Navigating Ethical Challenges in Modern Nursing Practice- Current Issues and Solutions
Introduction
Healthcare professionals can obtain informed consent through different methods. It is, however, essential to be aware of the practical realities associated with informed consent to improve legal and ethical standards. Informed consent preserves and maintains respect for participants’ dignity and autonomy and protects research subjects from potential harm and risks (Moeini et al., 2019). There are, however, persistent debates on how informed consent should be obtained and whether it is necessary. The failure to agree on this results in ethical tension. Nurses must thus be aware of the importance of informed consent in the healthcare delivery industry. They must be committed to adhering to their Codes of Ethics, which prescribes the importance of patient autonomy in providing quality healthcare services.
Article Summary
Moeini et al. (2019) conducted a study to determine the ethical challenges healthcare professionals face when obtaining informed consent from surgical patients. The study was a descriptive cross-sectional study that used a checklist and two questionnaires for collecting data. The study participants were 298. Ninety-five of them were nurses, while 203 of them were patients. The study settings were surgical wards of three university hospitals in Iran. Data analysis was done using descriptive statistics and a t-test.
The study researchers sought ethical approval from the Institutional Review Board. The study revealed that the mean authority, awareness, and competency scores were 67.7, 36.3, and 57.6 (Moeini et al., 2019). The overall quality of informed consent had a poor mean score of 53.9 out of 100 (Moeini et al., 2019). Patients with higher educational status were associated with less authority and lower awareness of giving informed consent. Among the nurses in the study, only 12.6% revealed that patients were given enough information to ensure they gave informed consent (Moeini et al., 2019). The risk of medical interventions was mentioned in 89.2% of informed consent forms. Still, alternative treatment benefits and risks of rejecting the intervention were not mentioned in any of the informed consent forms (Moeini et al., 2019). The study concluded that the ethical challenges associated with obtaining informed consent included the failure to provide the necessary information to patients, poor awareness of patients of their rights, and failure to consider the patients’ education levels. Additional challenges included unclear structure on which healthcare professionals should obtain informed consent from patients, use of medical jargon, ambiguous language, and time constraints (Moeini et al., 2019). The study recommended developing an ethical framework to guide nurses when dealing with ethical challenges associated with obtaining informed consent.
How Informed Consent Impacts Nursing/Healthcare
The foundation of a therapeutic and respectful relationship between a healthcare professional and the patient is informed consent. Obtaining informed consent is a legal and ethical obligation before performing surgical or nonsurgical procedures (Faison, 2018). Nurses are aware of the principles and practices of informed consent since it’s their day-to-day routine. Healthcare organizations must have informed consent procedures and policies that are compliant with federal laws, state laws, and Joint Commission Standards (Faison, 2018). Participating in the informed consent procedure is one of the daily tasks of nurses. Their roles may, however, differ.
Informed consent allows patients to take part in medical decision-making. They can choose to accept or deny care after necessary and adequate information is provided. Informed consent allows a collaborative process between healthcare professionals and patients. It will enable them to be involved in a shared decision-making process that accounts for the patient’s unique needs and preferences (Shah et al., 2020). Being informed allows patients to weigh the benefits and harms of diagnostic procedures, invasive procedures, certain medications, and surgical procedures. Informed consent guides the process of providing care to patients. Healthcare professionals should inform patients of the proposed medical intervention, benefits and risks, alternatives to the proposed intervention, benefits and risks, and patient preferences (Shah et al., 2020).
Patient safety is paramount in healthcare, and hence, an effective informed consent process is considered a significant safety issue. The Joint Commission emphasizes how informed consent should be obtained from patients. This guided the procedures and policies of healthcare organizations. Nurses must ensure that the patient’s signature is in the informed consent form (Shah et al., 2020). The informed consent process focuses on direct communication to patients. Many healthcare organizations are, however, facing barriers to ensuring informed consent. One major barrier is a high-level medical language that patients may not understand (Shah et al., 2020). Healthcare professionals such as nurses must thus implement strategies to ensure they address these inefficiencies. This will include using visual communication tools and active patient engagement to ensure patient understanding and safety (Shah et al., 2020).
Role of Nurses in Addressing Issues
Nurses have an ethical and legal obligation to ensure informed consent is obtained from patients. Nurses can act as patient advocates. They should evaluate patients during the informed consent process since their understanding can be affected by diseases, age, or medications (Faison, 2018). Subsequently, nurses should evaluate the patient’s decision-making capacity and their ability to participate in the informed consent process. The role of a nurse in patient advocacy is vital in the informed consent process. Nurses should constantly assess, counsel, and respond to the patient’s self-determination preferences since their consent during treatment can even change after the treatment process has begun (Faison, 2018)
Additionally, Nurses should inform patients about the care they are about to receive. They must ensure that patients understand the informed consent process. They can use web-based education tools to improve the patient’s decision-making (Faison, 2018). Nurse’s Code of Ethics requires nurses to advocate for patients. Conversely, nurses can raise concerns at the peer or institutional level whenever the informed consent process is not done appropriately (Faison, 2018). They can advocate for patients by constantly educating, assessing, and communicating on their behalf. Nurses can also advocate for patients by involving their family members. This is particularly true for geriatric patients. They can involve the family members in the decision-making process if the patient cannot give informed consent (Faison, 2018).
Furthermore, nurses can act as communicators in the informed consent process. Nurses achieve communication by evaluating, gathering, and interpreting information for patients and their family members. Effective communication is essential in the informed consent process (Faison, 2018). They can address the patient’s needs and undergo ethics training to meet them effectively. Besides, nurses can also act as witnesses in the informed consent process. Even though it is the responsibility of a clinician to initiate and discuss the benefits and risks of treatment with their patients, the nurse should act as a witness to the process (Faison, 2018). The nurse’s role as a communicator and an advocate is critical before the patient gives informed consent. The nurse can step in and answer any concerns the patient has and assess the patient’s capacity to comprehend the risks and benefits of the proposed treatment or intervention (Faison, 2018).
Patients have different cultural backgrounds, socioeconomic statuses, religions, or sexual orientations. They can be faced with complex situations when dealing with diverse patients. They should be culturally competent and recognize the unique needs of patients in the informed consent process. Nurse leaders can also develop, implement and evaluate policies that will allow nurses to respond to the diverse needs of patients when giving informed consent. Therefore, nurses can be part of nursing policy-formulating bodies and local ethics committees to develop appropriate informed-consent protocols that will ensure nurses respond to complex ethical situations and effectively advocate for patients (Faison, 2018).
Conclusion
Informed consent is important in nursing and healthcare. It involves sharing the benefits and risks of treatment and alternatives to ensure the patient voluntarily decides to participate in the medical process. Informed consent, however, creates an ethical dilemma in healthcare. Healthcare professionals do not know who should initiate the process of informed consent or the role of the patient in the process. Therefore, healthcare professionals have an ethical and legal obligation to ensure informed consent before treatment. Healthcare obligations must ensure that policies and procedures are implemented to protect the patient’s right to autonomy. Nurses have an important role in the informed consent process. They act as communicators, witnesses, advocates, and facilitators of the informed consent process.
Strategies must be implemented to eliminate the barriers to the informed consent process. Furthermore, nurse leaders must implement a nurse-driven informed consent process to improve patient outcomes. Informed consent is an important process in healthcare. Nurses and other healthcare professionals must be at the forefront of ensuring that patient’s right to autonomy and dignity is upheld.
References
Faison, M. (2018). Nurse’s Role Within the Informed Consent Process: A Systematic Review of the Literature [Doctoral dissertation]. https://scholarworks.waldenu.edu/dissertations
Moeini, S., Shahriari, M., & Shamali, M. (2019). Ethical challenges of obtaining informed consent from surgical patients. Nursing Ethics, 27(2), 527-536. https://doi.org/10.1177/0969733019857781
Shah, P., Thornton, I., Turrin, D., & Hipskind, J. E. (2020, August 22). Informed consent – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK430827/
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Question 
Purpose of Assignment:
Nurses encounter ethical issues in their practice. They need to be aware of currently relevant ethical issues, how they affect nursing practice, and how to address them.
Navigating Ethical Challenges in Modern Nursing Practice- Current Issues and Solutions
Course Competency:
Critique ethical issues in current nursing practice.
Scenario:
You recently discovered that a group of nurses from your community meet monthly to discuss current nursing issues. Recognizing the value of collaborating with other nursing professionals, you’ve inquired about joining the group. The group’s leader has asked you to write an essay for the group to discuss in next month’s meeting.