An Ethical Dilemma in Nurse-Patient Relationship

Putting the Health Interests of Patients First

While executing their duties, medical practitioners are always faced with a challenge of putting the health interests of the patients first or acting as the clients may propose. In such a scenario, a physician would be changed with a dilemma of discharging his/her roles as guided by the medical profession’s code of ethics or fulfilling the community members’ interests. As demonstrated in this paper, some of the critical factors that a nurse has to put into perspective while seeking the most appropriate way of handling an ethical situation include; making untimely decisions while under pressure, accommodation clinical incompetence, and enhancing exclusion during the decision-making process.

Accommodating Clinically Defined Incompetence

In some cases, health officers may be forced to accommodate the views of the respective patient’s relatives even though any health standards may not justify such opinions. The family members usually feel that they have a right of taking part in the decision-making process as a matter of ensuring the health interests of one of their own are upheld (St-Amant et al., 2012). Therefore, the medical practitioners are obligated to initiate a legal dialogue within the family setting to give each member a chance to air out his/her opinion.

Making Untimely Decisions Under System Pressures

While handling any medical case, the health officers are also required to make timely decisions that would be deemed as feasible (St-Amant et al., 2012). For example, in a scenario whereby the clinician would have to decide on whether an individual should be enrolled in a home care system, the primary factor that should be considered is the potential of the institution to accommodate the patient. However, the clinician has the right to use his/her powers to ensure that his/her opinions are upheld while determining whether a client should be admitted to a home care system or not.

Reinforcing Exclusion in Decision Making

Even though the patient’s family members may have the right to discuss whether he/she - the client - should be enrolled in a home care institution or not, the doctor may decide to exclude them from the decision-making process. St-Amant and her colleagues suggest that community members are autonomous and unconnected to each other, which implies that a respective individual is the only one who has the potential to make decisions that pertain to his/her health status (St-Amant et al., 2012).

The Decision Making Process and the Outcome

My decision on whether Walter should Walter should be placed in a community care access centre (CCAC) was based on my interactions with him and the observations I made on his home as well. Just like his daughter and the family physician have noted, it is true that Walter has been living in deplorable conditions that pose a significant risk to his health welfare. However, as a nurse, I am mandated to advocate for the upholding of the patient’s rights, which implies that my decision should be aimed at making sure that the health status of the client improves (Erdil & Korkmaz, 2009). Callister, Luthy, Thompson, and Memmott point out that ethical nursing is embedded on the essence of acting in the right manner that promotes the interests of the patients (Callister, Luthy, Thompson & Memmott, 2009). Although Walter seems to be suffering from a delusional disorder, I noted that he was clear-headed and he was also aware of his health status. It would also be important to note that the genesis of some of his behaviours - for instance, living in an untidy house - could be the frustrations he has encountered in life key among them being his wife’s death. Therefore, I am convinced that he should be allowed to live in his home as he points out. Nevertheless, he should be put under the watch of a professional caregiver who will be responsible for cleaning the house and offering him some companionship. Additionally, I will also be paying him some visits now and then to assess whether his welfare and living conditions would be improving, which would be used as the basis of determining whether he should be enrolled in a community care access centre in the future.

References

Callister, L.C., Luthy, K.E., Thompson, P., & Memmott, J. (2009). Ethical reasoning in baccalaureate nursing students. Nursing Ethics, 16(4), 499-510.

Erdil, F., & korkmaz, F. (2009). Ethical problems observed by student nurses. Nursing Ethics, 16(5), 589-598.

St-Amant, O., Ward-Griffin, C., deForge, R.T., Oudshoorn, A., McWilliam, C., Forbes, D., Kloseck, M., & Hall, J. (2012). Making care decisions in home-based dementia care: Why context matters. Canadian Journal on Aging, 31(4), 423-434.