Ethical Framework

Confidentiality is a concept of vast importance for professionals in the medical field. It is a professional obligation in this field and is considered to be an ethical concept that falls in line with integrity, compassion, veracity, charity, and fidelity as explained in both the International Council of Nurses Code for Nurses (1973) and the American Nurses Association Code of Ethics (1985). However, in today’s ever growing world of technology and demand for information, challenges continue to arise that force doctors and nurses to reexamine virtues such as confidentiality.

The topic of ethics is prevalent in health care and addresses a broad range of topics in nursing. In almost every interaction with a patient there could be a situation that may bring up the question of ethics. Fortunately, there is the realization that placing the nurse in the care of a patient, may put the medical personnel in an environment where the ethics are questioned. There are whole departments dedicated to advising nurses in these situations. There are also ethic committees to help guide you when you find yourself in a situation that may question your practice or circumstances.

Nurses rely on personal knowledge and their professional skills to provide ethical care (Creasia & Friberg, 2011). In everyday practice, nurses must balance the needs of their patients against those of the organization, society and themselves. They strive to deliver the highest level of care for patients, but adjusting for limited organizational and personal resources often requires difficult decisions. This paper explores the following scenario suggested by Maville and Huerta: “You are a nurse providing home care to a mother, and you suspect child abuse after observing the mother’s reaction to her child” (as cited by Arizona State University, 2014). When faced with a moral dilemma, a competent nurse incorporates ethical, bioethical and legal considerations. In the proposed story, incorporating the nursing ethics of advocacy, beneficence, nonmaleficence and collaboration will guide the nurse towards an appropriate and legal course of action.

Today many nurses, doctors, and other health care professionals encounter ethical dilemmas on a daily basis. An ethical dilemma can be defined as when there is more than one reasonable solution to a specific scenario. No one solution is more right than the other. In fact, they may both feel wrong, but a decision must be made (Butts & Rich, 2016). In the healthcare setting, nurses should be prepared to think critically and make ethical decisions. There are many factors that contribute to the process of ethical decision making such as ethical perspectives, principles, theories, and guidelines. Ethical decision making is to be rational and systematic. The selected case to be discussed is the case of Jahi McMath,

Confidentiality is critical for nursing professional to understand and undertake. If a nurse did not keep a

Nurses are faced with ethical dilemmas on a daily basis, each situation being unique and requiring the nurse to set aside their own values and beliefs in order to properly care for their patients. Situations requiring nurses to make an ethical decision are diverse and dynamic; the values set out by the College of Nurses of Ontario code of ethics remains the same. Therefore, all decision based on these vales regardless of the setting and circumstances ensure consistent solutions. The scenario involves a woman who was admitted to the NICU due to complications during her sixth month of pregnancy. The patient indicated that no extraordinary measures should be made to save her baby; she became further detached when the baby developed a bleed

Healthcare professionals have an ethical obligation to respect patient’s wishes. Consequently, many legal and ethical dilemmas arise in healthcare in response to clinical decisions related to the needs, beliefs, and preferences of patients and families. Other dilemmas result over concerns about the integrity, competence, or actions of other healthcare professionals. Preserving human dignity, relieving suffering, equality, integrity, and accountability are essential nursing values (Kangasniemi, Pakkanen, & Korhonen, 2015). Nurse leaders have an

Concepts of reasonable limits refers to limiting one’s actions or in reference to nursing, limiting what one can say or do in terms of a patient’s care (Jonstone & Fry, 2002). When discussing reasonable limits, a nurse has to take into consideration at what point is enough, enough. For example, in the case study regarding Mrs. Z, reasonable limit would prevent the nurse from pushing the patient further into pursuing treatment and disclosing her medical prognosis to her family. Mrs. Z is a lucid individual, so the nurse and doctor caring for her would have to limit their interference in disclosing information to her husband due to reasonable limits. In nursing, there are times when breaking a patient’s confidentiality becomes an ethical issue. If the nurse was thinking in terms of Utilitarianism, breaching confidentiality would be the only reasonable thing to do. For example, if a patient who is HIV positive is knowingly having unprotected sex in order to infect other people, it would only be right to break the confidentiality of their diagnosis to prevent further harm to other individuals in the future. Sometimes, in order to protect the greatest amount of people, confidentiality has to be broken. Another example where a healthcare individual can break confidentiality is if a minor is being harmed and the minor does not want to disclose to anyone their situation. For

moral positions of key individuals involved and identify value conflicts, if any, determine who should make the decision. Identify range of actions with anticipated

Truth-telling is an important issue within the nurse-patient relationship. Nurses make decisions on a daily basis regarding what information to tell patients. The specific issue in question is whether a nurse should abide by the Code of Ethics for Nurses by revealing the truth to the patient or refrain from telling the truth to the patient because they are respecting the wishes of the patient’s family. Nurses and health care professionals should always tell the truth to their patients unless the patient forgoes their rights to autonomy or cannot think for themselves. By providing the patient with the truth, they allow the patient to come to terms with their conditions and give them the options for further treatment.

As healthcare providers, maintaining a patient’s confidentiality, human dignity and privacy is expected at all times. Nurses are faced with maintaining patient confidentiality on a daily basis. The Coded of Ethics for Nurses is the framework of nonnegotiable ethical standards and obligations that all nurses are to uphold. Nurses are to be accountable for their actions and are expected to advocate and strive to protect the rights, health and safety of patients (American Nurses Association, 2011).

Nurses are constantly challenged by changes which occur in their practice environment and are under the influence of internal or external factors. Due to the increased complexity of the health system, nowadays nurses are faced with ethical and legal decisions and often come across dilemmas regarding patient care. From this perspective a good question to be raised would be whether or not nurses have the necessary background, knowledge and skills to make appropriate legal and ethical decisions. Even though most nursing programs cover the ethical and moral issues in health care, it is questionable if new nurses have the depth of knowledge and understanding of these issues and apply them in their practice

With the utilization of the Act-utilitarianism mindset, an alternative plan of action to focus on the circumstances surrounding Andrea and the community at large can be established using Uustals ethical decision making model. The nine steps identified by Uustal can allow the nursing process to be applied in an effort to guide the nurse in practicing proper judgment. The quandary involves community, personal and patient dilemmas. While many nurses strive for adhesion to values of patient autonomy and keeping ones word, the very nature of health care can raise cause for nurses to contradict and deviate from their own ethical stand points, all in an effort to do the right thing. Due to Andrea’s development of cervical cancer, nurse Hathaway was right in disclosing the minor’s disease to her parents. Adolescents usually are covered by their family’s insurance, but they may not have coverage for unaccompanied care, and they may

Ethical issues in nursing will always be an ongoing learning process. Nurses are taught in nursing school what should be done and how. Scenarios are given on tests with one right answer. However, there are situations that nurses may encounter that may have multiple answers and it is hard to choose one. “Ethical directives are not always clearly evident and people sometimes disagree about what is right and wrong” (Butts & Rich, 2016). When an ethical decision is made by a nurse, there must be a logical justification and not just emotions.

Nurses are subject to a plethora of legal, ethical, and professional duties which can be very challenging on a day to day basis. Some of these duties include respecting a patient 's confidentiality and autonomy, and to recognize the duty of care that is owed to all patients. As nurses our duties are always professional; however there are legal implications if these duties are breached. We also must consider when it is okay as nurses to breach these duties and therefore ethical issues arise. As nurses one of our main priorities is to advocate for our patients, without our own personal feelings on the matter taking over.