Ethical Nursing Essay

Ethical Nursing Essay

Ethical Nursing

Nurses deal with ethical issues and dilemma in their practice due to a host of issues, values, principles, and norms that govern the profession. The American Nurses’ Association’s Code of Ethics sets goals and values for the nursing profession and guides nurses when making decisions in their daily practice (Bilmes, 2020). The association reviews this code regularly to reflect the myriad challenges that nurses encounter and presents a social contract between the professionals and the public. The purpose of this paper is to address a host of ethical issues that nurses face in care provision and their effects on optimal care delivery.

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Struggles When Addressing End-of-Life Issues

The goal of end-of-life care for patients is to prevent and relieve suffering where possible while respecting their desires and values based on the principles of autonomy, beneficence, and non-maleficence. Because the decisions may affect patient’s family members and even society, healthcare workers should protect the rights, dignity, and vigor of all stakeholders involved in the shared clinical ethical decision-making process (Akdeniz et al., 2021).Advances in modern medicine and medical technologies continue to prolong life expectancies and have altered the natural norms of death. While these treatments and technologies may not offer a cure for chronic condition, interventions like artificial nutrition and respiratory support prolong the lives of individuals by offering secondary support (Akdeniz et al., 2021). As such, providers must create a balance as they contemplate end-of-life issues in a society that is increasingly becoming permissive and valuing personal autonomy as opposed to communal expectations on death based on existing practices, norms and perspectives about the issue.

Differences between Allowing a Patient to Die and Physician-Assisted Suicide

The debate on aiding patients to die with the aim of relieving them from natural pain and agony, and the need to let them face death naturally raises a host of ethical concerns and issues that impact effective decision-making. Individuals are expected to die a natural death (Goligher et al., 2018). However, situations like terminal and chronic illnesses create significant pain for individuals and the need to be helped which erode their perceived human dignity and autonomy.

Allowing patients to die means that the physician withdraws all life-sustaining support like respiratory support and artificial nutrition. Such a decision borders on euthanasia or mercy killing. However, due to the agony and pain that patients may endure before dying, others and their families may have advance directives that they get physician-assisted suicide. Therefore, the primary differences between allowing a patient to die and physician-assisted suicide are the former happens based on the concept of euthanasia or mercy killing(Mehta et al., 2019). In many cases, individuals with chronic or terminal conditions may have advanced directives that mandate aspects like “Not to resuscitate,” or “no life support” and “No artificial nutrition.” Based on these principles, the providers are compelled to allow the patient to die by withdrawing any life-saving or sustaining intervention.

Conversely, physician-assisted-suicide is a process where a patient and their family knowingly signs consent for the physician to help them to have a peaceful death. This entail offering someone strong sedatives to use to end their life or allowing them to die in places where assisted suicide is legal to end their life (Goligher et al., 2018). Therefore, allowing a patient to die and physician-assisted-suicide are different based on the procedures and legal frameworks as more jurisdictions accept euthanasia but not physician-assisted-suicide.

Potential Controversy on HIV/AIDS Disclosure

HIV/AIDS disclosures are a controversial ethical issue that patients, their caregivers, and even providers like physicians face in their daily practice. Certain states have in-depth disclosure laws at different practice levels that mandate providers or caregivers to disclose such information to potentially significant ones like partners (HIV.gov., 2021). Patient health information remains a preserve of an individual based on the principle of autonomy and the inherent right to personal information, privacy, and confidentiality. Individuals can only disclose such information by their informed consent but should not be compelled under any circumstance based on ethical provisions in nursing.

A controversy can occur when a patient’s right to know if a caregiver has AIDS and the caregiver’s right to privacy and confidentiality since existing statutes on HIV status of infected individuals are confidential. In this case, a patient may deserve the right to information, including knowledge on the AIDS status of their caregiver. However, that right is not protected by many statutes on HIV unless the caregiver intentionally infects the individual with the disease in the caregiving process. The right to privacy and confidentiality of the information may override the patient’s right to information on the caregiver’s AIDS status (Mehta et al., 2019). Conversely, the patient can sue a caregiver who risks his chances of getting the disease in such situations.

Distinctions among Wrongful Birth, Wrongful Life, and Wrongful Conception and Their Moral Dilemmas

The concepts of wrongful conception, wrongful birth, and wrongful life are related but very distinct in their definition and what they cover. Wrongful birth occurs when parents seek legal damage for a child born with birth deformities or shortcomings. These damages are based on the cost of raising an unexpected deformed child (Frati et al., 2017). The parents, especially the mother, brings the claim against a physician or a laboratory that negligently failed to inform them, in a prompt manner, of the higher probability that the mother will give birth to such a child leading to preclusion of an informed decision on whether to have the child.

Wrongful life, closely related to wrongful birth, is an action claim where the child or in some instances, the parents seek damaged founded on harm suffered due to being born rather than not being born. In this instance, the child seeks damages from either or the physician for endurance a life that is not worth living or existing (Frati et al., 2017). The implication is that the physician or laboratory failed to inform the parents of the risk of having a genetically defective infant and, therefore, prevent their right to avoid birth. On its part, wrongful conception is a damages claim sustained by parent of an unexpected child founded on evidence that conception of the child was a result of negligent sterilization processes or a defective contraceptive device or procedure.

These concepts raise critical ethical and moral dilemma for providers based on societal positions against the advancement of technology in healthcare and medical practice. The critical moral dilemmas about these concepts is the right to life, existing provisions on physicians’ decision-making abilities against parents’ desire for procreation or reproductive health. The issue of birth control and contraceptive devices remains a controversial with religious and cultural practices against them and even abortion. Again, the issue of abortion divides society into two distinct groups; the prolife and prochoice where the former is against while the latter group believes that women have the right to determine if to give birth or terminate the pregnancy based on socioeconomic and cultural issues.

Partial Birth Abortions

Partial birth abortions denote to an abortion procedure where a substantial part of a living child is delivered then killed by crushing its skull or removing its brain by suction. The main argument for partial-birth abortion (PBA) is that it allows the woman the right to choose to have the child or not. The implication is that a prochoice argument like in the ordinary abortion issue persists under this procedure. However, contrary position is categorical that PBA is more than an abortion but borders on killing of an innocent child and soul who is already formed and ready for delivery (Bilmes, 2020). In this instance, PBA leads to emotional and familial loss as a child is dismembered due to existing laws that support such practices. Healthcare providers only offer information about the procedures.

Controversy on Genetic Markers and Stem Cell Research

Genetic markers and stem cell research raise controversy because of the ethical perspectives concerning these scientific efforts to help humanity deal with chronic conditions and enhance the quality of life. Ethical issues about genetic markers include the possible use of genetic information to discriminate against individuals with higher risks for certain disorders (Ginoza & Isasi, 2019). Issues of privacy about one’s genetic information also raises controversy since such data should not be used to their disadvantage. Cloning is highly controversial as creating humans through the process is unethical, and illegal as it may lead to lethal consequences or cause severe health issues like pandemics resulting from infectious diseases.

Prenatal screening for genetic abnormalities and stem cell research raises concerns about the possibility of selecting traits that have aesthetic values that include physical appearance and intelligence (Munsie & Gyngell, 2018). Therefore, these issues raise fundamental ethical controversy about their morality and possible misuse to create individuals that may have certain characteristics and negate the natural order of things and creation.

Conclusion

Healthcare workers (HCWs) face a host of ethical issues that implore them to follow set guidelines by professional bodies like the ANA and regulatory frameworks through existing laws and statutes when making decisions. However, advanced medical and health technology is creating better diagnostic and treatment interventions, equipment, and processes that raise fundamental ethical concerns and issues of healthcare providers. These issues impact healthcare practitioners’ decision-making abilities leading to controversies. The paper demonstrate that HCWs should follow ethical guidelines and legal structures when dealing with such issue in their practice environment.

References

Akdeniz, M., Yardımcı, B., & Kavukcu, E. (2021). Ethical considerations at the end-of-life care.

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Bilmes, J. (2020). The discussion of abortion in US political debates: A study in occasioned

semantics. Discourse Studies, 22(3), 291-318. https://doi.org/10.1177/1461445620906026

Frati, P., Fineschi, V., Di Sanzo, M., La Russa, R., Scopetti, M., Severi, F. M., & Turillazzi, E.

(2017). Preimplantation and prenatal diagnosis, wrongful birth and wrongful life: a global view of bioethical and legal controversies. Human reproduction update, 23(3), 338-357. https://doi.org/10.1093/humupd/dmx002

Ginoza, M. E., & Isasi, R. (2019). Regulating preimplantation genetic testing across the world: a

comparison of international policy and ethical perspectives. Cold Spring Harbor perspectives in medicine, a036681. https://doi.org/10.1101/cshperspect.a036681.

Goligher, E. C., Ely, E. W., Sulmasy, D. P., Bakker, J., Raphael, J., Volandes, A. E., … &

Downar, J. (2017). Physician-Assisted Suicide and Euthanasia in the Intensive Care Unit: A Dialogue on Core Ethical Issues. Critical care medicine, 45(2), 149. https://doi.org/10.1097/CCM.0000000000001818

HIV.gov. (2021). HIV Disclosure Policies and Procedures.

https://www.hiv.gov/hiv-basics/living-well-with-hiv/your-legal-rights/limits-on-confidentiality

Karosaite, M. (2017). Wrongful Birth and Wrongful Conception: Is There a Right to

Compensation. Teises Apzvalga L. Rev., 15, 4. DOI: http://dx.doi.org/10.7220/2029-4239.15.1

Mehta, S. R., Schairer, C., & Little, S. (2019). Ethical issues in HIV phylogenetics and molecular

epidemiology. Current Opinion in HIV and AIDS, 14(3), 221.

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Munsie, M., & Gyngell, C. (2018). Ethical issues in genetic modification and why application

matters. Current opinion in genetics & development, 52, 7-12.

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For this week assignment, write a 1500-word essay addressing each of the following points/questions.

Describe why there is such a struggle when addressing end-of-life issues
What are the differences between allowing a patient to die and physician-assisted suicide?
Discuss the controversy that can occur when considering a patient’s right to know whether a caregiver has AIDS and the caregiver’s right to privacy and confidentiality.
Describe the distinctions among wrongful birth, wrongful life, and wrongful conception. Discuss the moral dilemmas of these concepts
Discuss the arguments for and against partial birth abortions
Discuss why there is controversy over genetic markers and stem cell research

Please combine all of these responses into a single Microsoft Word document for submission. Submit only completed assignments (not partial or “draft” assignments). Be thorough in your responses to adequately address all aspects of each question.