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10.3:

Nursing Ethical Principles II

JoVE Core
Nursing
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JoVE Core Nursing
Nursing Ethical Principles II

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To understand the application of ethical principles, here is a scenario of a patient diagnosed with early-stage liver cancer. The patient is admitted to the oncology ward for chemotherapy and requests the nurse keep medical information confidential. The nurse explains the patient's rights to privacy and assures them information will remain confidential. By adhering to the principle of fidelity, the nurse does not share the patient's medical information with family members. Next, the patient decides to discontinue chemotherapy due to severe side effects. Respecting the patient's autonomy, the nurse collaborates with the patient and healthcare team to create an alternative treatment plan. The nurse demonstrates beneficence by assisting the patient in making appropriate meal choices to reduce nausea and enhance nutrition.  The nurse demonstrates non-maleficence by adhering to the medication administration rights before administering antiemetics. The patient expresses concerns about treatment expenses and insurance coverage. To facilitate justice, the nurse refers the patient to interdisciplinary professionals such as social workers to identify financial support organizations.

10.3:

Nursing Ethical Principles II

Ethical principles are essential in guiding nurses to fulfill their responsibilities, focusing on the quality of nursing care and decision-making. These principles, including autonomy, beneficence, non-maleficence, justice, and fidelity, shape the ethical framework within healthcare settings.

Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.

Initially, Mr. John's cancer treatment plan included chemotherapy. Exercising his autonomy, Mr. John refused this treatment. The healthcare team respected his decision, emphasizing his right to reject medical interventions, treatments, medications, or surgery, regardless of potential benefits.

Later, Mr. John disclosed his struggles with anorexia and constipation to the charge nurse. Demonstrating autonomy in nursing care, the nurse evaluated the intake and output chart, educated Mr. John on potential dietary modifications, and encouraged him to participate in physical activities. Additionally, demonstrating beneficence, the nurse provided informational handouts focusing on fiber-rich foods to mitigate constipation and enhance overall well-being.

At one point, Mr. John requested a higher dosage of pain medication than medically recommended. Prioritizing non-maleficence, the nurse explained the risks associated with higher doses, such as respiratory depression, and suggested alternative, safer options for managing his pain. This decision underscored the nurse's commitment to delivering care that minimizes risks and ensures medical competence by carefully weighing each action's benefits, risks, and consequences.

Addressing broader concerns, Mr. John expressed apprehensions about treatment expenses and insurance coverage limitations. The nurse, embodying the principle of justice, took proactive steps by coordinating with social workers who could provide resources.

As the narrative unfolded, Mr. John requested that the charge nurse keep his diagnosis confidential during an upcoming visit from his children. Displaying fidelity, the nurse honored this request, emphasizing the importance of remaining faithful to professional promises. In this context, fidelity signifies maintaining confidentiality and delivering competent, safe, efficient, and quality patient care while supporting patient decisions and upholding individual autonomy.

The scenario with Mr. John demonstrates how integrating ethical principles enhances the nurse's role as they navigate complex situations while maintaining a commitment to ethical, patient-centered care.