Ethical Legal Dilemma Advanced Practice Nursing Case Study II Norman Ginn Kaplan Ethical and Legal Perspectives MN 506 Tracy Towne Ethical Legal Dilemma Advanced Practice Nursing Case Study II Health insurance policies have set limits on what services will be paid for with a terminally ill person in the home and these limitations may conflict with the nurse’s obligation to provide care for the terminally ill patient (Fry, Veatch & Taylor, 2011). Speaking with the family of a 59 year old male with his only history being terminal lung cancer that has metastasized to the brain, they express concern that they are beginning to have increase difficulty managing this condition. The patient is receiving hospice currently in the home, …show more content…
The Affordable Care Act bans insurance companies from placing lifetime dollar limits on health benefits, which will prevent individuals suffering from chronic diseases from having to worry about going without treatment because of their lifetime limits and it restricts the use of annual limits and bans them completely in 2014 (U. S. Department of Health and Human Services, n.d.). The ethical principle that will be violated here is the respect for person and the concept of deontology. Deontology means that some behaviors are our duty, whether there is benefit or not (Fry, Veatch & Taylor, 2011). The Stanford Encyclopedia of Philosophy (2012), says that deontology is within the moral theories that guide and assess our choices of what we ought to do and what type of person we should be. Again, proper education to the family, prior to discharge of this patient and by the nurses within the hospice agency could have avoided this occurring. Respect for person involves autonomy, but not all individuals are able to acting autonomously. This requires the ability to set goals and make choices, and this may be compromised at times in a person’s life. Defined by the Belmont Report, respect for persons requires that these vulnerable individuals be offered special protections during periods when they cannot act autonomously.
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Ethical issues have always affected the role of the professional nurse. Efforts to enact this standard may cause conflict in health care settings in which the traditional roles of the nurse are delineated within a bureaucratic structure. Nurses have more direct contact with patients than one can even imagine, which plays a huge role in protecting the patients’ rights, and creating ethical issues for the nurses caring for the various patients they are assigned to. In this paper I will discuss some of the ethical and legal issues that nurses are faced with each and every day.
The Affordable Care Act requires that health insurance does not put a lifetime limit on a persons’ coverage. This requirement is for all health insurers even those that offer school- sponsored plans for college students. Before the Affordable Care Act, these school- sponsored plans “commonly limit[ed] benefits on a per condition per lifetime basis." (Burnsed, 2010) This change is important to many people because no one can plan when or if a costly illness falls on them and by getting rid of lifetime caps, the people who do fall victim to server medical conditions will not have worry about coming up with the money to pay for their
#1. According to Nursing Leadership and management ATI ethics is defined as an expected behavior of a certain group in relation to what is considered right or wrong. (Henery, McMichael, Johnson, DiStasi, Ball, & Holman, 2016) There are six ethical principles they are autonomy which is the ability of the client to make personal decisions, even when those decisions might not be in the client’s own best interest. The second principle is beneficence which is care in the best interest of the client. Third is fidelity which is keeping ones promise to the client about care that was offered. The next principle is justice which is fair treatment in matters related to physical and psychological care and use of resources. Then there is non-maleficence which is the nurse’s obligation to avoid causing harm to the client. The last principle is veracity which is the nurse’s duty to tell the truth. (Henery, McMichael, Johnson, DiStasi, Ball, & Holman, 2016)
I enjoyed reading your post on Advanced Practice Nursing Policies. I do agree with you on that “The lack of practice standards across the United States regarding advanced practice nurses have been problematic for decades now”. Today at work I heard doctors talking about how APRN, taking over the primary care in Maryland and is very concerning to the doctors. Doctors were saying that the differences of NP and doctors were the training, clinical experiences, and problem-solving skills. Nurse practitioners luck in depth of understanding diagnosis or make correct judgement of complex medicine. Moreover, after reading some articles I found that “72 percent of Americans adults prefer physicians to nonphysician when it comes to health
Cost of the end of life medical care is too expensive to continue at the rate it is going. The fiscal year 2016 saw 672.1 billion dollars spent on Medicare participants with just 5% using 49% of those monies ("NHE Fact Sheet," n.d., p. 1). The ANA provides a code of ethics that nurses should use to help guide them in clinical practice decision making. There are four fundamental responsibilities for nurses to adhere too they are: promote health, prevent illness, restore health and alleviate suffering. Ethical Principals for nurses are; respect & autonomy, beneficence, justice, veracity, and fidelity ("Code of Ethics for Nurses," 2012). Attempting to keep ethical responsibilities and principals in mind, while conducting a cost-benefit analysis to determine resource allocation for an aging population and end of life care causes many ethical dilemmas.
Judie has been experiencing cut backs at work in regards to the hospitals budget, and these cuts have impacted the quality of patient care. She is feeling conflicted because she feels that she is unable to adequately fulfill her duty of nonmalficence. Budgets are a necessary part of running a successful company or business, however, if these budget cuts negatively impact a nurses ability to deliver adequate patient care than that poses an ethical dilemma for the nurse manager (Judie).
What makes this an ethical dilemma for the nurse, is that the daughter and family are going against the patient’s wishes documented in the patient’s chart and the documented DNR status signed. The decision was clear, his wishes as discussed just prior to him becoming incapacitated.
Nurses face ethical dilemmas each day. Whether its dealing with the patient or family members. A few ethical concerns are the patient right to refuse care, death and dying, and the ability to perform task due to it being a cost-effective issue (Yoder-Wise, 2015). Care may be compromise when the patient refuses which leads to more time spent in the hospital. Death and dying effects everyone because nurses may not be willingly to give proper medications and feel they are the ones killing the patient. Patients who are readmitted within 30 days causes the hospital to lose out on reimbursement through Medicare. This can lead to more cost saving concerns for each unit in the hospital for having enough staff and being careful on how many supplies
Legal and Ethical Issues in Nursing Practice Background As a clinical research nurse coordinator on an alcohol treatment unit, my duties are to coordinate the care of research participant in an alcohol treatment program. As part of the research protocol, the participants are administered a daily morning dose of the anti-craving medication, Nalrexone for one month One morning I was assigned as a research nurse coordinator for one of the participant and I could not locate the physician’s order Naltrexone for the participant. I immediately went to the participant’s research study binder and notice for the past week, nurses assigned to the participant, indicated by their signature that they administered Naltrexone to the participant.
With long-term suffering from a chronic illness, it is natural for any patient to have strong feelings and a coping deficit regarding a chronic condition. In this case study, Ms. S’s feelings are the result of a combination of factors, including pain, discomfort, and immobility. According to Butts and Rich (2013), chronically ill patients often have feelings of depression, anger, and powerlessness.
Beverly, a staff nurse has been exhibiting signs of being impaired on duty. The supervisor observed Beverly consuming alcohol in the locker room and confronts the behavior. This paper will analyze legal and ethical obligations the supervisor faces in this scenario and problem solving techniques for dealing with an impaired nurse.
Circumcision...Is it an issue? Explore the human and ethical issues surrounding circumcision. Is this a medical right or a human rights issue? Why are people so against it...why are some so for it? What is the role of the nurse in relations to an ethical dilemma involving circumcision?
The nurse's relationship with the patient is based on trust. In the Gallup poll for the last 8 years, nurses were selected as the most trustworthy professionals (Jones, 2009), showing that American society on the whole trusts nurses. When a nurse is caring for a terminal patient, the nurse witnesses patient's health growing progressively worse. Under nondisclosure, the nurse must maintain the guise that there is hope for recovery (Krisman-Scott, 2000). The nurse would be unable to acknowledge or help the patient prepare for the impending death. Even if the dying patient may not be able to move toward better health, they still deserve the same opportunity to prepare themselves (financially, personally and spiritually and interpersonal) and their loved ones for their death. The purpose of this paper is to outline some of the ethical issues surrounding nondisclosure in the