Introduction
This paper examines an ethical and legal dilemma in a nurse practitioner’s decision-making regarding honesty versus withholding information. Ethical principles, laws that may have been violated, integrity decisions, distinctions between legal and ethical reasoning, and advice for resolving moral discomfort in a dilemma among advanced nursing practitioners are all part of this situation. An ethical and legal quandary confronts nurses when determining what information to share and with whom. The malpractice case involved patient John, who has a history of malignancies and it is investigated in this case study. John is a regular visitor to an emergency clinic. Because of the dangers, the patient’s health state continued to deteriorate. When he found out later about his condition, he decided against receiving the treatment the emergency center gave. Even though they were aware of his ability to decide independently, the hospital still pressured him to take the drug even though they knew they should not. The specific dilemma at stake, in this case, was honesty.
Violation Constituting a Civil or Criminal Act
An ethical principle violated in this dilemma is beneficence, which involves a patient’s well-being and preventing harm from being done to them by medical personnel, including nurses. This demonstrates the patient’s right to autonomy, which must be respected. John’s nurses did not consider the patient’s benefit, so the hospital still pressured him to take the drug even though they knew they should not. By sharing her diagnosis and prognosis with John, the patient may be able to accomplish the remaining tasks in her life and spend quality time with her family, including her two children. In addition, becoming aware of her deteriorating health could have provided her with some much-needed relief and reduced her anxiety. The beneficence principle was thus breached by withholding diagnosis and prognosis information against the family’s will.
Patient Self-determination Act (PSDA) violation constitutes a civil offense punishable by law because the law mandates compliance. It ensures that patients’ rights to self-determination are safeguarded and communicated. Adult patients have the right to accept or reject treatment and full authority over their medical lives and key decisions. The nurses failed to consider John’s competence and the fact that he was in charge of her health care, rather than her family when making essential choices. Due to their failure to communicate with her family about her health state, the nurses violated the patient’s right to informed consent and were found in contempt of court for their actions
Relevant Codes of Conduct that Apply to the Practice of Nursing
A nurse’s code of ethics mandates that all communications with patients and their families, whether in writing or verbally, must be truthful and non-deceptive. When dealing with patients and their loved ones, healthcare professionals should never lie, cheat, or mislead. Nurses may find themselves in a situation where they must decide how to act ethically, professionally, morally, and legally to avoid moral discomfort. It is mandatory, for example, for healthcare workers to demonstrate a complete dedication to enhancing the physiological, emotional, and psychological well-being of their patients. Although it is against the ethical norm of honesty and integrity, withholding information from a patient after a diagnosis of a terminal illness can help promote psychological well-being by minimizing stress.
First, the autonomy code of ethics forbids doctors from pressuring their patients into participating in hospital-sponsored philanthropic projects. This means that requesting money directly from the patient is unethical since it places excessive pressure on them to join a program they may not have desired to participate in, which is unethical. Second, HIPAA’s current provisions on patient confidentiality will guide the solution to the problem, which is the privacy code. Medical records cannot be shared with specific groups without the patient’s permission under the new law (Johnstone, 2019). Consequently, the non-maleficence code ensures patient and community safety in all healthcare delivery aspects. Suicidal or homicidal thoughts, for example, should be brought to the attention of a nurse’s supervisor if they arise in a patient’s care. In this scenario, requesting intervention may be against best practice codes, but it allows the health facility to serve one of its most popular patients. The position presents an ethical and moral issue since any doctor wants to help their patient. The nurse administrator must choose between her ethics and the medical code of behavior.
A Decision that Demonstrates Integrity
The ethical dilemma that the nurse faces, which may include disclosing prognosis information to patients nearing the end of their lives, should be brought to the forefront. This ensures that patients are given accurate information, with the nurse’s discretion being used to determine how the information will affect the patient (Davis & Davis, 2017). In this scenario, the medical staff may have discussed the problem with John’s family members and given them guidance regarding the significance of revealing the information to John. If John had known that he would not be able to recover and that he was about to pass away, he might have found it easier to say his final goodbyes to his family. The nurses had the option of telling him the truth, which would have provided him with additional choices and maybe extended the number of days he could live.
The recommendation that resolves the Moral Distress Dilemma
When providing medical care, nurses should demonstrate integrity by being aware of the importance of a competent patient during medical care the roles of family members, and the boundaries of their participation. They also need to have a firm grasp not only on the importance of a mentally capable patient but also on the part that family members play and the boundaries of that role. Nurses should prevent the violation of ethical principles by getting involved in employee assistance programs to assist registered nurses in highly personal, sophisticated, and sensitive problems, such as those requiring legal action. Employee assistance programs are designed to support nurses dealing with susceptible, complicated, and confidential situations, such as those that require legal action.
Lastly, to prevent violation of the law, there should be a comprehensive education from the nurses, and the healthcare providers should take the lead in providing a comprehensive explanation of the risks and benefits of the treatment. In addition, a multidisciplinary care group should be responsible for ensuring the patient’s preferences are considered at all times. Therefore, nurses should be given as much assistance as possible in shared decision-making to reduce the moral anguish they experience during the process.
Conclusion
Professionals must make decisions based not only on their knowledge of the situation but also on their belief in what is morally proper. To have legally significant consent, patients must be able to make their judgments about their self-governance. It is because of this that patients are afforded a legal right to either accept or reject therapy. Ethics in nursing practice include autonomy, privacy, and non-maleficence. Patients nearing the end of their life should be made aware of the nurse’s ethical issue, which may entail revealing prognostic information.
References
Black, B. (2019). Professional nursing e-book: Concepts & challenges. Elsevier Health Sciences.
Davis, A. J., & Davis, A. J. (2017). Ethical dilemmas and nursing practice. Stamford, Conn: Appleton & Lange.
Johnstone, M. J. (2019). Bioethics: A nursing perspective. Elsevier Health Sciences.
Long, A. (2018). Interaction for practice in community nursing. Houndmills, Basingstoke: Macmillan.