Nursing ethics Essay

For the purpose of this assignment, ethics in relation to nursing exit be discussed. Ethics A code of principles governing correct behaviour, which in the nursing profession includes behaviour towards uncomplainings and their families, visitorsand colleagues (Oxford Dictionary of Nursing 2004).This assignment will examine shore surrender as identified in a convention placement, but will also look briefly at the ethical principle of non-malefience that is applicable in this assignment. It will also closely look at this issue and will describe how the principles of ethics apply to practice. In accordance with the Nursing and tocology Council (NMC 2004).Any names of patients referred to in this assignment pay back been changed to protect their confidentiality. The NMC states as a registered nurse you must guard against breaches of confidentiality by protecting information from faulty disclo undisputable at all times. The placement referred to in this assignment is an Elderly M entally Infirm (EMI) home, which is located on Merseyside.The United Kingdom Central obstetrics and Health visiting Council (UKCC 2002, clause 6)). Which is now known as The Nursing and Midwifery Council (NMC) Also state that Health C ar Professionals should recognize the respect the uniqueness and dignity of each patient and client, and respond to their need for care irrespective of their ethnic origin, religious beliefs, ain attributes, the nature if their health problems or every new(prenominal) factor.Autonomy (Greek Auto-Nomos nomos meaning law one who move ons oneself his own law) actor freedom from external authority Wikipedia, encyclopedia (2004).On this placement, there were several(prenominal) examples of how liberty influenced care delivery this assignment will address two of these examples. The first incident pick upd an eighty six year old lady called Betty, who suffered with severe dementia, the Practice nurse from her surgery was coming into the home to admini ster the flu injection to her and several other clients. It had been recorded in Bettys eccentric person notes that she had had a fear ofneedles in the past and had refused several injections before her mental health had deteriorated, Does an autonomous decision have to be rational? In the deification of autonomy day to -day decisions should be rational, i.e. consistent with the persons life plans Hope, Savulescu and Hendrick, (2003 p 34).Betty had no living relatives to contact to discuss her sermon. Patients suffering with dementia grassnot eer exercise autonomy. A client may be mentally incapacitated for various reasons. These may be temporary reasons, such as the effect of sedatory medicines, or longer-term reasons such as mental illness. It is important to remember that capacity may fluctuate, abouttimes over short periods, and should therefore be regularly reassessed by the clinical team treating the client. The principles of comply continue to apply to any medication for conditions not related to the mental disorder for which they are being treated. The assessment of their capacity to consent to or refuse such medication therefore remains important.The NMC (2004) recognises that this is a complex issue that has provoked widespread concern. It involves the fundamental principles of patient and client autonomy and consent to treatment, which are set out in common law and statute and underpinned by the Human Rights Act 1998.The principle of respect for autonomy entails pickings into account and giving consideration to the patients views on his or her treatment. Autonomy is not an all or nothing concept, an initial step maintaining Bettys autonomy may be to clarify all the facts in the case, for example does Betty have any understanding of the risks of not having this treatment?Her mental illness means that she is unlikely to be competent to consent or refuse the injection, but an attempt should be made to explain to her, in terms that she could und erstand, what the treatment would involve and what the outcome would be without treatment. Has her autonomy been enhanced as much as is possible? If the conclusion is that she is unable to understand the consequences of non-treatment, or that her fear of needles is stopping her evaluating the risks, therefore she will not be competent to make a decision. However, this does not mean that her fears and concerns should not beacknowledged.Mill (1982) states ..the only purpose for which power can be rightlyfully exercised over any member of a civilised community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant. He cannot rightfully be compelled to do or forbear because it will be better for him to do so, because it will make him happier, because, in the popular opinion of others to do so would be wise, or even right Mill (1982 p 68).The NMC (2004) Code of Professional Conduct 3.3 states that, When obtaining valid cons ent, you must be sure that it is given by a legally competent person, given voluntarily, and informed. Crow (1983) suggests that it is the nurses responsibility to deliver care within the manikin of agreed moral principles, for instance those reflected in the Code itself.The principle of non-malefience should also be considered in Bettys treatment, it would seem to be in her best interests to be treated. If the injection is the proposed treatment, the balance of harms and benefits may be such that treatment would causes distress for a short time not such that her life is intolerable. If the decision is to give the injection, then once again respect for Bettys wishes and concerns should influence the approach to treatment so that her fears are mitigated as much as possible. wholly medication given covertly must, be recorded in Bettys case notes for future reference this shows good nursing practice.According to Wikipedia, Encyclopedia. (2006). Primum non nocere is a Latin phrase tha t means First, do no harm. The phrase is sometimes recorded as primum nil nocereIt is one of the principal precepts all aesculapian and nursing students are being taught in medical school. It reminds a healthcare professional that he or she must consider the possible harm that any intervention office do. It is most often mentioned when debating use of an intervention with an obvious chance of harm but a less certain chance of benefit.Another example of how autonomy influenced care delivery on this placement was, the entire patients case notes where locked away at the nurses station and the accomplished nurse had the key, if anybody needed the notes the trained nurse had to either get them or issue the key, which had to be returned straight away. This involved the principle of autonomy but also the principle of non-malefience. In any situation where confidentiality is breached, the nurse or doctor must be prepared to vindicate his or her decision before the General Medical Counci l.Respect for patient autonomy (deontological theory)The principle of respect for patient autonomy acknowledges the right of a patient to have control over his or her own life, and this would include the right to decide who should have access to his or her personal information. Where the basis for the duty of confidentiality is the principle of respect for autonomy any breach of confidentiality means that the patients autonomy has not been respected, whether or not the patient is aware of the breach. Now due to The Freedom of information act 2000, which came into force in January 2005, patients and carers now have the right to ask to see confidential records.There are exceptions to the confidentially clause and the principles addressed in this assignment. The National Health Service (NHS) Confidentiality, Code of Practice. This provides generic guidance where there is a need to disclose information that identifies an individual and that information is held under a legal obligation o f confidentiality.The issues to be considered and the appropriate stairs to take can be ascertained by working through the model and referenced text refers to appendix one, two, three. A range of information revealing scenarios can be found in NHS Code of Conduct Confidentially (2003). These reference and illustrate the model that can be used to aid decision-making. They cozy up issues relating to particular decisions, e.g. disclosure to NHS managers or to the police. It is hoped that they cover many of the circumstances that staff currently have to deal with (NHS 2003).In 1997, the segment of Health published the Caldicott reputation (On the Review of Patient-Identifiable Information). It considered the flow ofidentifiable patient information and recommended that confidentiality should be safeguarded by anonymising health data, where possible. Each NHS organisation must have a guardian (normally a senior health professional) to oversee all procedures affecting access to person- identifiable information DOH Caldicott report (1997).The NMC code of professional conduct A standard for conduct performance and ethics (2004) requires each registrant to act at all times in such a manner as to justify public trust and confidence. Registrants are personally accountable for their practice and, in the exercise of professional accountability, must work in an open and co-operative manner with patients/clients and their families, protect their independence, and recognise and respect their involvement in the planning and delivery of care.According to Beauchamp and Childress (2001) there are four principles, which are the most widely used good example and offers a broad consideration of medical ethics issues generally, not just for use in a clinical setting. Ethics are also employ to every day living, and that everybody has their own opinion of what is right or wrong, to quote Hinchliff, Norman & Schober (2003) getting in touch with ones personal value base is a crucial first step in the study of nursing ethics.After considering these four Principles, which are general guides that, leave considerable room for judgement in specific cases. Respect for autonomy respecting the decision-making capacities of autonomous persons enabling individuals to make reasoned informed choices. Beneficence this considers the balancing of benefits of treatment against the risks and costs the healthcare professional should act in a way that benefits the patient. Non-maleficence avoiding the causation of harm, the healthcare professional should not harm the patient. All treatment involves some harm, even if minimal, but the harm should not be disproportionate to the benefits of treatment. Justice distributing benefits, risks and costs fairly the notion that patients in similar positions should be treated in a similar manner (Beauchamp and Childress 2001).This assignment claims that ethics are an important part influence in thedelivery of care, but are also a very compl ex battleground, and often leads the Healthcare Professional to examine their own ethical values, it is recommended that a wide range of reading is required to clarify the subject further.After examining the subject further, it is clear that that in the work place a majority of the delivery of care is, planned with the patients before it is put into practice, which try s to ensure that ethical principles are followed. Professional practice and ethics are changing every day, and it is a complex subject it is also debatable how unalike people interpret ethics. Ethics is also about questioning our own and others practice challenging our own and others practice requires courage and vigilance Kenworthy, Snowy, & Gilling (2006).Reflection on ones own and other peoples ethical values is a very useful part of continuing learning throughout both life and life, and as a health care professional we must have a good knowledge of nursing ethics and use this in practice rather than personal op inion. In addition, with such issues as euthanasia and cloning, in the news almost every day the ethical pressures on the nursing and medical profession grows stronger. Nurses are seeking to develop further their knowledge of ethics and are increasing their ability to recognise ethical issues in practice.REFERANCEBeauchamp, T. and Childress, J. (2001). Principles of biomedical ethics.Oxford Oxford University Press.Crow, J (1983).Professional responsibility. Nursing Timesi. 79, 19-21.Department of Health. (1998). Caldicott report. capital of the United Kingdom Department of Health.Department of Health. (2001f). The Essence of Care PatientFocused Benchmarking for Health Care Practitioners. RetrievedSeptember 27, 2006 London www.doh.gov.uk/essanceofcare.htmDepartment of Health. (2003). NHScode of practice confidentiallyi (25 28). London Department of Health.Department of Health. (2001). Seeking consent working witholder people London Department of Health.Hinchliff, S. Norman, S. &Scho ber, J. (2003). Nursing practice and healthcare. London Arnold.Hope, T. Savulescu, J. hendrick, J. (2003). Medical ethics and the law,the core curriculum. Edinburgh Churchill Livingstone.Kenworthy, N. Snowley, G. & Gilling, C. (Eds.). (2006). Common foundation studies in nursing. (3rd ed.). Edinburgh Bailliere Tindall.Martin, E A (Ed.). (2004). Oxford dictionary of nursing. OxfordOxford university press.Mills, J (1982). On liberty. Harmondsworth Penguin.Nursing ethics. (n.d.). Wikipedia, the free encyclopedia. Retrieved October 26, 2006, from Reference.com website http//www.reference.com/browse/wiki/Nursing_ethicsNursing and Midwifery Council (2002) Code of Professional Conduct. London NMC.Nursing and Midwifery council. (2004). bar for conduct, performanceand ethics. London NMC.Payne, R (1992). Accountability in principle and practice. BritishJournal of Nursing. 1, p301-305.Roper, N., Logan, W.L. & Tierney, A.J. (2000). The Roper-Logan-Tierney model of nursing based on activities o f living. Edinburgh Churchill Livingstone.United Kingdom Central Council. (1998). Guidelines for mentalhealth and learning disabilities nursing (12).London UKCC Publications.