Ethical Issues in Nursing

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INTRODUCTION
The ethical dimensions of code of professional conduct elevate various issues regarding the patients’ autonomy and informed consent in clinical nursing and midwifery practice. This essay is an overview of the patient’s right to accept or decline their treatment as a part of patients’ autonomy in self-decision making. Some issue that faced by the health professionals in refusal of treatment are highlighted. The discussion part deeply argue about the compromised autonomy of patients and the ethical dilemmas that confront by health professionals in safeguarding wishes of patients in that situations. The nursing and midwifery council (NMC) in the United Kingdom (U.K) has introduced new code of conduct, which is mainly to ensure the health and wellbeing for the public. This code of conduct, which came in to effect on 1st of may 2008, has been praised by Dr. Peter Carter, who is the Chief Executive & General Secretary of Royal college of Nursing (RCN), as “this code is perfectly fit to meet the ever changing requirements of today’s nurses and midwives” (RCN 2008). Besides, Cowan (2009) says that this is a legal binding document, which gives a special right to patients to accept or decline their treatment. Moreover, this law helps the patients’ to have some depth information about their illness and treatment options, and helps them to clear their usual doubts such as why this treatment? Or how this treatment is related to another? (Cowan, 2009). Though in words it sounds uncomplicated, as ever with the law, devil is in detail (Miola 2009). As it has been shown in the picture 1, there will be number of issues faced by health professionals in ensuring the patients autonomy in their treatment. The main reason for that, health professionals are obliged to do what is good for the patients’ on the other hand patients’ have got a right to refuse the treatment. As we know, the freedom to exert one’s rights may be restricted by the rights of others. Let us have a brief look at the situations where the autonomy of patients’ is getting collide with the professional duty of care and advocacy role of nurses and other health professionals while ensuring the rights of patients.

The principle of patient autonomy dominates the contemporary debate over medical ethics. In healthcare perspective the main reason for concern with autonomy is to guarantee that all clients or patience are being treated as human beings and their rights are protected and promoted. Being respected as human being means, nothing is being done against their will or wishes and getting every opportunity to make decisions about their treatment (Scott, et al., 2003). On the whole, adequate information should be given by health professionals to patients to decide whether or not to accept or decline treatment and care. Failing to inform all necessary information will result in an allegation of battery or civil assault and further legal actions. The NMC code (2008) strictly says that “Make the care of people your first concern, treating them as individuals and respecting their dignity”. According to Tomkin and Hanafin (1995) respect for the autonomy of patients can be expressed as ‘consent’. Put it in other way informed consent can be viewed as an agreement between both doctor and patient as a part of their mutual decision making (Johnstone, 1989).

Booth (2002) explains that Health professional should not make any decisions about their treatment until and unless they obtaining an informed consent from the competent patients’. In order to obtain a valid consent from patient, health care professionals should make sure that all necessary information about the diseases, which includes the diagnosis, treatment options, consequences that may happen due to the treatment etc.., have given to the patient in a sensitive and understandable way. The patient should avail sufficient time to think about the information and health professionals should not hesitate...
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