Ethical and Legal Problems Faced by Nurse Practitioners
HCA322: Health Care Ethics & Medical Law (BGE1226A)
Instructor: Eugene Elliott
Cara Gerlach
7/23/12
Ethical and Legal Problems Faced by Nurse Practitioners Every medical professional has or will face some ethical and legal issues in the Medical Field, the Nurse Practitioners (NP) are no different. Fant stated that in an ethical dilemma there are no right answers or solutions; however, in these dilemmas there are no wrong answers either. Sule feels that the ethical issues for NPs are in consent and capacity, confidentiality and autonomy, and in the non-compliance on part of patient. Offredy and Townsend both feel that a breech in clinical governance and management can cause
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Sule stated that, “The Patient Bill of Right adopted by American Hospitals Association states that ‘a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law’. However, this is true only if the patient is in position to understand the consequences of his treatment. Incompetent, senile patients neither have the correct judgment regarding which treatment is appropriate for them, nor are they in a state of understanding the implications of their treatment. In such case, their willingness to grant or deny consent cannot dictate the course of treatment.” Problem with the Act is being able to find that the patient component enough to make such a call. Another issue that Sule stated was on confidentiality and autonomy. According to Sule, “This is another ethical issue erupting from the conflict of patient's rights and professional ethics in nursing job and profession. The Patient Bill of Right makes it mandatory for the medical practitioners to reveal the form and extent of the ailment along with the course of treatment to be undertaken by the practitioners. However, this law of autonomy clashes with the nursing ethic that the professional should maintain high degree of confidentiality regarding the patient's health and treatment.” This can cause conflicting issues in the NP’s
Studies have shown that many factors have been contributing to influence patient’s care in an ethical manner. What factors could affects one decision for their medical care? Does it also included the nurse’s individual views or should consider their moral obligations? But what is ethics really is? Based on the book Nursing Ethics by Butts & Rich, “Ethics is a systematic approach to understand, analyze, and distinguish matters of right and wrong, good and bad, and admirable and deplorable as they relate to the well-being”. Ethics should follow the current AMA guidelines.
As a family nurse practitioner (FNP), we have the responsibility to provide the best care we can with the patient’s best interest at heart. On a daily basis we deal with the needs and wants of our patients, this alone provides an ethical dilemma. What we think is best and what our patients want could in fact create an ethical dilemma, however, when we have an ethical dilemma, it is our responsibility to get to a decision with caring, respect, an open mind and honesty to our patients (Parker, 2007). In making a decision regarding an ethical dilemma it is our responsibility to use a framework model to guide us in making an informed decision that is best for our patients. It may not always be the most popular decision but if it is in our patient’s best interest, then you are practicing as a good and prudent, NP.
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.
Upon reflection of the ethical principles affiliated with prescribing for family members, there are clinical, ethical, and legal aspects to consider. According to Thomas et al. (2012), ethical solutions should be integrated and evaluated in all clinical decisions. Nurse practitioners (NP) should refrain from prescribing to self, family, or friends because decisions related to care should be unbiased and fair related to allocation of health resources. This may be difficult under circumstances that involve personal connections. Moreover, there are potential legal and ethical principles that govern practice that may be at risk of when prescribing for family members.
Nurses confront numerous dilemmas throughout their professional lives. The different types of dilemmas include, but are not limited to, ethical, moral, and legal dilemmas. These are the three most common dilemmas in nursing. A dilemma can be defined in many different ways. But all dilemmas are situations in which you have to make a difficult choice. Chiaranai (2011) states that an “ethical dilemma is a circumstance that arises from fundamental conflicts between ethical beliefs, duties, principles and theories” (p. 250). Therefore, an ethical dilemma forces the nurse to address thought on what is right and what the harm might be to the patient.
Nurses are facing many legal or ethical dilemmas in their career. Nurses should combine knowledge of ethical and legal aspects of health care and professional values into nursing practice. It is very essential to know what kind of dilemmas nurses may face during their profession and how they have been dealt with in the past.
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
An ethical dilemma is defined as a mental state when the nurse has to make a choice between the options and choices that he or she has at her disposal. The choice is a crucial task as the opting of the step will subsequently determine the health status of the concerned patient, hence it requires a great deal of wisdom along with proper medical and health training before any such step is opted as it is a matter of life and death. Strong emphasis should therefore be on the acquisition of proper knowledge and skills so that nurses do posses the autonomy to interact with patients regarding ethical issues involved in health care affairs and address them efficiently. It is normally argued that nurses are not provided sufficient
As a professional health care worker, the implication confidentiality breach regarding ethical dilemmas are significant to nurse and patient. The information disclosed can cause problems on a personal and professional level. Breach of confidentiality occurs when the heath care work discloses the patient 's medical or personal information without the patient 's informed written or verbal consent. Confidentiality is needed between the nurse and the patient to maintain a good open and honest relationship between both parties. There are several ethical implications regarding breach of confidentiality, for example,
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
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).
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.
According to the ANA Code of Ethics for Nurse, as stated in Provision 1.4, “Patients have the right to decide what is to be done with and to their own person and part of that right involves the right to have the information and facts necessary to make an intelligent and enlightened decision regarding health care decision making. Patients have the right to assistance in weighing the benefits and risks of treatment or the refusal of treatment without any inflection of the morals, values,
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.
Professional nurses encounter a variety of legal ethical and bioethical issues on a daily basis. For this reason, it is essential that all nurses are aware of current state and national legislation, acts and guidelines and the implications of these for nursing practices as well as legal processes, principles of open disclosure and the role of a coroner in the health sector. In this way, nurses can adhere to the overarching guidelines for practice as well as working within the code of conduct, competency standards and scope of practice. This paper will provide an overview of legal and ethical parameters of professional nursing practice.