The Nurse’s Role in Upholding Patient Wishes: Analyzing Ethical Dilemmas

QUESTION

The nurse is often a moral spectator observing decisions made by others and dealing with the patient’s response to those decisions. Analyze an article about a situation where a decision by a physician, insurance company, government agency or health institution adversely affected a patient or countermanded a patient’s wishes.

1. Review the 2022 ANA Code of Ethics for Nurses with Interpretive Statements: https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/coe-view-only/

2. Using APA format, write a three-page paper to address:

• The nurse’s role in supporting the patient’s wishes and risks involved.
• The social and economic consequences of reversing this decision.
• Guidance from the ANA Code of Ethics that sheds light on this situation.
• The lessons to be learned for similar future situations.
• The moral conflict that impacts the nurse.

3. Include a reference page with at least five (5) references, the first of which is the citation for the article selected and another is the 2022 edition of the American Nurses Association Code of Ethics for Nurses with Interpretive Statements.

ANSWER

The Nurse’s Role in Upholding Patient Wishes: Analyzing Ethical Dilemmas

Introduction

In healthcare, nurses often witness situations where decisions made by physicians, insurance companies, government agencies, or health institutions can adversely affect patients or countermand their wishes. This essay analyzes an article discussing such a situation and explores the nurse’s role in supporting patient wishes, the risks involved, social and economic consequences, guidance from the ANA Code of Ethics, lessons learned, and the moral conflict that impacts nurses.

The Nurse’s Role in Supporting Patient Wishes and Risks Involved

Nurses play a vital role in advocating for patient autonomy and ensuring their wishes are respected. This includes effectively communicating patient preferences, ensuring informed consent, and collaborating with the healthcare team to uphold patient autonomy. However, in situations where decisions countermand patient wishes, nurses may face ethical dilemmas and potential risks, including:

Moral Distress: Nurses may experience moral distress when they witness decisions that go against their professional values and the best interests of their patients. This can cause emotional anguish and conflicts between personal beliefs and professional obligations.

Communication Challenges: Navigating communication barriers between patients, healthcare providers, and decision-making entities can be challenging. Nurses must advocate for effective communication to ensure patients’ voices are heard and their wishes are properly considered.

Social and Economic Consequences of Reversing Patient Decisions

Reversing patient decisions can have significant social and economic consequences, impacting the individual, their families, and the broader healthcare system. Some potential consequences include:

Psychological Distress: Reversing patient decisions can lead to emotional distress, loss of trust in the healthcare system, and a negative impact on the patient’s overall well-being.

Financial Burden: Adverse decisions may result in increased healthcare costs, potential legal battles, and financial strain for the patient and their family.

Guidance from the ANA Code of Ethics

The 2022 ANA Code of Ethics for Nurses with Interpretive Statements provides valuable guidance for nurses facing ethical dilemmas related to patient wishes. Key principles include:

Provision 1: The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person. This provision emphasizes the nurse’s obligation to treat patients with respect, support their autonomy, and advocate for their preferences.

Provision 2: The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population. This provision highlights the nurse’s responsibility to prioritize patient needs, including honoring their wishes and providing patient-centered care.

Lessons Learned for Similar Future Situations

From the analyzed article and ethical dilemmas, several lessons emerge for handling similar situations:

Strengthening Communication: Effective communication is crucial in ensuring patients’ wishes are respected. Nurses can enhance communication channels, advocate for patients’ voices to be heard, and engage in shared decision-making processes.

Ethical Decision-Making: Nurses should engage in ethical decision-making frameworks, such as ethical committees or consultations, to address complex situations and find the best possible resolution while upholding patient autonomy.

Moral Conflict Impacting the Nurse

Ethical dilemmas and decisions countermanding patient wishes can create moral conflicts for nurses. They may experience emotional distress, questioning their professional obligations, and struggling to find a balance between advocating for patients and adhering to institutional policies. Nurses need support systems, self-reflection, and ongoing education to navigate these moral conflicts while upholding ethical standards.

Conclusion

The nurse’s role in supporting patient wishes is crucial in upholding autonomy and providing patient-centered care. Ethical dilemmas and decisions countermanding patient wishes pose risks to patients and can have social and economic consequences. The ANA Code of Ethics provides valuable guidance for nurses in addressing these situations. By strengthening communication, engaging in ethical decision-making, and advocating for patients’ preferences, nurses can navigate moral conflicts and provide compassionate care. Continued reflection, education, and support systems are necessary to navigate ethical challenges and ensure patient-centered care in future situations.