Ethical and Legal Issues in Nursing

Ethical and Legal Issues in NursingINTRODUCTIONEthical and Legal Issues in Nursing are applicable for any nurse, from enlightened to expert. They are oftentimes diged as the abidely part of nursing. This assignment w adversity discover estimable and legal implication of the nurse who disguises the selective information of the lethal ill tolerant at the request of his family. The family does not want the nurse to notify the patient astir(predicate) the lethal spirit of his disease. The family also propensitys that the nurse should not secernate the patient about the medications prescribed to him.Johnstone (2011, p 21) says that nursing headmaster is very uncertain. The nurse is al manners in dilemma whether she should cooperate with the family or not. Now the questions that arises here is that if the nurse does not disclose the truth to the patient and so what would be the legal implications. Moreover, the nurse is uncertain whether she would go after the hankeringes o f the family or not. In the chase discussion, I will look at the ethical principles and legal implications of hiding information from the patient and administering morphine without his information or approval.PALLIATIVE CARE fit to WHO, alleviant superintend is defined as an approach that helps in improving the quality of life of the patients and their families facing the problem associated with life-threatening disease. Patients need a palliative get by to support their long and slow treatment procedure Tang, (2006, p. 360). It is focused on providing comfort and relief from the pain and the other distressing symptoms of a sedate illness. It integrates the psychological and spiritual aspects of patient forethought. It offers a support system that helps patients to be lively as much as possible until death. It also provides a hearty support to the family to compete up with the patient illness and also includes bereavement support for the family.Palliative care uses a team ap proach to cover the ask of the patients and their families. It is a team based effort of care giving and it is also responsible for initiating the concept of dedicated palliative care development team. The team includes atomic number 101, nurse, rub down therapists, nutritionists and pharmacists. A number of checkup professionals from different fields of medical exam sciences are constantly working on developing and designing new mea veritables to provide the outmatch palliative care to the patients who are ache from serious illness. All the principles of the palliative care must be applied from the time of diagnosis. Palliative care is often associated with terminal diseases like Cancer and AIDS solely now the concept has been changed. in that location are various palliative regimes which are applicable for other diseases, much(prenominal)(prenominal) as cardiac or renal disease, so as to help the patient to cope with the suffering (Johnson et al. 2011). Sometimes, a term Long term care is used to describe the palliative care.ETHICAL PRINCIPLES(Hodkinson 2008) state thatThe therapeutic nature of this nursepatient relationship is a central concept in nursing. The around important issues related to this bond are disclosure of truth, kindness and communication. The patients who are suffering from terminal illness generally prefer to hear the truth but they wish it to listen to it in a receptive way (Maria, Ann Anna 2011).Autonomy The main principle of autonomy is that the patient should have adequate information about his condition so as to make a signifi foundationt choice of treatment (Moulton King 2010). The nurse should properly converse with the patient and make sure that the patient is well aware of all available treatment options (Johnstone 2011). (Collis 2006) suggested that before disclosing the information to family members it is must to seek the patients consent. It expresses the respect for their autonomy. The nurse should consider patie nts autonomy before administering morphine.(Starzomski 2009) noted,Patients and families from diverse communities have different beliefs about autonomy and may not envision disclosure of information in the same way as their wellness care providers. In these cases this is an area that needs to be care proficienty explored with patients to ensure their wishes are respected and they are include in the information process in the way that they wish to be. In this scenario nurse should communicate with the family members in enounce to convince and find out their favored way to disclose the diagnosis and prognosis of disease.Beneficence- The principal of beneficence as a do good describes applications of interventions that are carried out by nurse and atomic number 101 for the benefit of patient .It also include the protection of pay of health service consumer (Staunton Chiarella 2008). Health professional should treat the person autonomously and prevent him/her from harm and care provider should also aware of legal implication of action taken(Ulysse, Balicas Yiquing 2011). Telling truth is not harmful for patient it will cause the peaceful death(OSullivan 2009). The health professional should motivate the family introducing them the benefit of therapeutic discloser and harmful effects of concealing information e.g. administer medication without consent.Justice -Justice described as treat everyone evenly and fairly. It is a primary phenomena in resolving ethical dilemmas .It required to be supplemented by providing good care to health service user (Botes 2000).In order to apply justice health professionals provide care evenly to all the patients in hospital not patient and family.Non maleficience This principle is based on the phenomena of does no harm for example in health care when privacy hard to maintain for research or study purpose then health professional ensure that they do not disclose the patients personal details .This principal helps in preven t the occurrence and possibilities of harm. Nurse should access the jeopardy of interventions that she /he is doing.(Ford Reutter 1990) .It also refrain the nurse from the intentional commission of a wrongful act.(Carlson et al. 2010)In many communities for instance Muslim and Indian cultures diseases are perceive as a family matter. Decision making is also family centered so withholding truth is not rare practice. Therefore beneficence and non-malfeasance play vital role in their moral values as compare to patient right to consent in western countries (Pentheny et al ,2011).It is also encouraged that in case of a dilemma a professional should seek help from their regulatory body or councils which can guide them towards a legally and ethically rightful path Hui, (2010, p.76).LEGAL AND ETHICAL IMPLICATIONSEthics and legal implications are very closely related with each other. Ethics deal with the standards of conduct and ethical judgement whereas legal issues deal with nursing pra ctise which includes licensing, nurse practice acts and standards of care (Chaloner 2007).According to Criminal Code (Palliative Care) Amendment Bill 2003,Section 282A does not speech communication consent. The administration of medical treatment including palliative care is already governed by a legal regime. If a person has capacity to decide their medical care the patient will consent to their medical treatment. Unauthorised administration of medical treatment would be assault.AMA Queensland emphasize that health professionals should respect the autonomy terminally ill patients in order to refusal and acceptance of their medical treatments.Ethical and legal implications in palliative care are very significant because it is an end head treatment where majority of patient are moving towards an impending death. It is a legal right of every Australian citizen to have complete and correct information about their medical berth. Because of this entitlement professionals delivering pa lliative care and family members of the patient involves in legal and ethical dilemma. Where they are not sure which course of action would be seize in both ethical as well as legal manner. Due to these legal issues and emotional disturbances families of the patient and patient itself undergo a draw play of stress and psychological trauma. It is also agreed by many experts of palliative care that increased stress would also impact the ability of the patient to cope with the trauma Oonagh (2009, p.123).In this case study patient is facing an impending death from cancer and terminal diagnosis of cancer which will brings her life to the end. This force in deteriorating in her physical health and she may ask question about her situation and prognosis of the disease. With an adult patient it is relatively important to register the concept of death and disease and they can take a realistic approach towards it by spending their remaining time in a full-bodied manner saying good bye to dear ones and taking care of all formalities before meeting a demises. (ACMA 2011). It is very complicated to produce the information opposite to relatives desires (Cavanna et al ,2009)In this scenario, the wishes of the family to hide information from the patient is not unusual.Ethically it looks wrong for a health care practitioner to lie to the patients regarding her medical situation and not inform her about her forthcoming death. There might be things which she wants to do before dying if she would have been informed. There is also legal implication with the fact that a patient is being treated without her consent and it is also violation of the law which throw offs a patient right to refusal for treatment on her body. For example many patients want to sign DNR (Do Not Resuscitate) forms to ensure that no attempts should be made to revive them if they are close to death. In this case study patient is being denied of this right as well Hanson (2002). If by family here it is implied that her legal guardian wishes to keep this information hidden from the patient, then according to Giacalone (2007, p.368) the nurse is not legally bound to honour their desires to do so would run counter to the law etc.Prima Facie it is a cod case of violation of constitutional rights of a patient if nursing professional does not inform the patient about her medical condition and learn her desire and judgment in designing and developing her future treatment and palliative care plan. According to Australian constitutional law the patient have the archetypal right on information regarding his medical condition and it is on his discretion that with whom this information should be shared. If a patient expressively states that he doesnt wish to share his medical information with his family then it is legal obligation of hospital and medical professional to maintain the wish of the patient. Law handbook Victoria recognizes some other law governing certain aspect of hospital ca re and ethical issue. This law is known as fasten patient confidentiality law this state that medical practitioner doctor, nurse or a paramedical personnel cannot divulge information about his patient to a non related person or a person without patients medical attorney until and unless directed by the court of law. . This regulation ensures that dignity and privacy of the patient is maintained and there is no legal or ethical negligence from the doctor in the entire transaction Vickers, (2004, p.232).SOLUTIONS AND BEING ETHICALLY RIGHTIn the past years, the physicians were very antipathetical to tell the truth to their patients regarding their existing health conditions. On the other hand, in these times the patients do want their physicians to tell them the truth about the diagnosis and the medical therapies. According a survey conducted almost three decades ago, it has been cleared that 97% of the physicians felt that it is correct to tell the truth to the patients regarding a ll the relevant aspects of their illness which includes the nature of the illness and its expected outcomes. Sometimes it is seen that there is psychological impact on the patients mindset and its really hard for them to cope with such a stressful situation (Kendall 2006). In such a situation, palliative care specialists can be proved quite helpful as they can provide resources to help the patient and his family deal with emotions that come with a serious illness. They may provide counseling, organize family meeting or make referrals to mental health professionals if needed (Bush Bruni 2008). However, if the conditions are presented in an undignified manner then it is possible that it may create a negative picture of the situation in the patients mind and in that case it is obvious that the sufferings and stress of the patient would increase instead of decreasing and the patient may lose the hope to live (Li et al. 2008). Tuckett suggests that it is necessary to understand the ment al state of the patient before passing on the entire information to him. The final decision is made by the doctor and his medical team regarding the disclosure of the truth to the patient after analyzing all his mental status (2012). Even the court of law has approved this argument that if the doctor and his medical team prove with an evidence that the information would have a devastating effect on the patient then they have a full power to hide the information from the patient or they reveal the truth to the patient when they believe it is appropriate time to tell Seymour (2004, p. 165). On the other hand, it may be possible that the patient does not want to listen to the information regarding his health but in such a situation it is the duty of the physician to provide the basic information to the patient (council 2004).IMPACT ON NURSING PRACTICEWhen the medical practitioners communicate with the patients, being honest is a fundamental way to develop trust and respect for the pati ent. Patients show a great deal of trust in their physician and they may feel deceived if they discover that there is insufficiency of honesty by the physician. But, sometimes a situation arises when the physician thinks that disclosure would create a harmful effect on the patient and it may be validated to hold back the truthful information in that case. (Robinson January-February) explains that sometimes holding back the truthful information from patient may lead to quality of regret in the health care providers. It can also be one of the main reasons of moral distress on them. (Goethals, Gastmans de Casterl 2010) state that many a times the moral distress may lead to less involvement of nurse in his work. It can also cause some kinds of health problems which may eventually leads to resignation from job. Ulysses et al (2011) asserts that in health practise the therapeutic nondisclosure may lead to frustration which in turn affects the practitioners certificate of indebtedness towards his patient and his family.CONCLUSIONMany types of complex situations are often faced by several nurses throughout their professional life. Some professionals consider such types of suffering more badly than death. It is totally unfair to withhold the truth from the patient about his existing health conditions, especially when the patient is capable enough to give the consent about various medications and procedures. According to the constitution of Australia, it is not at all acceptable to claim the life of a person for any medical reason and direct any medications without his consent. This case study has proved very beneficial in developing a very in depth appreciation of the various medical laws and legal problems which are faced by the health professionals. It should be the duty of every medical professional that in any situation he should not break any of the legal obligations. It also provides detailed information about the various significant steps that should be tak en to handle these types of ethical dilemmas.