Ethical Nursing Care
In the complex modern
world, we are surrounded by ethical is-sues in all facets of our lives.
Consequently, there has been a height-ened interest in the field of ethics, in
an attempt to gain a better understanding of how these issues influence us.
Specifically, in health care the focus on ethics has intensified in response to
con-troversial developments, including advances in technology and ge-netics, as
well as diminished health care and financial resources.
Today, sophisticated
technology can prolong life well beyond the time when death would have occurred
in the past. Expensive experimental procedures and medications are available
for at-tempting to preserve life, even when such attempts are likely to fail.
The development of technological support has had an influ-ence on all stages of
life. For example, the prenatal period has been influenced by genetic
screening, in vitro fertilization, the harvesting and freezing of embryos, and
prenatal surgery. In the early stages of life, premature infants are given a
chance for sur-vival by the use of technical support. Children and adults who
would have died as a result of organ failure are living longer be-cause of
organ transplantation. Technological advances have also contributed to an
increase in the average life expectancy. These advances in technology, however,
have been a mixed blessing. Questions have been raised about whether, and under
what cir-cumstances, it is appropriate to use such technology. Although many
individuals are afforded a better quality of life, others face
The Inquiring Mind: Critical Thinking in
Action
Throughout
the critical thinking process, a continuous flow of questions evolves in the
thinker’s mind. Although the questions will vary according to the particular
clinical situation, certain gen-eral inquiries can serve as a basis for
reaching conclusions and de-termining a course of action.
When
faced with a patient situation, it is often helpful to seek answers to some or
all of the following questions in an attempt to determine those actions that
are most appropriate:
· What relevant
assessment information do I need, and how do I interpret this information? What
does this information tell me?
· To
what problems does this information point? Have I iden-tified the most
important ones? Does the information point to any other problems that I should
consider?
· Have I
gathered all the information I need (signs/symptoms, laboratory values,
medication history, emotional factors, mental status)? Is anything missing?
· Is
there anything that needs to be reported immediately? Do I need to seek additional
assistance?
· Does
this patient have any special risk factors? Which ones are most significant?
What must I do to minimize these risks?
· What
possible complications must I anticipate?
· What
are the most important problems in this situation? Do the patient and the
patient’s family recognize the same problems?
· What
are the desired outcomes for this patient? Which have the highest priority?
Does the patient see eye to eye with me on these points?
· What
is going to be my first action in this situation?
· How
can I construct a plan of care to achieve the goals?
· Are
there any age-related factors involved, and will they re-quire some special
approach? Will I need to make some change in the plan of care to take these
factors into account?
· How do
the family dynamics affect this situation, and will this have an affect on my
actions or the plan of care?
· Are
there cultural factors that I must address and consider?
· Am I
dealing with an ethical problem here? If so, how am I going to resolve it?
·
Has any nursing research been conducted on this
subject?
extended suffering as a
result of efforts to prolong life, usually at great expense. Ethical issues
also surround those practices or poli-cies that seem to allocate health care
resources unjustly on the basis of age, race, gender, disability, or social
mores.
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