Ethical nursing care implies that patients’ autonomy in making decisions regarding their health and interventions is respected. I agree that it does not mean that a practitioner should get rid of all their personal values and beliefs and blindly accept whatever patients say and want. However, a care provider should not impose anything on patients. It is pivotal to be sensitive to their needs and interests and remain open.
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Autonomy was and remains one of the fundamental ethical principles in the nursing practice. Nevertheless, ethical dilemmas associated with coercion and paternalism are frequent in healthcare. For example, coercive interventions are often implemented in mental health care, especially when patients engage in self-harm (Hem, Molewijk, & Pedersen, 2014). However, even in the case when practitioners’ forced measures evidently aim to benefit patients, coercion is a detrimental practice since it threatens the autonomy of patients (Hem, Molewijk, & Pedersen, 2014). Moreover, it hides the risk of practitioners’ biased perceptions of what is good and bad for their patients.
On the contrary, recognition of individuals’ autonomy is linked to multiple benefits. When patients are allowed to make health-related choices in harmony with their values and personality traits, it contributes to their psychological well-being. An example of a patient with dementia who wishes to live at home illustrates this perfectly. According to Smebye, Kirkevold, and Engedal (2016), when a person with this health condition is given a chance to construct their life according to personal preferences and identity, it obtains more value and meaning. However, while practitioners should strive to benefit patients, they still have to pay attention to the abilities of the latter to execute their choices and warn them about potential detrimental consequences of each decision. Overall, an individual approach to every ethical dilemma, along with a proper balance between patient autonomy and nurses’ soft paternalism, is required.
Hem, M. H., Molewijk, B., & Pedersen, R. (2014). Ethical challenges in connection with the use of coercion: A focus group study of health care personnel in mental health care. BMC Medical Ethics, 15, 82.
Smebye, K. L., Kirkevold, M., & Engedal, K. (2016). Ethical dilemmas concerning autonomy when persons with dementia wish to live at home: A qualitative, hermeneutic study. BMC Health Services Research, 16, 21.