I was part of a mixed ward with intellectually disabled and more able residents.
Mary was 54 and approximately two stones overweight, according to her height-weight ratio.
She liked her food, and she had no medical problems.
The ward sibling decided that she should be given a diet with fewer calories.
Mary was generally a good-mannered, capable of walking alone into town, dressing herself, and taking care of her hygiene.
After just a few days of following her diet, Mary was discovered to be stealing food from residents and, more often than not, taking food out of the garbage bins.
One Friday it was fish.
Mary was given boiled cod.
She was adamant that she disliked the food and refused to eat it.
One of the skilled staff forced her back in her chair, shouting at her repeatedly: “You will not eat this food.”
Mary refused to eat the food, so the nurse forced Mary to eat.
Mary became distressed by the incident and slowly became depressed and withdrawing.
I spoke to my ward sister, stating that I found it unkind and that Mary should have some control over her diet, especially as she was a voluntary residents. Force feeding isn’t allowed in prison.
The sister dismissed my complaints, saying that Mary would be better off losing weight. But, she said, ‘It’s good for Mary, but we can’t let Mary get the better.’
The fact that Mary was at least three-stones overweight made the situation worse.
Identify and discuss at minimum one ethical issue that arises in this case. Use appropriate ethical principles and value or any relevant legal and professional standards to help you identify and address it.
A young mother, who was being treated at a Dublin maternity hospital after the High Court placed an order for her blood transfusion to be administered against her will, was in recovery.
The mother of a Congolese 23-year old suffered significant blood loss after giving birth at the Coombe Women’s Hospital.
But she spoke fluently in French with an interpreter and stated to hospital staff that she did NOT want blood transfusions as she was a Jehovah’s Watch.
The hospital’s doctor, Dr Chris Fitzpatrick rushed to High Court for instructions. At an emergency lunchtime session, Mr Justice Henry Abbott was informed that the woman, Ms K (or simply K), had lost 75-80% of her blood. It was possible she would die in a matter of hours if no transfusion was authorized by the court.
The judge directed that the hospital do all it could in order to save the life the woman. Staff could also restrain her if they tried to stop doctors from administering a lifesaving transfusion to her.
He said that the welfare of the newborn boy, whom he was told was in good health, was paramount. The baby could not be left with anyone in the State to care for its welfare if its mother died.
(Eithne.Donnellan, The Irish Times. 22/09/2006).
Discuss and identify at least one of these ethical issues in this case. Use appropriate ethical principles and value or other relevant duties as required by legal and professional standards.
Answer to Question: NU4027 Nursing Ethics
The nursing profession is the epitome love, care, affection.
It helps people who have lost their lives or are in need of support.
Each nurse must uphold important principles of bioethics in order to care for such patients.
These principles are beneficence and autonomy, dignity, justice, and justice.
However, nurses are often faced with ethical dilemmas as they try to follow the principles.
Sometimes, principles of nonmaleficence and beneficence conflict with autonomy, dignity, and justice.
Nurses in these situations must be able analyze situations critically to understand the requirements and needs of the situation.
The nurses will then need to follow the different codes and conduct all interventions.
It is also important to ensure that nurses have strategies in place that are appropriate for the situation.
Interventions will enable patients to get the best care, while also respecting their autonomy.
Their care should be filled with affection and love, so that patients feel valued and taken care of regardless of their circumstances.
Nurses must also make sure that they maintain dignity and their intervention is in accordance with the principles of justice, beneficence, non-maleficence, as well as maintaining justice.
These cases show the potential problems that can result from an improper amalgamation.
Nursing is known for its compassion, love, care and affection.
Nursing is a profession that focuses on the characteristics of compassion, love, care, affection and attention. A nurse who doesn’t portray these qualities isn’t keeping her word and is not being responsible in her performance of her duties.
The nurse must respect the resident’s autonomy as well as her right of control over her own lives.
One denotes autonomy or patient autonomy. It is the right of patients to make their own decisions and not have healthcare staff influence them (Lindberg, et al. 2014).
This nurse is disrespectful of the nursing profession, and has an inhuman attitude to disabled residents.
The nurse should have explained to the patient that her overweight condition meant that she should eat a balanced diet. Researchers have shown that patient education in a structured manner often has positive effects on patients.
Raab (2014). This situation would have been different had the nurse been more compassionate and shown empathy.
This was also due to her inexperience with the principle of Justice.
Johnstone 2015 states that the principle od justice states that a nurse has a duty to provide treatment and care without discrimination for any patient based on their social gradient, racism, ethnicity or personal bias.
The resident was depressed and lonely as a result.
This could have been interpreted as discrimination and could have caused her to become rude and unmanageable.
Not only must a nurse be emotionally intelligent and compassionate to her patients, but she also needs to encourage social inclusion that makes patients happy and joyful and has a positive impact on their overall health.
Inflicting on a patient food that she doesn’t like was the most ethical behavior. (Dunn and Moore 2016, Dunn and Moore).
Nursing staff should never use a rude or violent approach to making the patient eat.
Additionally, she should have explained to her the reason for giving her boiled salmon due to her weight. Fish chips and fried fish may have been contributing factors to her gaining more calories.
The nurse should have educated her patient well and offered strategies that would have helped her manage her weight.
In such a situation, the nurse should have kept her independence and justice intact and practiced her profession after careful analysis (Grace 2017.
Respecting autonomy of the patient is an important principle of clinical ethics.
Entwistle (2010) states that autonomy refers to allowing patients to make their own decisions regarding the kind of health care they receive.
The ethical dilemma here is to either ignore the wishes of the patient to save her lives or respect her autonomy and not compromise care standards.
The principal ethical dilemma was that the healthcare professionals had to choose between honoring the patient’s autonomy and religious beliefs or compromising their moral duty of providing high quality care in compliance with established standards (Ghua-Tham, 2006).
The case, which is featured in the case study, is one of most difficult and complex cases that have been reported in the renowned daily the Irish Times.
The job of protecting human Rights is often assigned to healthcare professionals. Healthcare professionals are advised that they follow cultural and religious guidelines when treating patients.
The woman in question was a Jehovah-believer.
The bioethics state that the healthcare provider should not plan any interventions that could cause conflict with the patient’s religious beliefs, or demand from their ethnicity.
This case presents an ethical problem because the healthcare professional must both preserve the patient’s cultural ethics and save their life.
In this instance, the healthcare professional has to act in order save the patient’s lives.
This leads to conflict between the principles beneficence and treating the patient in ways that respect her cultural values.
Because her religion does not allow for blood transfusions, this presented an ethical dilemma.
The consent of the patient should be given in this situation, since it is the pillar of patient autonomy.
This creates a dilemma in which the doctor must choose whether to save the patient’s life or maintain their autonomy and dignity (Stuart, 2014).
In this case, it is important to consider the principle of beneficence.
This case was unique and delicate. The court involved made the decision on behalf a doctor and healthcare professionals.
Although the decision was made with consideration for the health and well-being of the baby, it violated human rights by ignoring the right to free speech and human rights. (Makaroff et. al. 2014).
Every nation’s healthcare department must be able to conduct research about serious issues that may arise from conflict between patient life and culture.
These policies and guidelines are vital to ensure that nurses don’t have to face such dilemmas and that they follow them in order to solve any issues that arise in practice (Chadwik, Gallagher 2016).Conclusion:
Healthcare professionals often find themselves in ethical dilemmas that can lead to confusion.
Social, personal, and cultural factors influence nurses.
The healthcare professional still has the same responsibilities, which include the prevention of illness, the elimination of suffering, the promotion and extension of services beyond the individual’s family and to the community.
While it may not be in the patient’s best interests, it is vital that both the nurses and physicians respect the autonomy of each Jehovah- Witness patient.
Friends and families can help find solutions and ways to assist both the patient as well as the healthcare professionals in overcoming ethical dilemmas.References:
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