Ethics, a moral philosophy or branch of philosophy that determines the course of human action pertaining to the concepts of right and wrong (Longstaff, 1995, Web). Ethics is being observed in the society as a universal benchmark of human behavior. More importantly, it is being practiced in all industry particularly in healthcare. The fact that healthcare is dealing with patients and their welfare, it is detrimental that people in healthcare industry religiously follow the ethical standards of their profession. Health professionals deal with circumstances and situation that has a direct impact to another person's life on a daily basis. Therefore, it is crucial that the healthcare industry has an ethics committee that will help resolve dilemmas and ethics related issues. Furthermore, policies and procedures as well as written code of ethics should effectively map the right conduct of the people working in the healthcare industry.
However, despite keeping ethics in mind there are still dilemmas that healthcare industry and its professionals are facing. Mindy Beth Zeitzer (2009) in her study of “Ethical issues and decision making related to resuscitation of severely injured patients: Perceptions of emergency department nurses” (Zeitzer, 2009), discussed the specific ethical issues that emergency department nurses encounter and their effects. The nurses working in emergency department of hospitals and trauma centers are very important set of hands during the resuscitation procedure. Such decision to resuscitate are made without or having very little background about the patient. Therefore, the decision to perform the responsibilities of a life saver are contradicted by the ethical issues pertaining to respect for the patient, care, and justice concerns. Such issues had several effects on participants including threats with physical, emotional, ontological and professional role (Zeitzer, 2009, p. vii). In this dilemma, nurses in hospital emergency department are obliged by their professional principles and their decisions are governed by their job protocols. Therefore, the decision to perform resuscitation on severely injured patients as mandated by their practice are competing with the ethical principle of respect for autonomy. Respect for autonomy means that people have and should be allowed to make decisions for themselves.
This ethical theory also refers to the idea that people understand themselves more than anybody else, thus any decision that will have an immense impact to their lives should be respected regardless of the circumstances (Rainbow, n.d., Web). In relation to the given issue about nurses performing resuscitation procedures on severely injured patients, at one end the nurses are doing what their job calls them to do. However, on the other side, they are neglecting the important principle of respect for autonomy. There are many reasons that the patient ended up with severe injuries, could be that it was because of an accident or self inflicted. It is true that some people are just too vulnerable when it comes to difficult life situations that they come to a point that they try to harm themselves. People with suicidal tendencies are not the most appreciative when it comes to being saved. Therefore, nurses resuscitating patients with suicidal backgrounds are violating the ethical principle of respect for autonomy. That is because the patient obviously doesn't want to the saved. On the other hand, the situation puts the nurses in great pressure because they are bound by their code of ethics to save people's lives.
The nurses in emergency department recognize the patient's suffering, but it cannot always be assessed that the people's suffering should have implications for clinical practice (Carnevale, 2009, p. 178). Although saving a life is the main priority of the healthcare professionals, ethical principles particularly respect for autonomy should also be considered. Nurses in emergency department are torn in between their professional code of ethics and the patient's right for autonomy. Therefore, it should be part of their protocol to learn the background of the patient and make prior assessment of the situation. In some cases, saving a person's life may not always be the right thing to do especially if the person doesn't want to be saved at all.
Another dilemma that healthcare professionals are facing is telling the patient and their family the truth about clinical procedures done to the patient and the patient's health condition. In an article by Randy Cohen (2006) in The New York Times, he told a story about a physician and an elderly patient admitted with a case of multiple organ dysfunction. The patient is an elderly and at the same time a Jehova's Witness by faith. The patient's condition requires a blood transfusion. However, the religion does not allow it and the patient's family does not also agree to the idea. According to Cohen's story (2006), an on-call resident ordered to proceed with the blood transfusion without consulting the patient's religious background. The blood transfusion was discontinued the following morning because the staff are afraid that if the patient's family sees that there were blood bags hanging in the ICU it might upset the family.
This situation is also the same as the previously discussed issue, the practitioner failed to check the background of the patient. Therefore, the physician violated several ethical principles in the process. Although it is in the best interest of the patient to get a blood transfusion, but his lack of ability to decide for himself because of the medical condition should not void his rights to refuse. In the context of the ethical theories, rights are something that the society have set forth and should be given the highest priority and protection. In the given scenario, the physician's lack of initiative to consider checking the patient's background resulted to him violating his professional code of ethics as well as the patient's ethical principles. Again, respect for autonomy is in question in the given situation with the doctor and the patient. The fact that the doctor is adamant in disclosing the truth to the patient's family members. It is clear that the procedure was a medical error. However, it is the physician's responsibility to tell the patient the truth at all times regardless of the circumstances. Physicians are sometimes less likely to behave ethically, but it doesn't justify the reason to keep the truth from the patients especially if the patient's life is on the line (Deshpande, 2009, p. 389).
References
Carnevale, F. A. (2009). A Conceptual and Moral Analysis of Suffering. Nursing Ethics 2009, 16(2), 178. doi:10.1177/0969733008100076.
Cohen, R. (2006, June 18). Medical Misstep - New York Times. The New York Times. Retrieved September 22, 2012, from http://www.nytimes.com/2006/06/18/magazine/18wwln_ethicist.1.html?_r=1
Deshpande, S. P. (2009). A Study of Ethical Decision Making by Physicians and Nurses in Hospitals. Journal of Business Ethics, 389. doi:10.1007/s10551-009-0049-5.
Longstaff, S. (1995, April). What is ethics education or training? | St James Ethics Centre. St James Ethics Center. Retrieved September 22, 2012, from http://www.ethics.org.au/ethics-articles/what-ethics-education-or-training
Rainbow, C. (n.d.). Descriptions of Ethical Theories and Principles. Biology @ Davidson. Retrieved September 22, 2012, from http://www.bio.davidson.edu/people/kabernd/Indep/carainbow/Theories.htm
Zeitzer , M. B. (2009). Ethical issues and decision making related to resuscitation of severely injured patients: Perceptions of emergency department nurses. Udini by ProQuest. Retrieved September 22, 2012, from http://udini.proquest.com/view/ethical-issues-and-decision-making-pqid:1894169681/
