Ethical Dilemmas and Applying The ANA Code of Ethics

Ethical Dilemmas and Applying The ANA Code of Ethics

First, I will discuss scenario 3. In this scenario, a patient in hospice care wants to communicate with his children from another wife living in another state. However, his current wife, with a challenging personality, advises the hospice staff against this as it will upset him. The questions ask what part(s) of the Code is relevant for the nurses to consider and what the Code requires of the nurse who notices this situation. In my opinion, the nurses should let the patient contact his children regardless of the patient’s current wife’s beliefs. Provision 2, section 2.1 of the ANA Code of Ethics would support this response as it states that the “nurse’s commitment is to the recipient of nursing and healthcare services-the patient- whether the recipient is an individual, a family, a group or a community.” As for ethical theory, a Principlism based on Immanuel Kant’s Moral theory with a focus on beneficence and respect for patient autonomy would also support this response. The principles of beneficence and autonomy note that the care provider has an obligation to act for the benefit of the patient and prevent harm, while respect for autonomy grants the patient the capacity for self-determination, provided they can make rational decisions (Varkey, 2021).

Second, I will discuss situation 7. In this case, a patient’s close friend is now dating the patient, and the nurse has access to private details regarding the patient’s sexual history. The questions asked were about the parts of the Code to consider and the demands of the Code in this situation. In my opinion, regardless of the moral duty to protect her friend from harm with disease, she should also not disclose her patient’s health information, including his sexual health history—provision 3. Section 3.1 of the ANA Code of Ethics would support this response because the provision states that nurses have a duty to safeguard the patient’s right to privacy and confidentiality of all patient information. As for the ethical theory, I think Kant’s Categorical Imperative would support this response because the motivation for the actions the nurses take must respect the moral codes in nursing or the Code and not for personal or external motivates. In this case, the Code requires her to prioritize protecting the privacy and confidentiality of her patient’s information, including not exposing such information to her friend, to avoid a conflict of interest as indicated under Provision 2, section 2.1.

Third, I will discuss scenario 8. In this scenario, a nurse is aware that a physician in her clinic is conducting medical experiments on patients, some of whom have dementia, and does not understand the risks of the experiments. The questions inquire about the appropriate section of the Code to guide the nurse’s response to the scenario and the Code’s demands for the nurse in the specific situation. In my opinion, the nurse should consider the state of dementia patients, report the matter to the relevant authorities, and push for the protection of vulnerable populations in research. Provision 3, section 3.2 of the ANA Code of Ethics would support this response because the provision states that nurses are obligated to protect human research participants. As for ethical theory, I think the vulnerable populations models by Flaskerud and Winslow would also support this response because it defines what are considered vulnerable populations and their susceptibility to harm. In research, populations such as those with dementia are considered vulnerable and need special protection (Gordon, 2020). Therefore, the Code demands that she employs necessary protections for such vulnerable populations to ensure they do not get harmed, including reporting the experiments and reminding the physicians of the values of autonomy and duty to protect patients’ health, safety, and rights.

 References

Gordon, B. G. (2020). Vulnerability in Research: Basic Ethical Concepts and General Approach to Review. The Ochsner Journal, 20(1), 34. https://doi.org/10.31486/TOJ.19.0079

Varkey, B. (2021). Principles of Clinical Ethics and Their Application to Practice. Medical Principles and Practice, 30(1), 17. https://doi.org/10.1159/000509119

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American Nurses Association Code of Ethics Exercise
Assignment Instructions:
1. Read the Code: Read the “American Nurses Association Code of Ethics” online. You can find the Code of Ethics With Interpretive Statements here: https://www.nursingworld.org/practice-policy/nursingexcellence/ethics/code-of-ethics-for-nurses/ When you go to this page, scroll down into the box with the pdf of the document. Read pages iii to v and then read pages 1-37.
2. Analyze three scenarios: Choose three of the situations below to answer. Clearly indicate the number of the problem you choose. Then address the following questions for each scenario you choose: 1)
Briefly summarize the dilemma, 2) Identify the relevant provision and provision section (e.g. “Provision 1, Section 1.1”) that addresses this type of scenario, 3) Explain the proper response to this scenario in light of this section in the Code, 4) What ethical theory reinforces this response (explain your reasoning on this too)?
3. Submit into Dropbox: Your full response to this assignment should be a total of 1.5-2 pages double-spaced. Upload your paper with your response into the Dropbox.
Scenarios: Choose any three below.
1. A nurse notices that another nurse drinks a cocktail at lunch. They return to work. What part(s) of the Code is relevant to considering the nurse’s response to the situation? What do you think the Code requires of the nurse who notices this situation?
2. A patient is quite messy (in need of cleaning) and seemingly aware, but the patient is not able to complain about it because of a disability. Another patient is less bad off (less messy) but quite vocal about it. What part of the Code is relevant to considering the nurse’s response to the patient in this situation? What do you think the Code requires of a nurse who notices this situation?
3. A patient is in Hospice. His wife has a very challenging personality, and his children (from his prior wife) are in another State. The man is trying to contact his children, but his current wife advises Hospice that this contact will only upset him. What part(s) of the Code is relevant to considering the nurse’s response to the situation? What do you think the Code requires of a nurse who notices this situation?
4. A patient makes it clear that she wants to reject further life-support services. She seeks no further discussion. The nurse tells the patient that, “I understand your request. You’re choosing
to die. It’s just a shame, in my opinion, to see someone reject God’s plan in this way.” What part of the Code is relevant to considering the nurse’s interaction with the patient? Do you think the Code supports the nurse’s behavior here?
5. A Registered Nurse (“R.N.”) is told by the doctor to limit the dosage of pain medicine to a patient. The nurse knows this patient personally, though, and he knows that this patient has responded well in the past to a stronger dosage. The patient’s family is also requesting a stronger dosage. When the patient is in extreme agony, and the nurse is unable to reach a doctor quickly, she considers giving more than the prescribed dosage. What part(s) of the Code is relevant to considering the nurse’s response to the situation? What do you think the Code demands of a nurse in this situation?
6. A patient and physician have been talking through some end-of-life options, and the primary nurse who attends to this patient (knowing the patient’s family as well) walks into the room. The patient asks the nurse for her opinion on the moral dilemma. The nurse has her own personal view, but she also knows that her view is different from the physician’s point of view. What part(s) of the Code is relevant to considering the nurse’s response to the situation? What do you think the Code demands of a nurse who notices this situation?
7. A nurse has access to information about the sexual history of a patient, and his close friend is now dating this patient. What part(s) of the Code is relevant to considering the nurse’s response to the situation? What do you think the Code demands of a nurse who notices this situation?
8. A nurse is aware that a physician in her clinic is conducting medical experiments on patients. The nurse is concerned that these patients are particularly unable to understand the risks due to dementia. What part(s) of the Code is relevant to considering the nurse’s response to the situation? What do you think the Code demands of a nurse who notices this situation?
9. When the clinic was overcrowded with patients, an administrative nurse delegated duties to nurse interns that were to be done without supervision. Some mistakes happened. Who is responsible for the mistakes? What part(s) of the Code is relevant to considering the nurse’s response to the situation? What do you think the Code implies about responsibility/accountability in such cases?
10. A nurse is aware of some recently collected data on a patient that would be helpful to the monitoring of a patient. The doctor on duty is not aware that the data exists and thus has not specifically asked for it. The nurse prefers working with another doctor, who will be on later that evening. If she holds onto the data, the doctor on duty will not notice that it was not provided and it seems that the patient is quite stable. Because the nurse dislikes interacting with the doctor on duty, she considers holding onto the data in order to share it with her preferred doctor later that night. What part(s) of the Code is relevant to considering the nurse’s response to the situation? What do you think the Code demands of a nurse who notices this situation?
11. A Nurse Practitioner advised a patient to change her diet and exercise in order to lower her cholesterol. This was after a discussion with the patient, learning that the patient would not be comfortable pursuing medication. The patient then had a heart attack. Supervisors now want the Nurse Practitioner to explain her decision to recommend diet and exercise instead of medication. Does the nurse have an obligation to explain this to others? What part(s) of the Code is relevant to considering the nurse’s response to the situation? What do you think the Code demands of a nurse who is asked to explain her decision to her notices this situation?
Example: Below is a rough example of how someone might answer all four prompts for a scenario. (I’ll pretend there is a scenario 11 so that I’m not answering any of the real problems.) Remember to respond to all four prompts for three of these scenarios!
Your answer can look something like this:
First, I will discuss scenario 11 in the assignment. In this situation, the nurse is being asked to share information about her patient with a spouse but the patient has made it clear that she does not want the spouse to have access to this information. The question asks what the nurse should do. In my opinion, the nurse should not share any information with the spouse – though the nurse is
free to respectfully encourage the patient to do so if the nurse believes this is clearly in the patient’s best interest. Still, it’s really the patient’s decision.
Provision __.___ of the ANA Code of Ethics would support this response because the provision states that nurses have a duty to “………….”. As for ethical theory, I think Kant’s Categorical Imperative would support this response as well because his principle emphasizes respect for individual autonomy – which in this case is the patient’s right to control personal information.
• See how I identified which scenario I’m analyzing.
• See how I briefly summarized the scenario.
• See how I answered the specific question in that scenario.
• See how I identified a specific provision from the ANA Code of Ethics that supports my answer – and I illustrated how it supports my response.
• See how I also identified an ethical theory or principle that supports my response as well – explaining that also?