Throughout the history of the world hitherto, monotheistic religions have been the source of numerous discordant debates more so in critical life and death moments regarding patient care. A patient’s religious or personal beliefs remains a hindrance in the provision of healthcare services despite the mercurial rise in scientific research leading to evidence based practice. The existence of different religious beliefs means that the belief systems of patients are equally varied and thus providing certain medical procedures and care to patients is a challenge as Mendes, (2015) opines. Medical practitioners and nursing professionals working with diverse patients having varied beliefs must thus be aware of these varied beliefs, respect them and abide by them in order to provide quality patient care and in worst case scenarios, avoid legal suits. Varied patient belief systems in itself, presents an ethical dilemma and a moral issue. The question thus arises whether nurses should support a patient’s right to making a decision (s), even when it is against science-based, experimental knowledge or whether they should act to their best ability in stopping a patient’s avoidable action (s). This manuscript thus presents this argument succinctly and argues that nurses have a responsibility of identifying and knowing different belief systems in patients and should develop the ability to relate with patients with who have diverse viewpoints and beliefs.
According to the Royal College of Nursing (2015), majority of nurses enter the nursing profession with an ultimate goal of helping other people (Royal College of Nursing, 2015). However, no matter how genuine a nurse’s resolve to provide care may be, underlying issues such as a patient’s belief system may hinder the honest of motives. Patients often holds to their own worldviews which are dependent upon numerous aspects such as religion, culture, gender education, family traditions, socioeconomic status among others which defines a patient’s belief system (McSherry & Jamieson, 2011). These belief systems in return affect the delivery of care.
For instance, nurses working in palliative care may be inclined to think that the most suitable care for a critical care patient during the end of life is to make their patients as comfortable as possible. However, due to personal beliefs, a patient may choose to have a prolonged life despite persistent suffering so as to see their progeny for instance. In this case, prolonging the life may appear cruel to a healthcare professional but the patient’s wishes have to be respected in order for them to feel respected and feel that they have received impartial, considerate and supportive care (O'brien, 2013).
In some documented cases, patient s have refuses body transplants, lifesaving therapy, blood transfusions among other life crucial interventions due to religious inclinations. However as El Nawawi, et al., (2012) observes, in as much as such scenarios present an ethical and professional dilemma, nurses and other healthcare professionals have a responsibility of upholding obligatory beneficence (Mendes, 2015). Beneficence, (contributing to a patient’s wellbeing) is a responsibility expected from all healthcare professionals by the society. Beneficence was frequently mistaken for paternalism in the 20th century, with the ‘doctor knows best’ mantra being upheld often times by the patient. However, the healthcare practice in the contemporary society expects all professionals to offer care to the patient’s best interest alongside the patient’s beliefs and or worldviews. This view is alongside other ethical principles including patient autonomy and respect of life. Consequentially, a patient’s refusal of life saving therapy or intervention leaves a nurse with limited options.
Limited legal legislations are in place regarding incidences of refusal of life saving therapy by patients. With the exception of invalids, mentally challenged and minors, most jurisdictions lack relevant legislations to force patients to submit to a nurse’s call to provide requisite intervention. However, in the event that a patient’s health condition possess a threat to the public such as incidences of communicable diseases, their personal religious belief systems may not prevent the administration of needed therapy by healthcare professionals. In this regard, the patient’s autonomy is not infringed upon as O'brien, (2013) documents.
However, various approaches can be used in resolving ethical dilemmas regarding patient care having diverse beliefs. For instance, refusal of life saving therapy on religious grounds may warrant the summoning of the patients clergy or religious leader who serves as a go between the nurse and the patient. The religious representative may thus convince the patient to accept the recommended medical procedure or treatment being proposed on religious grounds. This approach is necessitated by the fact that some patient’s refusal of medical intervention is based upon their misinterpretation of religious dogma.
Nurses equally bear the responsibility of ensuring clear communication with the patient is achieved regarding the critical life death issue. However, patient issues related to their beliefs presents a delicate balance between patient autonomy and the physician’s obligation to beneficence.
As McSherry & Jamieson, (2011) documents, care in the contemporary world is planned and given in partnership with patients, and rightly so. However, this approach may raise ethical dilemmas especially when a patient’s belief system is not in tandem with what a healthcare professional deems his or her duty of care. This may also be the case when the healthcare professional is unaware of the patient’s customs or beliefs.
A good solution with regard to varied patient beliefs and a nurse’s duty of care would involve a nurse getting knowledge on a patient’s personal and religious belief system. Understanding a patient’s belief system and how they perceive care is needed including the patient’s perception on how they should be given care. Additionally, the patient’s desired approach to receiving care is needed as well as their reasoning behind care given to them is vital in promoting relevant, compassionate and impartial care delivery. Moreover, the ability to find solutions and inconsistencies between a patient’s belief system, their preferences and a nurse’s duty of care is a skill that nursing professionals need and it calls for strategy, reflection and knowledge acquisition. This also calls for a multidisciplinary cooperation among healthcare stakeholders.
Conclusively, in as much as understanding different patient beliefs may be beneficial in delivery of care, it may not make a nurse an expert on every patient. Ethical dilemmas are still bound to arise with regard to patient care. Consequentially, providing healthcare which is appropriate to each patient emanates from a nurse’s willingness and ability to talk and listen without judging, their own beliefs, and his or her ability to offer unprejudiced and personal care with the greatest compassion and thoughtfulness as Mendes, (2015) documents. These measures alone are bound to have unimaginable effects and impacts on the psychological support which the patient feels with regard to receiving care.
References
El Nawawi, N. M., Balboni, M. J., & Balboni, T. A. (2012). Palliative care and spiritual care: the crucial role of spiritual care in the care of patients with advanced illness. Current opinion in supportive and palliative care, 6(2), 269-274.
McSherry, W., & Jamieson, S. (2011). An online survey of nurses’ perceptions of spirituality and spiritual care. Journal of Clinical Nursing, 20(11‐12), 1757-1767.
Mendes, A. (2015). The role of nurses' and patients' personal beliefs in nursing care. British journal of nursing (Mark Allen Publishing), 24(6), 345-345.
O'brien, M. E. (2013). Spirituality in nursing. Jones & Bartlett Publishers.
Royal College of Nursing (2015) Look in the mirror. http://tinyurl.com/k3cbwmz (accessed 28 March 2016)
