Patient Advocacy
Name
Affiliations with Institutes
Patient Advocacy
Case Study
Nursing is a field that frequently has to deal with an ethical dilemma in a medical ground. A demonstration of a case study encountered by healthcare providers who provide services and manage Jehovah's witnesses who are positioned in a dangerous state due to clinical life-threatening condition. A 22-year old African American pregnant lady admitted to the emergency department in a medical situation resulting in a car accident. She was presented with symptoms and signs of internal bleeding and was suggested to have emergency surgery and blood transfusion to save the fetus and her life. She has believed in Bible scripture and due to fear of surgery, she refuses to have a blood transfusion and surgery ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"NmIPvU2H","properties":{"formattedCitation":"(Sari, Baysal, Celik, & Eser, 2018)","plainCitation":"(Sari, Baysal, Celik, & Eser, 2018)","noteIndex":0},"citationItems":[{"id":311,"uris":["http://zotero.org/users/local/qnvKw9vm/items/Y6LJWJ3A"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/Y6LJWJ3A"],"itemData":{"id":311,"type":"article-journal","container-title":"Pakistan journal of medical sciences","issue":"3","page":"724","title":"Ethical Decision Making Levels of Nursing Students","volume":"34","author":[{"family":"Sari","given":"Dilek"},{"family":"Baysal","given":"Ebru"},{"family":"Celik","given":"Gul Gunes"},{"family":"Eser","given":"Ismet"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Sari, Baysal, Celik, & Eser, 2018). Now physicians and nurses have to compromise on the care standards or to respect the patient's autonomy or have to go for surgery to save her life without informing or taking her consent ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"CJeeC03u","properties":{"formattedCitation":"(Norlyk, Haahr, & Hall, 2016)","plainCitation":"(Norlyk, Haahr, & Hall, 2016)","noteIndex":0},"citationItems":[{"id":310,"uris":["http://zotero.org/users/local/qnvKw9vm/items/HRF6SDLW"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/HRF6SDLW"],"itemData":{"id":310,"type":"article-journal","container-title":"Journal of Advanced Nursing","issue":"4","page":"936-945","title":"Interviewing with or without the partner present?–an underexposed dilemma between ethics and methodology in nursing research","volume":"72","author":[{"family":"Norlyk","given":"Annelise"},{"family":"Haahr","given":"Anita"},{"family":"Hall","given":"Elisabeth"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Norlyk, Haahr, & Hall, 2016). In this critical state, physicians have to opt for medical emergency surgery and to present the standards of care to save her life.
Ethical Dilemma and Bioethical Decision Making
Ethical Dilemma is a condition where physicians have to handle a situation that arises where they have to opt for a decision exclusively alternative ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LANez6QU","properties":{"formattedCitation":"(Sari et al., 2018)","plainCitation":"(Sari et al., 2018)","noteIndex":0},"citationItems":[{"id":311,"uris":["http://zotero.org/users/local/qnvKw9vm/items/Y6LJWJ3A"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/Y6LJWJ3A"],"itemData":{"id":311,"type":"article-journal","container-title":"Pakistan journal of medical sciences","issue":"3","page":"724","title":"Ethical Decision Making Levels of Nursing Students","volume":"34","author":[{"family":"Sari","given":"Dilek"},{"family":"Baysal","given":"Ebru"},{"family":"Celik","given":"Gul Gunes"},{"family":"Eser","given":"Ismet"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Sari et al., 2018). A bioethical decision model is an approach that is intended to improve the procedure that involves decision making in an ethical scenario. It has been observed that the decision is sometimes undesirable and sometimes desirable (Epstein & Turner, 2015). In the current scenario, if the physicians have to follow and respect the patient's autonomy and in that case, the patient would have died (Sari et al., 2018). The other option would have possibly saved her life but would undesirably violating the patient's autonomy.
Medical and Non-Medical Facts
Medical departments are designed to follow the code of ethics to save patients and deliver the quality of care. Healthcare providers have to choose decisions that are best suitable for patients ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1QYkd6Oa","properties":{"formattedCitation":"(Epstein & Turner, 2015)","plainCitation":"(Epstein & Turner, 2015)","noteIndex":0},"citationItems":[{"id":313,"uris":["http://zotero.org/users/local/qnvKw9vm/items/9XDPS99I"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/9XDPS99I"],"itemData":{"id":313,"type":"article-journal","container-title":"OJIN: The Online Journal of Issues in Nursing","issue":"2","page":"1-10","title":"The nursing code of ethics: Its value, its history","volume":"20","author":[{"family":"Epstein","given":"Beth"},{"family":"Turner","given":"Martha"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Epstein & Turner, 2015). Following the ethical principles, the critical state of the patient required a prompt decision to save her life and the fetus ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"sd9Yefrd","properties":{"formattedCitation":"(Aitamaa, Leino-Kilpi, Iltanen, & Suhonen, 2016)","plainCitation":"(Aitamaa, Leino-Kilpi, Iltanen, & Suhonen, 2016)","noteIndex":0},"citationItems":[{"id":312,"uris":["http://zotero.org/users/local/qnvKw9vm/items/HGDZDWIU"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/HGDZDWIU"],"itemData":{"id":312,"type":"article-journal","container-title":"Nursing ethics","issue":"6","page":"646-658","title":"Ethical problems in nursing management: the views of nurse managers","volume":"23","author":[{"family":"Aitamaa","given":"Elina"},{"family":"Leino-Kilpi","given":"Helena"},{"family":"Iltanen","given":"Silja"},{"family":"Suhonen","given":"Riitta"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Aitamaa, Leino-Kilpi, Iltanen, & Suhonen, 2016). Therefore, they decided to take the patient to the surgery and without her consent, she was saved and her baby was delivered. In the current scenario, the patient was not in a state that she would have decided also she was not having any person with her from her family member except her little brother ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"CMDrwC32","properties":{"formattedCitation":"(Norlyk et al., 2016)","plainCitation":"(Norlyk et al., 2016)","noteIndex":0},"citationItems":[{"id":310,"uris":["http://zotero.org/users/local/qnvKw9vm/items/HRF6SDLW"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/HRF6SDLW"],"itemData":{"id":310,"type":"article-journal","container-title":"Journal of Advanced Nursing","issue":"4","page":"936-945","title":"Interviewing with or without the partner present?–an underexposed dilemma between ethics and methodology in nursing research","volume":"72","author":[{"family":"Norlyk","given":"Annelise"},{"family":"Haahr","given":"Anita"},{"family":"Hall","given":"Elisabeth"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Norlyk et al., 2016). Considering the religious believe that states Jehovah's witness as whatsoever would eat any blood would not be from among his people is also true, however, Bible does not allow anyone to take his/her life and also does not allow to let patients die in front of you.
Ethical Principles Applied to this Scenario
The ethical principles applied to this scenario are autonomy, beneficence, and non-maleficence ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ZFegBnY6","properties":{"formattedCitation":"(Aitamaa et al., 2016)","plainCitation":"(Aitamaa et al., 2016)","noteIndex":0},"citationItems":[{"id":312,"uris":["http://zotero.org/users/local/qnvKw9vm/items/HGDZDWIU"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/HGDZDWIU"],"itemData":{"id":312,"type":"article-journal","container-title":"Nursing ethics","issue":"6","page":"646-658","title":"Ethical problems in nursing management: the views of nurse managers","volume":"23","author":[{"family":"Aitamaa","given":"Elina"},{"family":"Leino-Kilpi","given":"Helena"},{"family":"Iltanen","given":"Silja"},{"family":"Suhonen","given":"Riitta"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Aitamaa et al., 2016). Autonomy was to respect patients' believes and let her choose natural birth and this could have been achieved at the cost of her life ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"hoBM46XT","properties":{"formattedCitation":"(Epstein & Turner, 2015)","plainCitation":"(Epstein & Turner, 2015)","noteIndex":0},"citationItems":[{"id":313,"uris":["http://zotero.org/users/local/qnvKw9vm/items/9XDPS99I"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/9XDPS99I"],"itemData":{"id":313,"type":"article-journal","container-title":"OJIN: The Online Journal of Issues in Nursing","issue":"2","page":"1-10","title":"The nursing code of ethics: Its value, its history","volume":"20","author":[{"family":"Epstein","given":"Beth"},{"family":"Turner","given":"Martha"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Epstein & Turner, 2015). Beneficence is a case where physicians have to deliver quality of care that is best suitable for the patient. Not opting for the blood transfusion would be against the principle of non-maleficence ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"GXzDhudG","properties":{"formattedCitation":"(Epstein & Turner, 2015)","plainCitation":"(Epstein & Turner, 2015)","noteIndex":0},"citationItems":[{"id":313,"uris":["http://zotero.org/users/local/qnvKw9vm/items/9XDPS99I"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/9XDPS99I"],"itemData":{"id":313,"type":"article-journal","container-title":"OJIN: The Online Journal of Issues in Nursing","issue":"2","page":"1-10","title":"The nursing code of ethics: Its value, its history","volume":"20","author":[{"family":"Epstein","given":"Beth"},{"family":"Turner","given":"Martha"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Epstein & Turner, 2015). Allowing her to die would be against the code of ethical principles of healthcare facilities ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"xIHSROZ5","properties":{"formattedCitation":"(Norlyk et al., 2016)","plainCitation":"(Norlyk et al., 2016)","noteIndex":0},"citationItems":[{"id":310,"uris":["http://zotero.org/users/local/qnvKw9vm/items/HRF6SDLW"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/HRF6SDLW"],"itemData":{"id":310,"type":"article-journal","container-title":"Journal of Advanced Nursing","issue":"4","page":"936-945","title":"Interviewing with or without the partner present?–an underexposed dilemma between ethics and methodology in nursing research","volume":"72","author":[{"family":"Norlyk","given":"Annelise"},{"family":"Haahr","given":"Anita"},{"family":"Hall","given":"Elisabeth"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Norlyk et al., 2016). The healthcare organizations are intended to deliver services that are best for the patients and communities.
Patient Advocacy
It is important to take decisions according to the will or informed consent of the patient, whereas in the current scenario, she was not able to give her consent for the blood transfusion and surgery ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"MCkXTSvb","properties":{"formattedCitation":"(Epstein & Turner, 2015)","plainCitation":"(Epstein & Turner, 2015)","noteIndex":0},"citationItems":[{"id":313,"uris":["http://zotero.org/users/local/qnvKw9vm/items/9XDPS99I"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/9XDPS99I"],"itemData":{"id":313,"type":"article-journal","container-title":"OJIN: The Online Journal of Issues in Nursing","issue":"2","page":"1-10","title":"The nursing code of ethics: Its value, its history","volume":"20","author":[{"family":"Epstein","given":"Beth"},{"family":"Turner","given":"Martha"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Epstein & Turner, 2015). Therefore, physicians have to opt for surgery without her consent ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"CH31nNpT","properties":{"formattedCitation":"(Sari et al., 2018)","plainCitation":"(Sari et al., 2018)","noteIndex":0},"citationItems":[{"id":311,"uris":["http://zotero.org/users/local/qnvKw9vm/items/Y6LJWJ3A"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/Y6LJWJ3A"],"itemData":{"id":311,"type":"article-journal","container-title":"Pakistan journal of medical sciences","issue":"3","page":"724","title":"Ethical Decision Making Levels of Nursing Students","volume":"34","author":[{"family":"Sari","given":"Dilek"},{"family":"Baysal","given":"Ebru"},{"family":"Celik","given":"Gul Gunes"},{"family":"Eser","given":"Ismet"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Sari et al., 2018). After surgery and saving her life and her baby’s, physicians and nurses need to explain her state and the critical condition to show her accept what physician did was best for her and her baby ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"azKA7iSe","properties":{"formattedCitation":"(Aitamaa et al., 2016)","plainCitation":"(Aitamaa et al., 2016)","noteIndex":0},"citationItems":[{"id":312,"uris":["http://zotero.org/users/local/qnvKw9vm/items/HGDZDWIU"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/HGDZDWIU"],"itemData":{"id":312,"type":"article-journal","container-title":"Nursing ethics","issue":"6","page":"646-658","title":"Ethical problems in nursing management: the views of nurse managers","volume":"23","author":[{"family":"Aitamaa","given":"Elina"},{"family":"Leino-Kilpi","given":"Helena"},{"family":"Iltanen","given":"Silja"},{"family":"Suhonen","given":"Riitta"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Aitamaa et al., 2016). The patient needs to understand the critical states in which she was admitted and also, following the principles of non-maleficence and justice, it was significant to take decisions on behalf of her ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"yLQocFe4","properties":{"formattedCitation":"(Norlyk et al., 2016)","plainCitation":"(Norlyk et al., 2016)","noteIndex":0},"citationItems":[{"id":310,"uris":["http://zotero.org/users/local/qnvKw9vm/items/HRF6SDLW"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/HRF6SDLW"],"itemData":{"id":310,"type":"article-journal","container-title":"Journal of Advanced Nursing","issue":"4","page":"936-945","title":"Interviewing with or without the partner present?–an underexposed dilemma between ethics and methodology in nursing research","volume":"72","author":[{"family":"Norlyk","given":"Annelise"},{"family":"Haahr","given":"Anita"},{"family":"Hall","given":"Elisabeth"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Norlyk et al., 2016). The patient was guided by the believes she had as it was the physician's responsibility to save her life and to make the decision that was best suitable for her and her baby. The healthcare providers have guided and advocated their patients regarding ethical principles and compared her condition to following the best suitable decision was to opt for surgery ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ncRMG9D7","properties":{"formattedCitation":"(Sari et al., 2018)","plainCitation":"(Sari et al., 2018)","noteIndex":0},"citationItems":[{"id":311,"uris":["http://zotero.org/users/local/qnvKw9vm/items/Y6LJWJ3A"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/Y6LJWJ3A"],"itemData":{"id":311,"type":"article-journal","container-title":"Pakistan journal of medical sciences","issue":"3","page":"724","title":"Ethical Decision Making Levels of Nursing Students","volume":"34","author":[{"family":"Sari","given":"Dilek"},{"family":"Baysal","given":"Ebru"},{"family":"Celik","given":"Gul Gunes"},{"family":"Eser","given":"Ismet"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Sari et al., 2018).
Ethical Principles
American Nursing Code of Ethics has established principles to deliver safe healthcare practice of all aspects of healthcare facilities ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"XFa6wqZJ","properties":{"formattedCitation":"(Aitamaa et al., 2016)","plainCitation":"(Aitamaa et al., 2016)","noteIndex":0},"citationItems":[{"id":312,"uris":["http://zotero.org/users/local/qnvKw9vm/items/HGDZDWIU"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/HGDZDWIU"],"itemData":{"id":312,"type":"article-journal","container-title":"Nursing ethics","issue":"6","page":"646-658","title":"Ethical problems in nursing management: the views of nurse managers","volume":"23","author":[{"family":"Aitamaa","given":"Elina"},{"family":"Leino-Kilpi","given":"Helena"},{"family":"Iltanen","given":"Silja"},{"family":"Suhonen","given":"Riitta"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Aitamaa et al., 2016). The principles of ethics that must be adhered to in the healthcare facilities are justice, beneficence, autonomy, and non-maleficence. Justice is termed in a sense of fairness and it means that the services delivered to the patient are fair, just and equally to all groups of communities ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1uZy5OPM","properties":{"formattedCitation":"(Aitamaa et al., 2016)","plainCitation":"(Aitamaa et al., 2016)","noteIndex":0},"citationItems":[{"id":312,"uris":["http://zotero.org/users/local/qnvKw9vm/items/HGDZDWIU"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/HGDZDWIU"],"itemData":{"id":312,"type":"article-journal","container-title":"Nursing ethics","issue":"6","page":"646-658","title":"Ethical problems in nursing management: the views of nurse managers","volume":"23","author":[{"family":"Aitamaa","given":"Elina"},{"family":"Leino-Kilpi","given":"Helena"},{"family":"Iltanen","given":"Silja"},{"family":"Suhonen","given":"Riitta"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Aitamaa et al., 2016). The principle of beneficence is defined as delivering healthcare facilities to the patients that are good for them. The principle of non-maleficence is described as not harm the patients and it includes intentional and unintentional harm ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"jblsBYWZ","properties":{"formattedCitation":"(Sari et al., 2018)","plainCitation":"(Sari et al., 2018)","noteIndex":0},"citationItems":[{"id":311,"uris":["http://zotero.org/users/local/qnvKw9vm/items/Y6LJWJ3A"],"uri":["http://zotero.org/users/local/qnvKw9vm/items/Y6LJWJ3A"],"itemData":{"id":311,"type":"article-journal","container-title":"Pakistan journal of medical sciences","issue":"3","page":"724","title":"Ethical Decision Making Levels of Nursing Students","volume":"34","author":[{"family":"Sari","given":"Dilek"},{"family":"Baysal","given":"Ebru"},{"family":"Celik","given":"Gul Gunes"},{"family":"Eser","given":"Ismet"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Sari et al., 2018). The principle of autonomy is respecting patients' believes and decisions therefore, nurses accept the patient as an individual and unique person to be respected in all ways.
References
ADDIN ZOTERO_BIBL {"custom":[]} CSL_BIBLIOGRAPHY Aitamaa, E., Leino-Kilpi, H., Iltanen, S., & Suhonen, R. (2016). Ethical problems in nursing management: The views of nurse managers. Nursing Ethics, 23(6), 646–658.
Epstein, B., & Turner, M. (2015). The nursing code of ethics: Its value, its history. OJIN: The Online Journal of Issues in Nursing, 20(2), 1–10.
Norlyk, A., Haahr, A., & Hall, E. (2016). Interviewing with or without the partner present?–an underexposed dilemma between ethics and methodology in nursing research. Journal of Advanced Nursing, 72(4), 936–945.
Sari, D., Baysal, E., Celik, G. G., & Eser, I. (2018). Ethical Decision-Making Levels of Nursing Students. Pakistan Journal of Medical Sciences, 34(3), 724.
