of nursing include trustworthiness and honesty but are not limited to these two.

However in the situation described above, the nurse is in a dilemma whether to hold the news of prognosis from the patient or not. In terms of moral ethics, the nurse should speak the truth and convey the news to the patient. While on the other hand, the nurse has to respect the decision of the family of withholding the information which is thought to be in favor of the patient as revealing the truth might deteriorate patient’s condition. Nevertheless, the consequences of such a decision to hold the news of poor prognosis could cause a delay in further treatment plan, and later on some paternalistic approach as directed by the family members in terms of care. Such a situation may continue for a longer period of time and may override the ethical principle of autonomy.

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Another angle to this situation is the breaking apart of the therapeutic relationship between the nurse and the patient that could occur as a result of withholding the information. Compare and contrast of ethical principles in the situation the principle of autonomy focuses on rights and obligations. It emphasizes on the rights of patients to make decisions about their medical treatment. According to beuchamp and childress 2001 autonomy relates to being free from controlling influences or personal limitations such as inadequate understanding p.56. The healthcare providers are obliged to be truthful veracity to their patients and to respect the choices that their patients make.

This is supported by edwards 2011 who believes that the obligations to respect autonomy include the obligation to be truthful to the patient p.107. The patients have the right to decide for themselves in regard to the treatment plan, provided that they receive complete, accurate and comprehensive information. Relating this with the scenario above, the nurse who is asked by the family not to disclose the news of poor prognosis violates the ethical principle of autonomy by not giving the patient the complete information and therefore a chance to decide for herself the future treatment plans. Edwards 2011 believes that by keeping the necessary information from the person, the number of choices available to that person is reduced which inhibits her autonomy.

Consequently, while hiding the news the nurse at some point in time in future may provide false reassurance to the patient or give the wrong information so as to fulfill the family’s expectation of avoiding to tell the truth to the patient. Hiding the prognosis from the patient and informing it to the family is in its self another ethical dilemma. In the given situation, this is to be noted that there is a collective decision made by the family for the patient but the patient herself is not the part of this decision. The question arises, to what extent is it right to share patient related information with the family when the patient is in a perfect state of receiving and processing the information. The answer to this question can be found in the american nurses association 2001 code of ethics for nurses provision 2 which states that the nurses primary commitment is to the patient whether an individual, family, group, or community. Therefore the nurse’s primary responsibility is the patient and not the family. While autonomy is taken in terms of rights and obligations, this takes us to the next two principles the principles of beneficence and non maleficence which are considered in terms of the consequences or outcome.

Beneficence and non maleficence if the scenario is analyzed, and the family’s decision of hiding the prognosis is taken into consideration, a question arises about the intentions of the family. However, if the intensions are good then this act takes us towards the ethical principles of beneficence and non malificence. The ethical principle of beneficence requires healthcare professionals to treat their patient in a way that provides maximum benefit to that patient and the principle of non malificence assures the duty of healthcare staff to avoid causing any harm to the patient conn, gillam, amp conway, 2005. The principle of non maleficence dates back to florence nightingale who strongly believed in doing no harm to the patient.

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This means that it is the responsibility of the healthcare professionals to protect their patients. This goes along with the ethical theory of utilitarianism which believes in the actions that provide the greatest good for the greatest number of people. In healthcare ethics, utilitarianism supports the idea of maximum benefits and minimized costs and risks mack, 2004. The two principles of beneficence and non maleficence often go simultaneously hand in hand. In the given situation where the nurse is asked to keep away the news of poor prognosis, the decision to do so may be in favor of the patient and the intention of the family members to do so may be to protect the psychological wellbeing of the patient through beneficence. This act according to edwards 2011 outweighs the respect for autonomy in regard to obligations of non maleficence.

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However, in doing so, the nurse may lose the trustworthy relationship built with the patient. In addition to the therapeutic relationship, if the diagnosis is accidentally revealed to the patient, she might end up to more serious complications like suicidal attempt or acts of self harm. Moreover, hiding the news may end up in mental and psychological trauma to the patient which could be more fatal than the disease itself.

In this way, the principle of beneficence holds true but the probability of non maleficence is high. Conflict between autonomy and beneficence the principal of autonomy often comes into conflict with the principle of beneficence. In this situation, intentionally or unintentionally, healthcare professionals use paternalistic approach while caring for their patients as they consider that approach as useful for their patient. Though the intervention seems useful for the patient, yet it breaches the autonomy of the patient by disrespecting the right of her decision in the treatment. It is important to note that while situations like these require healthcare professionals to critically analyze the risks and benefits associated with the choices that they make, in the process of choosing the best option, the entire situation along with its consequences should be taken into account, well discussed and planned so that the decision made should promote maximum beneficence and minimum or no harm with respect to autonomy.

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