The nursing profession, just like any other profession, is bound by ethics, rules and regulations. The most pertinent legal and ethical issues revolve around getting the consent of the patient for any given treatment. However, when the patient is incapable of giving an informed and voluntary consent, the nurse may have to act in the best interests of the patient. This is applicable to both adults and children.
Mature Minor Concept
One of the most controversial legal and ethical doctrines in the nursing profession is the mature minor doctrine. The mature minor doctrine is a statutory, regulatory policy stating that un-emancipated minors have the right to choose or reject certain treatments, even without the knowledge and agreement of their parents (Guido, 2013). The statute protects health care providers from criminal and civil claims by parents of minors willing to take certain health care treatments without the knowledge of their parents. However, this statute should not be confused with the emancipation of minors’ doctrine.
Emancipation of minors is just a legal confirmation that the minor is freed from the control of parents or guardians, and thus can make decisions on their own. However, unlike the mature minor concept, emancipation of minors’ doctrine does not grant minors the extensive rights to decide which treatments to choose and which ones to reject (Neeb, 2005). In some cases, limited guardianship is provided when making medical decisions and the emancipated minor may not be allowed to choose or refuse treatment. This is unlike the case in mature minors where the minor has the full capacity to make serious medical decisions. Again, emancipation of minors is subject to the age of majority, which is 18 years in most states.
Voluntary and Informed Consent
It is important for the nurse to understand whether a patient makes a voluntary and informed consent regarding any treatment. This calls for the nurse to make a judgment on whether the decision is made voluntarily and after assessment of all the facts of medical case. To ensure that the decision is voluntary, the nurse should ensure that the patient makes the decision alone without any unnecessary pressure. Sources of pressure include from medical staff, family and friends. Again, the nurse should assess whether the client has made an informed decision. The nurse facilitates the making of informed decisions by given all the information regarding the treatment as well as the risks and benefits involved (Lewis, Dirksen, Heitkemper, & Bucher, 2013). The nurse should also explain whether there are other reasonable alternatives or not. Lastly, the nurse should assess the ability of the patient to make a voluntary and informed decision.
If the patient has a history of conditions such as dementia, schizophrenia and bipolar decision, the nurse may be forced to act on the best interests of the patient since the patient does not have the capacity to make a voluntary and informed consent. Other cases whereby consent is not necessary include cases of emergency treatment whereby an immediate emergency operation is needed in order to save the life of the patient. In such circumstances, the patient may be physically and mentally incapacitated (Miller & Hutton, 2004). There are also cases whereby additional procedure maybe needed. For example, when carrying out an abdominal surgery, the surgeon may realize that the gallbladder needs to be removed, and if the decision is delayed, the condition may become too dangerous. However, there are political arguments regarding the decision to disregard the patient’s choice. To some, this is leeway is prone abuse by medical practitioners. However, this may not be entirely true because medical practitioners are guided by a code of ethics.
In conclusion, nurses need to be aware of their expectations and limitations when delivering healthcare. In this days and age, people are well-informed of their rights, and it is essential to understand the legal boundaries beyond which the nurse should not cross. Above all, it is important to make ethical decisions.
References
Guido, G. W. (2013). Legal and ethical issues in nursing, 5th Ed. Upper Saddle River, NJ : Pearson Education.
Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., & Bucher, L. (2013). Medical-surgical nursing: Assessment and management of clinical problems . Philadephia, PA : Elsevier .
Miller, R. D., & Hutton, R. C. (2004). Problems in health care law. Sudbury, MA : Jones & Bartlett Learning.
Neeb, K. (2005). Fundamentals of mental health nursing. Philadephia, PA : F.A. Davis.
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