Question) For the last few days, you have been taking care of Mr. Smith, a 30 years old patient with end stage cystic fibrosis. You have developed a caring relationship with Mr. Smith and his wife. They are both aware of the prognosis of his disease and realize that he has only a short time left to live. When Dr. William made rounds with you this morning, she told Mrs. Smith that Mr. Smith could be discharged today if his condition remains stable. They were both excited about the news because they had been urging the doctor to let him go home to enjoy his remaining time surrounded by things he loves. When you bring in Mr. Smith's discharge order to his room in order to review his medications and other treatments, you find Mrs. Smith assisting Mr. Smith as he coughs up bright red blood. When you confront them, they both beg you not to tell the doctor or chart the incident because they do not want their discharge to be delayed. They believe that it is their right to go home and let Mr. Smith die surrounded by his family. They said that they know that they can leave against their physician's wishes and go home AMA( against medical advice), but if they do, their insurance will not pay for home care.

(1) What is your duty in this case?

(2) What are Mr. Smith's right?

(3) Is it ever justified to withhold information from the physician?

(4) Will you chart the incident and will you report it to anyone?

(5) Solve this case, justifying your decision by using ethical principles( Veracity, fidelity, beneficence, etc.). Need reference cited.

 

Introduction

Ethics, clearly defined, is a theory that defines what in terms of actions, is anticipated in terms of good and right and wrong or wrong. For one the American Nurses Association Code of Ethics holds nurses to ethical standards. In all facets of health care, principles and professional practice are integrated.

The values of;

Beneficence- doing good and the right thing for the patient.

Responsibility- nurses are accountable for their nursing care and other actions. They must accept all of the professional and personal consequences that can occur as the result of their actions.

Fidelity- maintaining one's promises. By delivering good quality, stable service in a competent way, the nurse must be faithful and truthful to their professional commitments and obligations.

Autonomy- When the nurse acknowledges the individual as a particular individual who has the inherent right to express their own thoughts, perspectives, ideals and convictions, patient self-determination is maintained. Without any judgment or pressure from the nurse, nurses encourage patients to make their own choices. The patient has the right to deny or approve all services. And the professional standards that nurses have to stick to are veracity(being completely truthful with patients; nurses must not withhold the whole truth from clients even when it may lead to patient distress).

Fairness is justice. In the delivery of treatment, for example, when they deliver to the people in the category of patients they are taking care of, nurses must be equal. Treatment must be administered among a population of patients equally, justly, and equitably.

It is the duty of nurses to recognize ethical concerns affecting staff members and patients; and they are also responsible for advising staff members and impacted consumers about ethical issues that can and do with affected customer service.

Mr. Smiths rights

The Patient Self Determination Act upholds and stresses the responsibility of the client to make decisions about current and future health and care. Legally, upon diagnosis and with their initial communication with a health agency or provider, all patients and clients must be advised of their ability to approve or refuse all treatments. The Act on Portability and Transparency of Health Care (HIPAA) encourages and upholds the rights of clients to confidentiality and the protection of their personal records.

Informed consent - informed consent is characterized as the choice of a treatment or procedure for the patient based on their complete knowledge of the treatment or procedure, its advantages, its risks and any alternatives to the treatment or procedure in question. In order to approve or refuse both therapies and procedures, all clients have the fundamental right to autonomy and self-determination.

Medical confidentiality

Medical confidentiality is a set of rules that limits access to information discussed between a person and their healthcare practitioners. However, whether the health or welfare of you or anyone else is severely endangered and the knowledge benefits, for example, whether you are unconscious and paramedics, physicians and nurses ought to know whether you are resistant to any medicine, whether the information eliminates or prevents a significant public health or safety danger, for example, whether you have a severe infectious disorder, then the public wants to be notified. In this case though both Mr. and Mrs Smith pleaded for the discharge despite the ill condition, it was necessary for the nurse to inform the doctor.

Keeping Heath information of a patient

Health information is any details concerning the health or condition of an individual and any information that applies to a health service that they have accessed or may receive. In order to keep your health records confidential, health information is important and intimate, which is why there are regulations to protect your rights. It is, therefore, not good according to the law to share the information with anybody else. Health care information should be kept private.