Ethical Issues in Health Care Delivery

Every day nurses make decisions that have critical ethical and legal implications. In addition, nurses must follow doctors’ orders and defer to the wishes of patients and families even when they are not in agreement with those actions. A study conducted by Pavlish et al. (2011) highlights this tension. Researchers surveyed 91 nurses attending a nursing ethics conference and found many of the nurses’ concerns centered on relieving pain in patients while still respecting the wishes of the family (Pavlish et al., 2011). One such dilemma was described as follows:

Family of 40-year-old terminally ill patient with cancer refuses all pain medication for fear patient will die. Patient often moans and cries with pain and indicates she wants pain medication. Family has power of attorney and threatens lawsuit if patient is given anything that results in her death. (Pavlish et al., p. 390)

Consider your own experiences when faced with ethical challenges. Were you able to advocate for the patient in the way you thought was best? How do you handle situations when your own clinical judgment may differ from other health providers or from the patient’s family members?

This week, you will discuss ethical principles related to the aging population, and you will analyze specific provisions of the ANA Code of Ethics in relation to advocacy for population health.

Reference:

Pavlish, C., Brown-Saltzman, K., Hersh, M., Shirk, M., & Rounkle, A. (2011). Nursing priorities, actions, and regrets for ethical situations in clinical practice. Journal of Nursing Scholarship, 43(4), 385–395. doi:10.1111/j.1547-5069.2011.01422.x

Learning Objectives

Students will:

• Evaluate ethical standards for the allocation of resources for an aging population and end-of-life care 
• Analyze challenges related to the provision of health care for an aging population
• Analyze attributes of an effective health advocacy campaign
• Propose a policy solution for a population health issue 
• Assess the role of ethics in developing an advocacy campaign