Introduction
To begin with, code of ethics for nurses can be contented as being one of the universally and globally agreed set of laws and rules that are internationally applicable to all nurses all over the world. Basically, nurses can be debated as having four significant and essential responsibilities and duties in the medical field: First, they are responsible to ensure that patients, families and communities remain in healthy conditions all the time irrespective of color, age, locality, gender, political background, physical disability, nationality, sex and tribe. In addition, nurses are expected to prevent, avert and obviate illness, sickness, disease and infection that may arise at any time to any given person, family or community (ICN Codes of Ethics, 2006). Finally, nurses are ever expected to be able to restore, reinstate and bring back health to patients or alleviate, lessen and reduce pain from patients at all costs and the time. The codes of ethics that are universally accepted and globally practiced may include the following: First, nurses are expected to respect the sovereignty, autonomy and integrity of patients and other individuals which are not related to any financial, cultural backgrounds and other discriminatory devices that patients may be discriminated against. This is also related to factors associated with decision making in terms of seeking for medical care services which include treatment services.
In case of insanity or the patient is not able to make any sound decisions, paternalism may be used to seek decisions regarding the treatment methods to be offered to patients. Moreover, the code of “informed consent” is mostly encouraged so that individuals are supposed to state how they actually want to be treated in cases they are faced with illnesses or diseases. Secondly, the code of “confidentiality and privacy” is among the most essential codes. Nurses and other medical practicing individuals are expected to be very secretive when it comes to disclosing information regarding the health status and treatment procedures for their patients. Additionally, nurses are highly recommended to strictly follow the code of “beneficence” which bars and prevents them from doing things that harm patients. They are always supposed and looked upon by the society “to do no harm” at all times. This and other many codes of ethics are supposed to regulate nurses and ensure that they offer the best health care services to the individual patients, families and societies at large (Stanhope and Lancaster, 2000).
This paper basically highlights a health care set-up whereby the code of ethics which stipulates the respect for autonomy and integrity of patients is actually challenged and defied which leads to the nurses responsible being arraigned and sued in a court of law. In addition, the paper really describes the various trends in health care setups, society and community which have historically shaped, influenced and modeled the need to provide patients with the right to choose and make decisions regarding their health care.
Fictional Scenario
John, who was a grade sixteen student by then, was a basketball player in his college. He was one day playing an inter-college basketball tournament when he fell on the ground and broke his skull on the process of trying to dunk the ball. He suffered brain hemorrhage and was immediately rushed to the nearby hospital where the nurses taking care of him were forced to put him on a respirator since he was unconscious. He stayed in the respirator for a few hours before the nurses actually decided to check whether his pulse rate was really normal or not. They transferred him to an electrocardiogram which gave and displayed a graph with an abnormal heartbeat. John actually was in the company of his games teacher and a few students whom out of desperation were very much scared about the state at which he was.
Moreover John’s father was a minister in a foreign country and was not reachable on phone therefore; the nurses were actually forced to make decisions based on the principle of “beneficence” which recommends that one should do no harm. John’s situation on the electrocardiogram was actually deteriorating and he almost had a pulse rate reading zero in the electrocardiograph. Two nurses taking care of him were forced to put him in a defibrillating machine to be able to restart his heart. He bounced back to life but with uncoordinated functional activities which forced the doctor in charge to recommend for an operation or else he was going to have a permanent brain damage which might have rendered him mad. The medical staff in general did not agree to that basing their arguments on the fact that John had suffered a serious brain damage which even an operation could not save his life. He was actually left unconscious for a week without any improvement where finally the medical doctors recommended two nurses to euthanize him since he was never going to recover.
In this and many other cases, nurses are actually required to make sound decisions that are very significant and fundamental towards the wellbeing of the patients they are taking care of or nursing. In addition, it can be contended that nurses really have to follow the code of beneficence or goodness and the code of nonmalificence when making such decisions that are very essential regarding the wellbeing of the persons they are actually taking care of. This ethical code has recently been the subject of much contention in regard to the ethical code that guarantees and warrants patients with the right to demand which treatment they actually want. For example, Hooke and White (2001) argue that the code of nonmalificence should be put before the ethical code that renders patients autonomous in regard to which treatment measures they actually want nurses to impose. However, they restrict this freedom to cases where the patients cannot make their own decisions may be due to mental illnesses or just insanity. In addition, this freedom is also very much restricted and confined to occasions where the relatives and family members of the patient are not around or cannot make any reasonable decisions maybe due to age or also some mental illnesses. For example, in this case the guardian of John could not actually be traced and the decision regarding his treatment needed so much urgency, therefore the nurse was ethically and professionally right to make the decision for him.
Trends in the Health Care and Society which have shaped the Code of Autonomy
The argument on the code of autonomy, independence and self-determination was actually born since the beginning of medicine and is experienced until today (Kilpi,). This idea was actually extracted and obtained from the rational theory of Immanuel Kant and the Christian quotes in the Judean law, that debate that individuals should treat others the way they also want others to treat them (Hooke and White, 2001). There has been a big debate and contention on whether the principle of autonomy should be placed first or the principle of beneficence or nonmalificence which is extracted from one of the codes of Hippocrates, a philosopher, which debates that the physician is actually obligated to use his/her skills and expertise to secure and defend the patient from harm. Kilpi argues that the patient’s obedience, compliance and submission to the physician were actually the order of the day during the times of Hippocrates. On the other hand, the principle of autonomy actually was debated upon by Plato who argued that the patient is really liable to make his or her own decisions regarding the type of medication to receive or which physician to carry out medication. It is important to note that, the first authorization and certification of code of for nurses was done after the Second World War in 1950 by the American Nurses Association (ANA) although in 1986 “the Nurses’ Associated Alumnae of United States and Canada’ had already met to discuss the formation and implementations of the code of ethics for nurses (Hooke and White, 2001).
Additionally, other factors that have shaped historically the provision of this code of autonomy and self dignity, is the ever changing global perception on Medical Codes of Ethics in regard to nursing. According to Kilpi, the need for individuals to gain and attain their autonomy in regard to decision making was ideally initiated after the Second World War. It was as a result of the ever evolving man, whose main aims were focused in developing personality and emphasizing on the ethical responsibility. This eventually led to the emergence of various Codes of Ethics in various countries for example, “nursing code of ethics in Greece in 1996, revision of the American Nurses Association in 1976, Codes of Nursing Ethics for the European Countries, the Principles of European Medical Deontology in 1987” and “the Code of Professional Conduct for Nurses, Midwives and Health Visitors (UKCC) in the United Kingdom in the year 1992. All the above named associations insisted and emphasized on the code of autonomy as a way of embracing integrity and honor to patients. Moreover, the perception that nurses and other physicians actually had much control over the well being of patients has continuously been eroded over time. In fact, this notion, belief and concept is seen as being outdated and old-fashioned since the current code of ethics emphasizes so much on the need of nurses to respect the autonomy, integrity and independence of individuals in regard to decision making concerning the choice which type of medical treatment the patient actually wants to be used or applied on them (Stanhope and Lancaster, 2000). Finally, in cases of insanity or incompetence of the patients which affects the act of decision making, the current codes of ethics encourage the use of ‘informed consent’ whereby the patient is required to make a decision or suggestion regarding how they actually want to be treated in cases of illnesses and diseases.
References
Hooke, K. D., & White, G. B. (2001). Code of Ethics for Nurses with Interpretive Statements. A study Model. Retrieved on 11 January, 2011. From < http://www.nursingworld.org/mods/mod580/code.pdf>.
Kilpi, H. L. (2000). Patient’s Autonomy, Privacy and Informed Consent. Amsterdam: IOS Press. Retrieved on 11 January, 2011. From < http://books.google.co.ke/books?id=gvNTGQmTJWYC&printsec=copyright#v=onepage&q&f=false>.
Stanhope, M., & Lancaster, J. (2000). Community and Public Health Nursing. St. Louis, Missouri: Mosby, Inc. Retrieved on 11 January, 2011. From < http://books.google.co.ke/books?id=ux4yA-on7XQC&printsec=copyright#v=onepage&q&f=false>.
The ICN Code of Ethics for Nurses. (2006). Jean-Marteau, Geneva: International Council of Nurses, 3: 1-8. Retrieved on 11 January, 2010. From < http://www.icn.ch/images/stories/documents/about/icncode_english.pdf>.
