Nurses that work in a psychiatric clinical setting deal with ethical dilemmas daily. One of the ethical issues that are common in psychiatric nursing is autonomy. Autonomy is defined as the patients’ rights to make decisions about their own lives and health without interference from the nurse, physician, or other team member that is included in the care. As a nurse this right must be respected.
Characteristics of the Ethical problem An example of autonomy of care from a case study shown is, “Mary was a 25 year old female who sought treatment with an eating disorder specialist for a one year history of what had become daily binging and purging, accompanied by severe weight loss and dangerous medical complications. The psychiatrist made the
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The clinical application is the respect. As a nurse there should be respect for the patient’s autonomy such as the individual’s right to self-determination as well as other choices. While working in a psychiatric unit it can be hard to remember that patients have the right to make their own decisions. “Autonomy is constrained when nurses and other care givers control patients, because they judge patients’ ability to make responsible choices to be limited by psychotic illness/mental health problems Studies emphasize that nurses have an important role in involving patients in decisions regarding their individual needs and desire for autonomy. Studies also report that psychiatric nurses modify their experiences of patient’s ability to make responsible, autonomous choices in order to justify actions that constrain patient’s autonomy.” (Puthran, 2013). Some psychiatric nurses feel that they violate the patient’s autonomy when giving the patient something such as medication when their autonomy is legally controlled. Nurses are also violating the patients’ autonomy when the nurse uses strategies of manipulation towards patients’
Autonomy is the agreement to respect another’s right to self-determine a course of action such as support of independent decision making. The patient self-determination act was passed by the United states in 1990 which stated that competent people could make their wishes known regarding how they what they wanted in the end of life if they were competent or have a power of durable power of attorney who is designated to make decision on their behalf when the individual is no longer competent (American Nurses Association, 2009).
Autonomy includes three primary conditions: (1) liberty (independence from controlling influences), (2) agency (capacity for intentional action), and (3) understanding (through informed consent) (Beauchamp & Childress, 2009, p. 100). According to Beauchamp & Childress (2009) to respect autonomous agents, one must acknowledge their right to hold views, to make choices, and to take actions based on their personal values and beliefs (p. 103). Respect for autonomy implies thaturges caregivers to respect theassist a patient in achieving? Heed? the autonomous choices of their patients. From there, patients can act intentionally and with full understanding when evaluating medical treatment modalities. Autonomy also includes a set of rules, one of which requires that providers honor patient decision-making rights by providing the truth, also known as veracity (Beauchamp & Childress, 2009, p. 103). In this case, several facets of the principle of respecting autonomy, specifically veracity, informed
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
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
In this assignment I will be discussing Adult Nursing and Mental Health Nursing and issues regarding consent. Consent is important within all fields of nursing as it is essential to conduct any medical procedures. The Nursing and Midwifery Council Code of Conduct (NMC,2008) states that all healthcare professionals must presume that all patients have the mental capacity to accept or deny medical treatments after being given all information which may be needed. However there may be some instances where consent cannot be obtained. An example of this is if the patient is in a medical emergency and may be unconscious or if the patient lacks the mental capacity to make a knowledgeable choice. In this situation treatment would be
To begin with the person is the centre of the plan, to be consulted with and their views must always come first: It should include all aspects of their care, and every professional should work together to provide it. (Leathard 2000) Autonomy refers to an individuals’ ability to come to his or her own decisions and requires nurses to respect the choices patients make concerning their own lives (Hendrick 2000).However Gillon Argues that the principle respect for autonomy may need some restriction, otherwise we may be morally obliged to respect an autonomous course of action with unthinkable consequences.( Gillon 1986) Every human being has an intrinsic value, they all have a right to well being, to self-fulfilment and to as much control over their own lives as is consistent with others (British Association of Social Workers 2002).Professional Judgement and patient preference cannot be suspended if practice is to be safe and effective rather than routine(DOH 2005) Alex had to attend this session as it was within his Timetable, how could it have been effective?, he was unhappy and
Those decisions can range anywhere from deciding what you want in your coffee to how you want to die. Beauchamp & Childress (2009) ideas about autonomy can not entirely be applied to those who are mental ill or with deficits. This paper will explain Beauchamp & Childress (2009) ideas about autonomy and how the movie, Awakenings can act as an exemplar of how the principle of autonomy is flawed in mentally ill or patients with deficits. Moral principles such as autonomy, are not easily understood which makes this topic extremely difficult to pick. Being a nursing student we were taught from the very beginning what autonomy was and how important it is to ensure that our patients remain as autonomous as possible.
Decision making and best interests of the patient in the care for people with mental health problems are one of the main concerns in nursing practice. Healthcare professionals should be knowledgeable enough to practice the legal code regarding decision making and protection of the patient with mental health problems (NMC, 2008).
Nursing as health care provider every day facing multiple challenges in decision making to provide a good care, that parallel to ethical competency which reflect nurses critically best ethical behavioral practice (Cannaerts, Gastmans & Casterle, 2014). Furthermore, nursing ethics teaching nowadays appear highly importance, because of many argumentative and debatable issues in clinical practice become a challenge for nurses to make a balance decision with patient care.
Great post, I liked the way that, you have explained autonomy in your post. I think that you have made a great point that nurses are reasonable for their own profession autonomy by maintaining their license, along with, with the continuing their education throughout their practice. Thanks for sharing.
Reyes, J. A. (2016). Nursing Delegation Guidelines for Nurses and Advanced Practice Nurses. Iowa Board Of Nursing Newsletter, 35(3), 1-4.
Nursing is an all encompassing profession in which practitioners are not only proficient in technical medical functionality, they also have the obligation to remain compassionate and respectful of patients and as such are expected to adhere to pre established codes of ethics. Of these ethics, autonomy is of extreme importance as it offers patients a sense of personal authority during a time where they may feel as if their lives, or at the very least their health, is no longer under their control. Autonomy in the context of nursing allocates the patient and often their family with the final word on the course of treatment. The concept of patient autonomy is a highly variable subject in all fields of health care. It is a universal concept that varies widely in its meaning and interpretation. Autonomy in its simplest form can be defined as a state of independence or self governing (Atkins, 2006). Patient autonomy can also be defined as the ability to make once own decisions, based on one’s sound judgment. It is defined by the American Nurses Association (ANA, 2011) as the "agreement to respect another 's right to self determine a course of action; support of independent decision making." This seemingly straight forward ethical concept is rife with difficulties when one considers potential disagreements that may arise even when informed consent is provided, particularly among children or vulnerable people. Relevant research and
Although autonomy is very important, it is significant that the family fully understand all BOOK> To avoid violating autonomy, health care workers must fully understand the involved disease processes, the options available for treatment, and possible outcomes.
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
Autonomy applies to the profession of nursing because the patient should always be allowed to make decisions regarding their care while being treated with respect and dignity; however, autonomy can serve as a limiting agent when the patient decides to refuse care that would be of benefit to them. Autonomy is a sensitive issue because it allows the patient to choose to die and all health care can do from that point is allow the patient to do so comfortably. With healthcare always being one step ahead, it allows a surrogate to serve as a voice piece for that patient when they are unable to make decisions. However, that surrogate can end up making decisions they think is best for the patient ignoring the patients’ will. The responsibility of the nurse and interdisciplinary team is to inform and educate the patient and patient’s surrogate on all aspects of care to include medical diagnosis, treatment, and care plan so that the patient and