Implementing Ethico-Legal Issues in Nursing Practice

Caldwell, E.S., Lu, H., & Harding, T. (2010). Encompassing multiple moral paradigms: a challenge for nursing educators. Nursing Ethics 17 (2), 189-199.

Aim

This is a case study conducted on a Chinese student studying in a European nursing school to explore the challenges that this student and his instructors face upon encountering complex ethical situations.

Summary

The authors present a case study that indicates how globalization and internationalization of the medical education impacts the way ethical traditions are presented to international students in western Universities. The study further indicates that most Universities in western countries are home to thousands of international students particularly from Asia and Africa. These students bring with them various ethical traditions reflecting the practice in their countries of origin. Therefore, these students will face numerous challenges in their practical nursing practice, and their practice may be regarded as unethical by many patients in western countries. In line with this, the authors recommend that the nurse educators should continuously review their teaching programs to give room for integration of ethics into the curriculum.

Discussions

This article provides resourceful facts addressing the topic in that one major way of implementing ethical issues in nursing practice is to integrate ethics into nursing curricular. Studies indicate that the ethical tradition is based on the existing culture, which plays a fundamental role in building people’s beliefs, values, and customs (Johnstone, 2004, p. 24). Therefore, there is the need to incorporate culture into the teaching practice in order to avoid the challenges that many international students acculturated to their respective traditions face during practical nursing practice. As observed in the case, an individual’s culture can influence his/her behavior in such a way that it violates the traditions of the nursing profession or those of the patients. The behavior of the nurse will also influence the nurse-patient relationship because it affects the level of confidentiality between the patients and nurse (Swider et al., 1995, p. 108). In case, the nurse and the patient come from different cultures, there may be a conflict of interest, which lowers confidentiality between the patient and the nurse. In such a case, it would do well if the nurse followed the ethical traditions governing the nursing profession rather than following his/her tradition. This is the basis of the professional code of ethics for healthcare professionals, which requires that no information concerning the patient’s condition will be disclosed without the clear consent of the patient (Hans & Ahn, 2000, p. 113).

Hanssen, I. & Alpers, L. (2010). Utilitarian and common-sense morality discussions in intercultural nursing educators. Nursing Ethics 17 (2), 201-211.

Aim

This article presents two major areas of ethical disagreement that most nurses come across when working in intercultural health facilities. These issues include the tribal minority patients’ needs and the level of compliance on the part of nurses to those needs.

Summary

This study looks at the ethical issues facing nurses in intercultural health facilities whereby different patients share varied perceptions of healthcare services and illnesses among other issues. The authors present a study addressing the ethical issues from a Utilitarian and common-sense perspective. The study indicates that, the two premises determine the nurses’ behaviors, which influence the decisions made by these nurses when faced with challenges associated with ethnic and human diversity. The challenges involved in this case are mostly irresolvable because the nurses lack the ability to address them. Through incorporation of the two theories into practice, it is shown that the nurses will be able to deal with various complex ethical issues associated with ethnic and cultural diversity.

Discussions

Studies indicate that the utilitarian theory is based on the fact that an individual’s actions are judged relative to the outcome that arises from them. An action is thus said to be ethical when it provides the greatest positive benefits to the greatest number of people or otherwise (Williams, 1985, p. 23). On the other hand, the common sense view of morality involves one individual committing oneself towards fulfilling the obligation of achieving the right thing and avoiding the wrong one (Rachels, 1995, p. 10). The article states that most nurses build sensitivity feelings towards their patients and in the process they become aware of their suffering. In the event that a nurse is aware of the patients’ suffering, chances are that the nurses’ ethical considerations will be adjusted towards doing the right thing (Vaartio et al., 2008, p. 504). Therefore, this article provides resourceful factual materials that can address the topic from the utilitarian and common-sense perspective. However, it is worth noting that there are some fundamental differences between the two premises. The common sense theory provides a more intense connection between the nurse and the patient more than the one observed under the utilitarian theory. In line with this, an individual addressing an issue from the common sense view-point is bound to realize greater ethical benefits than the one practicing utilitarianism (Jameton, 1984, p. 34).

Lachman, V.D. (2008). Whistleblowers: troublemakers or virtuous nurses? Medical Surgical Nursing, 17 (2), 125-134.

Aim

The article seeks to look at whistle blowing as an ethical issue in nursing practice.

Summary

The author presents a detailed account on whistle-blowing as an act undertaken by one individual in an organization with the aim of uncovering the unethical issues, which are masked by the organization. The article further provides an account of the necessity of whistle-blowing in nursing practice and the moral justifications behind it. In this article, a whistle-blower is defined as an individual who opposes the practices perceived to be unethical in the workplace. Such an individual risks certain consequences such as isolation and humiliation among others. However, the U.S. constitution provides for protection of whistle-blowers through certain amendments introduced into the State laws and federal regulations. In this article, a guide is provided that shows the procedure of ethical decision-making before engaging oneself in whistle-blowing. Moreover, the article provides a variety of approaches meant to curb whistle-blowing in different organizations.

Discussions

Unethical issues in an organization ranges from incompetence, disregarding the safety of the patients, and deception. In nursing practice, competent practitioners are required who will not only practice the nursing ethics as required of them but who should also follow ethical traditions as provided for by the society (Catalano, 2008, p. 33). In this case, the practice of whistle-blowing becomes important and morally acceptable if only it is employed in uncovering the wrong-doing hidden from the community (Ahern & McDonald, 2002, p. 303). Additionally, the theory of utilitarianism plays a major role in justifying the morality of whistle-blowing. There are other theories, which also justify the necessity of whistleblowing in an organization. These include the deontological and the virtue theories. The theory of virtue requires that an individual observes high standards of integrity and courage during whistle-blowing. On the other hand, the deontological theory encourages the practice of truth-telling (Bolsin et al., 2005, p. 612).

The basis of whistle-blowing is pegged on the idea that failing to report the wrong-doing is not only unfair to the victims but it is also termed as going against the code of conduct that governs the nursing practice. Therefore, this article is resourceful in addressing the topic in that whistle-blowing, which is a practice opposed by many, is justified as being moral and ethical. On the other hand, the article provides a variety of guidelines on the various ways of preventing whistle-blowing while avoiding the legal implications involved.

Reference list

Ahern, K.M. & McDonald, S. (2002). The beliefs of nurses who were involved in a whistle-blowing event. Journal of Advanced Nursing, 38 (3), 303-309.

Bolsin, S., Faunce, T. & Oakley, J. (2005). Practical virtue ethics: healthcare whistle blowing and portable digital technology. Journal of Medical Ethics, 31 (10), 612-618.

Catalano, J. T., (2008). Nursing now: today’s issues, tomorrow’s trends (5th ed.). Philadelphia, PA: F.A. Davis Co

Hans, S.S. & Ahn, S.H. (2000). An analysis and evaluation of students nurses’ participation in ethical decision making. Nurs Ethics, 7 (1), 113-123.

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