When is consent informed?
Consent is a deliberate move by which an individual agrees to allow someone else to carry out an activity. In the past, the absence of consent to medical treatment allowed a client to sue for battery. Currently, informed consent has been acknowledged as a certified standard of conduct and disregard is the basis for liability. According to legal aspects of nursing, regulations concerning informed consent safeguard the client’s right to self-determination (Guido, 2001). A client should be able to communicate an informed choice regarding complaint to or decline to a treatment regime only when adequate information have been offered. The law mandates that a client or his or her guardian be offered with appropriate information concerning several treatment modalities for the consent to be an informed process. Informed consent implies that the client recognizes the motives for the planned intervention, its benefits, its hazards, and approves the treatment by signing the consent. Based on the above descriptions, consent is informed when it has been signed by the client after being provided with enough information on the treatment modalities in the presence of a nurse.
In general, consent is informed when three conditions are met. These conditions are appropriate information, voluntary consent, and competence. As stated above, a client should be provided with appropriate information before the consent form is signed. Through this, the client will be informed on all the risk associated with the treatment together with the risks associated with refusing the treatment. Voluntary consent implies that the client should not be under any pressure or intimidation when agreeing or disagreeing to the terms of a treatment regime. Therefore, nurses are required to verify that the informed consent was obtained before administering their medication. In addition, the client must be competent for the consent to be informed. It is a fact that competent clients provide relevant information concerning treatment, understand the risk of these treatments, and appreciate the steps taken towards these treatment processes. Concerning this, nurses should evaluate whether their patients are competent enough to give consent. This can be done by assessing the client’s ability to communicate choices.
What factors influence the process of informed consent? Do you think Mrs. X’s education level was a factor here?
Several factors influenced the process of informed consent (Cowen & Moorhead, 2006). These factors affect the outcome of the informed consent. Ages of the clients, their educational levels, and their socio-demographic factors have been identified as the major factors. Concerning age, it has been found that aging leads to various physical challenges that may directly or indirectly affect the process of informed consent. As an individual age, hearing and vision are compromised hence affecting his or her ability to make an informed consent. In some instances, it has been realized that older people are prone cognitive impairments. Therefore, their ability to deliver messages that they wish to deliver has been compromised. Equally, older people may have difficulties in speaking clearly or may take more time before responding to a query. Based on the above illustration, it is apparent that age is a major factor that influences the process of informed consent.
Another factor that influences the process of informed consent is the culture of the client. One way or another, culture influences the thoughts, actions, and customs, beliefs of everyone. Concerning informed consent, people are likely to be influenced by the culture during their decision making process. Therefore, nurses should ensure that the language used during the process of informed consent is considerate to the clients’ cultural values.
An additional factor that influences the process of informed consent is the level of education of the client. An educated individual will listen carefully to the nurse’s information, understand the treatment’s repercussions, and make informed decisions in a more appropriate manner compared with uneducated individual. Therefore, nurses should note that the client’s level of education contributes to the quality of their informed consent. With regard to the case study, Mrs. X’s education level was a major factor that affected the quality of her daughter’s informed consent. In the study, it is asserted that Mrs. X’s level of education is fifth grade. If Mrs. X was more learned than she was, she would have agreed with the nurses for her daughter to be provided with appropriate emergency care, intubation, and a ventilator. Instead, she sided with her ill daughter in refusing to be offered with the above services despite her knowing that their daughter was incompetent to make an informed consent at the time of uncertainty.
Should health care providers even attempt to engage in the process of informed consent in emergencies?
In my opinion, health care providers should attempt to engage in the processes of informed consent in some emergency cases. I believe that nurses should try as much as possible to engage in the processes of informed consent when they think that the delay in the treatment process would endanger the lives of their clients. In the same way, if a nurse realizes that the patient is unconscious or incompetent in giving informed consent they should engage in the process of informed consent. Equally, when a client has no guardian or agent to help him or her in the decision processes nurses should play a role. I believe that some emergencies require a health practitioner to intervene in the process of informed consent if the health expert has no doubt that the client would refuse the treatment.
Do you think that the emergency room staff had a stereotyped opinion of Mrs. X’s ability to understand the situation? Explain
Based on the case study, I believe that the emergency room staff had a stereotyped opinion of Mrs. X’s ability to understand the situation. This evidenced from their lack of interest in getting Mrs. X’s to understand the situation. In the case study, we are only told that the health practitioners pleaded with her to accept her daughter to be placed under life supporting machines. We are not informed of their efforts in trying to make Mrs. X’s understand the risk she was exposing her daughter by refusing to be placed under life supporting machine. There are higher chances that Mrs. Y received poor health care services because of the nurses’ prejudices against their ethnic or racial background.
How does this type of thinking impact patient care? How can this attitude be changed?
Stereotypical thinking affects patient care in a number of ways. Researchers have shown that stereotype is the leading cause of reductions in performance expectations among the minority groups in the workplaces (Cowen & Moorhead, 2006). In the health care setting, stereotype thinking against the minority patients makes them look less important compared with the majority patients. Through this perspective, some medical practitioners might consider the minority patient unworthy of good care compared to the majority patients. Such attitudes may lead to favoritism and bad-mannered treatment in the patient care setting. In accordance with the process of making informed consent, health care experts may embrace conscious or unconscious prejudices against a minority group. Through this, the victimized group might be perceived as less educated or less competent to make informed consent on their own. Because negative prejudices against a particular group lower their self-esteem, the affected group might find it hard to communicate freely with the rest of the members in the society. Equally, the stereotype might affect the minority patient’s ability to communicate freely with the health experts and the other patients.
Despite that stereotype held by the majority, members in the society against the minority members are hard to erase, the attitude can be changed in the patient care setting. As such, health care administrators should be in the forefront in fighting this vice by embracing diversity. All health care departments should embrace diversity by involving both the majority and minority members in solving day-to-day tasks. Through this, all the personnel will embrace the differences in their cultures. Other means of fighting the vice in the health care setting are eliciting patient’s values and strengths and recruiting more minority group members in the health sector.
Was the Emergency Room nurse correct in telling Mrs. X that the ventilator was not life support and was being used to keep her daughter comfortable? Explain why or why not?
In my view, the emergency room nurse was correct in telling Mrs. X that the ventilator was not a life support machine but rather a system to keep her daughter comfortable. Ventilator unlike the life support machine helps the patient with breathing difficulties to breath with ease. On the other hand, life support machine is a combinational of numerous therapies aimed at prolonging a patient’s life.
What ethical issues arise in this case? Explain
In the case study, it is of ethical and essential concern that Mrs. X cannot make reasonable choices in this time of uncertainty. Therefore, ethical issues arise on whether the emergency room nurse should carry forward with their plan to putting Ms. Y in a life-supporting machine or abide by the mother’s choices. If the nurses proceed with their plan and complications arise in the future, they may be sued for battery. However, on the other hand if they neglect to put the daughter through a life-supporting machine, she may die and they may be sued for neglect (Lachman, 2006).
If a lawsuit is filed, who would be the defendants and what would be the charges? Explain
If a lawsuit were filed in this case, the defendants would be the emergency room nurses. I believe that the health practitioners together with Mrs. X played a huge role in worsening Ms. Y’s condition. Although the informed consent in this case holds there is a possibility of the nurses would be sued for neglect, since the informed consent may be overridden in emergency circumstances (Guido, 2001). Mrs. X might not be sued because, she is acting in accordance with the informed consent signed prior the treatment.
References
Cowen, P. S., & Moorhead, S. (2006). Current issues in nursing (7th ed.). St. Louis, Mo.: Mosby Elsevier.
Guido, G. W. (2001). Legal issues in nursing. Stamford, Conn.: Appleton & Lange.
Lachman, V. D. (2006). Applied ethics in nursing. New York: Springer Pub. Co..