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.
