Introduction
The integrity of the nursing profession depends on ethics since it helps to provide better patient care. Given the increased number of new nurses joining the field, many need more experience to handle ethical dilemmas in nursing (Guido, 2020). If nurses do not adequately deal with ethical issues, the result could be a decline in patient care, tense clinical relationships, and moral distress. Hospital executives must work together to ensure that all appropriate and ethical decisions are made with their patient’s best interests in mind while respecting their wishes.
Legal Issues and Ethical Concepts
New issues arise in nursing every day, and nurse managers all over the country face similar moral conundrums. Nursing is a fast-paced profession, and protecting patients’ rights, having enough staff, making informed decisions, and providing high-quality patient care are at the heart of many circumstances. Therefore, the following legal issues and ethical concepts can be considered crucial to the issue at hand.
Informed Consent
Informed consent, which derives from the patient’s right to control what happens to their body, is both an ethical and legal requirement of medical professionals in the US. During the informed consent process, patients are given all the information they need to decide whether to participate in a medical procedure or treatment plan.
For nurses, informed consent occasionally raises ethical issues. Patients are more likely to adhere to a treatment plan and have better results if they feel supported and trust their doctors and nurses. By adhering to informed consent, nurses can build trust and support with their patients and help ensure the best possible outcomes for their health.
To avoid the patient feeling coerced into deciding with the provider, the provider must make it apparent that the patient is involved in the decision-making process. The service provider must give a suggestion and explain why it is a good idea. Nurses must respect patient autonomy while upholding their patients’ rights and acting in their best interests.
Patient Privacy
When a trustworthy environment is established and patient privacy is respected, the patient is more likely to seek treatment and be as open and honest as possible during a medical visit. Patient confidentiality protects the patient’s reputation and builds trust with healthcare providers. Simply put, this allows doctors not to be afraid that a person will withhold information and choose the wrong treatment.
Patient information has other significant uses in addition to direct care. As it makes it possible for health services to run effectively and securely, several of these indirectly relate to patient care. Other applications, such as disclosures for public protection purposes, are not directly connected to healthcare delivery but serve broader public interests. Compared to a single nurse-patient interaction, it will probably take more work to protect patient information in a complex health and social care environment.
The doctor-patient relationship depends on trust, and confidentiality is a vital component of that. Certain patients believe clinicians will expose their personal information without their agreement or the opportunity to have some control over the timing or amount of announcement. According to the General Medical Council, such patients may decide not to seek medical attention or underreport symptoms (2018). This underlines that patient confidentiality and privacy concerns are serious ethical dilemmas for nurses.
Shared Decision-Making
Shared patient decision-making (SDM) is the process by which healthcare providers work with patients to make decisions about their care. This process involves discussing treatment options and exchanging information about each option’s advantages, drawbacks, and potential results. By engaging in shared decision-making, patients can make informed decisions about their care, leading to better outcomes. This is because patients can choose the medical interventions and care that are most appropriate for their needs and preferences at the time. Shared decision-making also helps empower patients and respect their autonomy, an essential ethical principle in healthcare.
When patients and healthcare professionals collaborate to make the best decision feasible for a patient’s treatment, this practice enhances patient autonomy. With a relationship, nurses and other healthcare providers can get patients to comply and communicate effectively (Van Nistelrooij et al., 2017). Patients are more likely to be satisfied with their care and have more faith in the doctor’s treatment recommendations when they actively participate in decision-making.
Even though the information shared with patients can be complex, patient education is crucial for SDM. Ultimately, delivering safe and effective care depends on the correct exchange of information. Patients need access to pertinent, accurate, and current information to participate in the process.
Advanced Care Planning
ACP is an ongoing process that helps patients, families, and healthcare providers understand and communicate patients’ beliefs, aspirations, and choices for future medical care, palliative care, and care setting. It aims to strengthen the relationship between the patient and healthcare providers by establishing a direct relationship of trust. People can become familiar with the ACP and actively participate in their treatment process.
ACP is recurrent and usually occurs over an extended period in an ongoing patient-family-healthcare professional connection. Healthcare providers can find it challenging to discuss advanced care planning. Throughout ACP, patients will investigate, discuss, and record their healthcare preferences (Poveda-Moral, 2021). They can define their beliefs and goals about possible medical care through this approach.
Policy Proposal
A hypothetical policy proposal to address these legal and ethical issues could include four measures. These measures would ensure nurses can effectively communicate with patients and involve them in their care. This policy aims to respect patients’ wishes and ensure they receive the care they want.
Due to the importance of informed consent, shared decision-making, and advanced care planning, nurses should be trained to effectively communicate with patients about proposed medical treatments or procedures, including explaining the benefits, risks, and alternatives. They should also be trained to involve patients in their care and decision-making, including shared decision-making processes and advanced care planning.
Moreover, healthcare institutions should establish systems for tracking and documenting when informed consent, shared decision-making, and advanced care planning occur. This could include using electronic medical records to document these processes and checklists or other tools to ensure that all necessary steps have been completed.
Healthcare institutions should develop protocols for protecting patient privacy, including requiring that patient information only be shared with those who have a legitimate need to know. This could include establishing secure systems for storing and accessing patient information and training staff on protecting patient privacy.
Nurses should be encouraged to advocate for their patients and to speak up if they see any issues with informed consent, shared decision-making, or advanced care planning. This could include speaking with patients and their families about their concerns and working with healthcare institutions to address any issues or challenges that may arise.
Advocating the Policy Proposals into Practice
To incorporate this policy proposal into practice, nurses could work with healthcare institutions to implement the measures outlined in the proposal. They could also advocate for adopting the policy proposal at the state or national level by working with nursing organizations or engaging in advocacy efforts with lawmakers. Nurses could also raise awareness about the importance of these legal and ethical issues by educating patients and their families about their rights and the benefits of informed consent, shared decision-making, and advanced care planning.
Conclusion
For nurses, dealing with ethical dilemmas is a challenging task. Nurses are frequently questioned about medical procedures and how to handle moral conundrums. They must continually make these choices on the spot as well. They can learn how to handle these situations through patient interaction and years of expertise. Ensuring that patients’ rights are respected and upheld is essential for the nursing practice. This includes ensuring patients can make informed decisions about their care, protect their privacy, and consider their wishes in their care planning. To effectively support these concepts, healthcare providers, including nurses, need training, protocols, and patient cooperation.
References
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Guido, G. W. (2020). Legal and ethical issues in nursing (7th ed.) Pearson.
Hirakawa, Y., Aita, K., Nishikawa, M., Arai, H., & Miura, H. (2022). Tips for Managing Ethical Challenges in Advance Care Planning: A Qualitative Analysis of Japanese Practical Textbooks for Clinicians. International Journal of Environmental Research and Public Health, 19(8). Web.
Noroozi, M., Zahedi, L., Bathaei, F. S., & Salari, P. (2018). Challenges of confidentiality in clinical settings: Compilation of an ethical guideline. Iranian Journal of Public Health, 47(6), 875–883. Web.
Poveda‐Moral, S., Falcó‐Pegueroles, A., Ballesteros‐Silva, M. P., & Bosch‐Alcaraz, A. (2021). Barriers to advance care planning implementation in health care: An umbrella review with implications for evidence‐based practice. Worldviews on Evidence-Based Nursing, 18(5), 254–263. Web.
Pozgar, G. D. (2020). Legal and ethical issues for health professionals (5th ed.) Jones and Bartlett.
Shah, P., Thornton, I., Turrin, D., & Hipskind, J. E. (2020). Informed Consent. PubMed; StatPearls Publishing. Web.
Van Nistelrooij, I., Visse, M., Spekkink, A., & de Lange, J. (2017). How shared is shared decision-making? A care-ethical view on the role of partner and family. Journal of Medical Ethics, 43(9), 637–644. Web.