Ethical Issue
Ethical Issue
Consequentialism and ethical decision making in relation to provision one of the code of ethics
Consequentialism sustains that actions are considered as moral by the ratio of good to evil produce by that action. This implies that moral actions are very much dependent on the consequences considered as nonmoral that arise from those actions. The view of this theory is that people should execute right actions only in terms of good and evil. This is because all people understand good and evil and right and wrong. In consequentialism, a person should always act in a way that yields what is in their best of long-term interests. This is known as ethical egoism. Nurses are not exempted.
Provision 1 ANA code of ethics requires that the nurse observes empathy, high opinion for the intrinsic, worth, distinctiveness of every individual, regardless of social, individual characteristics, financial status, and character of health problem in all practiced relationships (Nursing world. 2010). Through this provision, the nurse is required to observe human dignity respect during practice. The nurse should also ethically handle all relationships to patients and avoid discriminatory practice owing to the form of health problem they are suffering. The nurse is also expected to understand and observe the rights of each patient especially on self determination. During practice, the nurse is called to respect colleagues and patients and all persons who he or she interacts. Nurses are legally bound by the ANA code of ethics provisions, which means that, any violation is legally acknowledged, and the nurse will face the resulting consequences thereof. This paper evaluates consequentialism theory relative to provision 1 of the ANA code of ethics.
Consequentialism is a form of appeal to common sense. This means that consequentialism affect how nurses make decisions. During each interaction with patients, a nurse is expected to observe intense respect (Nursing world. 2010). Respect to patients should not be dependent on any factor but should be exercised naturally. Patients, colleagues, and other people who a nurse interacts with should be dealt with a high opinion. This means that it is unethical for a nurse to discriminate against patients or other people owing to their color, nationality, economic or social status. Common sense requires that the nurse relates with other people in a way that does not compromise her position. For instance, the nurse is looked upon by patients to offer neutral services to them all. It would be unacceptable that a nurse favors some patients more than others by bending the first come first serve rule for outpatients due to relations.
Apart from exercising an action because of it is considered right by self, a nurse is expected to act in consideration of those affected by such an act (Parker, 2007). For instance, prioritizing relations in outpatient practice means that all patients are not happy with the discrimination arising from the action. A nurse acting in such a capacity is said not to act in the happiness and satisfaction of those affected. However, when a patient presented is critically ill, and the nurse prioritizes him or her other unattended patients are happy and satisfied since such an act is moral as it is geared towards saving a life. In weighing right and wrong, patients are bound to understand the act of prioritizing a critical patient, while they criticize acts of prioritizing relatives (Parker, 2007). All patients regardless of their position in the society, their health problems or personal qualities are equally eligible for healthcare services. Respecting all individuals during all professional relationships implies that patients ‘ needs and values are put into account such that the patient receives treatment that guarantees them quick healing and restoration to health.
For the most part of practice, the nurse has to establish relationships with patients (Parker, 2007). Relationships with patients are essential for health care services delivery. During relationship establishment, the nurse must ensure that his or her actions demonstrate respect for human values and needs. Nurses must also ensure that they do not exercise prejudice. For his or her long term interests, a nurse should avoid depending on preconceived judgment towards patients. Each patient is unique, and preconceptions will prevent the nurse from understanding patients’ needs and values effectively. When a patient receives wrong treatment or is misdiagnosed, the nurse is considered as having acted immorally (Parker, 2007). Before the eyes of the majority, the nurse is held responsible for her unethical actions. In order to avoid prejudice, a nurse should consider understanding an individual’s lifestyle, religious beliefs, and value system. Such an understanding plays an important role in planning healthcare for and with each patient.
Consequentialism does not, however, encourage that the nurse agrees with certain choices by patients. For instance, a nurse may be required to terminate a patient’s life to eliminate pain. However, the nurse is expected to respect such a patient as a person. In order to resolve such a situation, the nurse is expected to evaluate the situation consider all possible consequences of a decision. For instance, the nurse should consider factors like the best interest of patient, interest of patient’s family and interest of other patients or staff. In most cases, family does not agree with action of assisted suicide and this result to criminal activity punishable under the law. What such families do no understand is whether or not their patient willingly agreed to or was pressurized to be killed.
Denying euthanasia to a willing patient may be considered as denying a patient the right to self determination or autonomy (Heiskell, 2010, p. 3). According to provision 1.4 of ANA code of ethics, a patient have both moral and legal rights to decide what should become of them. A patient is also eligible to receive precise, inclusive and comprehensible information in a way that allows informed judgment. This implies that prior to the provision of any form of treatment or diagnosis, a nurse should inform the patient what is anticipated of him or her and the cost of each treatment decision they choose. Despite the rights to autonomy and informed consent, a nurse should understand the difficulties associate with practical application of some patient decisions. In such a case, there is little to guide a nurse on the decision of what would result to acceptable consequence. At this point, patient autonomy and informed consent decisions have to be considered from legal and ethical fields before justifying any decision as right or wrong (Heiskell, 2010, p. 3). In addition, the nurse should assist the patient in weighing the burdens, benefits, and alternative options to in their treatment. Alternative treatment options include the choice of no treatment, rejection, refusal, or termination of treatment. When exercising the right to self determination, a nurse must ascertain that he or she is not influenced by deceit, undue influence, coercion or compulsion. In such a case, inviting knowledgeable nurses, families and significant others would be essential in relevant decision making and maintenance of ethical nursing practice.
A nurse should also ensure that patients are aware of their moral and legal rights to autonomy (Heiskell, 2010, p. 3). In order to verify this, nurse should assess a patient’s understanding of information and implications associated with patient’s decision. A nurse should consider involving a surrogate in the case where a patient is not in capacity to make own decisions. For instance, in the case of treatment to a child, a nurse is required to consult with the parent or guardian who would then make the decision as the child. The nurse is not obliged to make decisions on behalf of such an incapacitated patient. In itself, such an action denies the patient the right to autonomy. In support of autonomy, a nurse is expected to understand that culture affects decision making especially in cases where people from a given culture would defer family or society values in health decision making. In adhering to the morality as the good of the majority, a nurse must understand that there are situations where the right to patient autonomy is outweighed by the health, rights, and welfare of others especially the public (Heiskell, 2010, p. 3). For instance, when a patient suffers from a contagious and incurable disease, their right live is outweighed by the welfare of the public. Releasing such a person to the public means dealing with a pandemic. Such decisions must be made by the nurse with the right justification.
For fair treatment of the patient, a nurse is expected to hold compassionate and caring relationships with colleagues and others (Parker, 2007). Such relationships are essential in promoting a work environment that is not prejudicial, or that condones harassment, and disregardful of one’s actions to others. Effective patient treatment is collaborative. In addition, the overall goal of a health institution in the provision of quality service requires collaboration. Nurses must not consider self interests in establishing proper relationships with colleagues. Conversely, a nurse must also think about the consequences of such acts on patients.
References
Heiskell, H., (2010). Ethical decision making for the utilization of technology based patient/family education. Online Journal of nursing informatics. Vol. 14. Iss. 1.
Nursing world, (2010). Code of ethics for nurses. International council of nurses. Retrieved from https://www.icn.ch/about-icn/code-of-ethics-for-nurses/
Parker, F., (2007) Ethics Column: “The Power of One” OJIN: Online Journal of Issues in Nursing. Vol. 13, No. 1.
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