NURSING QUESTION Scenario: Peter, a 35-year-old, was brought via ambulance to th

Question

NURSING QUESTION

Scenario:

Peter, a 35-year-old, was brought via ambulance to the emergency department after collapsing on the street. He was diagnosed with appendicitis and the surgical team was alerted to the potential surgery. The physician prepared to obtain informed consent and began discussing the simple effective surgery and the treatment with the patient. The RN was present at the bedside. The patient stated he did not want surgery. Based upon his beliefs as a Christian Scientist, it is against his practices. He requested a Christian Science practitioner. The patient rated his pain as 9 on 0-10 verbal pain scale so the RN prepared the narcotic analgesic to relieve the patient’s pain. The patient declined the medication. The RN believes the patient should accept the pain medication and have the surgery thinking “If it were me I would proceed with the surgery and treatments proposed by the surgeon.” The surgeon can be heard speaking to a fellow surgeon about how to go about changing the patient’s decision.

In 100 words or more, please state and discuss the legal and ethical considerations occurring in this scneario. Include supporting citations.

Thank you.

Explanation / Answer

The ethical aspects are going to determine which is good and which is bad to implement across various religious & cultural communities mainly in the aspects of public health. There are various cultures, religious communities across the human societies & these are different from individual to individual.

In the above case, 35-year old Peter (a Christian Scientist) has been suffering from chronic “appendicitis pain” and He is a Christian believer. Therefore, as per Christian religious belief, he felt himself that his pain will reduced “through payer and healing”. So that, he is rejecting pain mediation (i.e. narcotic analgesic) even though patient’s verbal pain scale is as 9 on 0-10. However, RN should respect patient’s cultural beliefs, autonomy. RN should follow beneficence and he/she must get patient’s informed consent or refusal consent for surgical procedures from Peter politely.

One should respect patient autonomy, religious and cultural aspects in every community within the society. The philosophical perspective of public health is to respect patient privacy in terms of strict prohibition of disclosure of information irrespective race, religion or culture. These are aspects of relativism essentially enable to “work out our common values, norms, mores in the midst of diversity”. Every health care individual have crucial responsibility in recognizing cultural diversity, religious diversity, context finally implementing ethical –based decisions in maintaining patient’ health information safe & secure. Majority of human beings do not wish to share their disease profiles mainly HIV, syphilis due to their individual cultural, religious norms. Therefore, it is our common responsibility in to work out our common norms, values in “the midst of cultural, religious diversity” in terms of contextualist perspective without any bias and inconsistencies. The public health implications should be implemented as per care ethics, virtue ethics. Therefore, health care workers, nurses, clinicians ensure & competent about the ethical dilemmas, solutions in their professions. Nursing informatics promote clinical nurses to make ethical based health care decisions in the aspects of public health.

Every healthcare provider should think seriously to Peter’s pain situation to deliver an efficient ethical based decision without ethical dilemma. The ethical theories including principlism, justice, and fidelity should be applied in public health, health care informatics in which ethical dilemmas associated with the incorporation of bio-informatics, should be examined to deliver an ethical framework. Ethical theories of informatics should follow code ethical –professional conduct to protect patient cultural & religious rights, patient’s privacy of health information about HIV, syphilis infection. An ethical framework in informatics should help healthcare practitioners to ethical treatment of electronic medical record & data collection, storage, manipulation and dissemination about the patients in this pluralistic society.

Various ethical issues are associated with during informatics based public health practice mainly in terms of culture, religious aspects of patients. A registered health care professional must respect patient autonomy, patient’s individual choices and beliefs (ex. Moral, religious) finally; a nurse must take a decision without dilemma. Patients of different cultures, religions have right to be given all the risk factors, adverse effects & benefits that are associated with sexually transmitted diseases & their respective medication. Nurses must provide a systemic and reflective method of approach to convey sufficient information & reasons for patient’s moral beliefs during informatics based nursing practice to maintain proper public health.

Health care workers must follow code of ethics with ethical decision & beneficence in which registered clinical nurse should possess adequate responsibility to ensure that their service positively benefit their patients of different cultures. Justice must be maintained as part of professional code of ethics during the ethical based nursing practice at every rural & urban community level with impartiality. The public health aspects should be implemented with “veracity” i.e. patients must not be given false or misleading information & should not lie or deceive.

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