Introduction
Laws are laid-down rules that clearly stipulate what should be done and what should not be done. When such rules are not adhered to (any form of deviation), it may lead to punishment. Ethics, on the other hand, may not be likened to law since they are not measurable. Since they are basically a person’s perception of issues, it may not be possible to say whether something is right or wrong.
During the career of a practicing nurse, one may encounter several dilemmas that may be either ethical or legal in nature (Huang, 2009). Unfortunately, most of them are not trained to deal with such situations. Therefore, they may end up being caught up and may not have a clue on how to defend themselves when their ethics or conduct are questioned. When this happens, the medical practitioner may not be in a position to defend himself or herself from a malpractice suit. For this very reason, it is important for every nurse to understand the damaging consequences of such issues to their careers. In today’s society, such knowledge is vital and a requirement for every practicing nurse (Creel, 2010). This paper will identify and discuss the dilemmas in nursing and particularly the legal and ethical issues. It will also look at how nurses may be able to negotiate the conflict when they arise.
Ethics and legal responsibilities of a nurse
In nursing, there are various legal and ethical guidelines that are stipulated in the Nurse Practice Act. Such laws protect the public and the nurses in case their integrity in the line of duty is questioned. These laws usually differ from one state to another. They usually define what is legally and ethically correct for the nurse to do. Therefore, they ensure that high quality health care is provided by the nurses and that they become upstanding people in the society.
One of the general ethical considerations in nursing is that everyone must be treated individually and their dignity and worth respected. The nurses should also handle all their interactions professionally. The client’s socioeconomic status, health condition or perceptions should not influence the nurses’ professionalism. The nurses’ primary concern should be the client’s well being and state of mind. Any breach of these values is legally binding and one may be held responsible.
Another ethical responsibility of the nurse is the promotion of health (Toren & Wagner, 2010). One is expected to devote his or her attention to the health care environment of their clients. Nurses should also work towards the prevention of illnesses. This may be done through educating the patients to understand how to avoid illnesses. This may be through the observation of the correct diet and taking of correct and prescribed medication. Patients should also be trained to follow the doctor’s instructions. The nurses are expected by law to ensure that the patients are relieved of any pain and suffering. This may include the provision of sufficient pain relief pills. They should also inform the doctors of the pain levels of the patients.
Conflicts between ethics and law
There are several situations whereby conflict may arise between ethics and the law and the nurse may be in dilemma. In such situations, the nurse needs to decide on the best course of action to take. An example of situation whereby a nurse may be faced with an ethical and legal issue is whereby a nurse may give a patient the wrong medication then he or she covers up the wrongs. The nurse may not report the issue but instead withholds the information in order to protect him or herself. Another situation is whereby the medical practitioner may allow the patient to smoke marijuana due to its medical characteristics. This way, the nurse would be going against the law since marijuana smoking is prohibited (in most countries). However, the nurse may see the usefulness of the drug to the particular patient. Such a situation is an ethical one rather than a legal one.
In other situations, the medical practitioner may force a client to do something against his or her own will. One may also fail to take the client into complete confidence. A nurse may decide to force the patient to do something that he or she believes is good for the patient. This situation is legal rather than ethical. Other situations are neither ethical nor legal. An example of such is whereby a nurse does exactly as the doctor instructed.
Other situations may appear ethically right but legally unacceptable or legally correct by unethical. Some activities such as abortions or mercy killing may be illegal but may appear as the best solution at specific cases. For example, if performing an abortion is the only way to save the mother, the nurse may be put into dilemma.
Historically, some nurses have acted away from their ethical obligations to provide mothers with abortion bills since the mothers were not in a position to financially support the child. This may not necessarily be legal but they have acted out of their own beliefs and emotions. For a long time, nurses have gone out of their personal ethics in order to promote family planning. Others have promoted safe sex and encouraged the use of birth control pills.
How nurses should negotiate such conflict
Nurses should be trained well and be informed of how best to deal with such situations that may jeopardize their career (Creel, 2010). They should be able to justify their actions legally rather than to act out of their gut. Countries such as Canada have laid down clear guidelines pertaining to such ethical and legal dilemmas. For example, the Canadian Nurses Association (CAN) has such guidelines. Such information is important for all nurses so that they may be in a position to make ethically acceptable choices and those that are not legally punishable.
Therefore, standardised ethical codes assist the nurses to make the best decisions when they face difficult situations (Toren & Wagner, 2010). Such situations may be difficult to make or may be too complicated for individuals to resolve. Nurses may have their own beliefs about such matters that may conflict with the code of ethics. In such situations, the nurse has to abide by the professionally standardised ethics. One is also required to use his or her judgment to balance the principles of ethics.
One way a nurse may make a decision on what to do is through evaluating the issue from the point of view of beneficence (doing good). This means that the nurse has the responsibility to take a particular course of action when he or she sees the need to do so. Another point of view that one may reason out is that of nonmaleficence. This is whereby the nurse acts in a way as not to harm the patient. However, some situations may not present a possibility of not harming the patient. Therefore, the nurse may need to choose an option whereby the activity may be least harmful.
Another thing that nurses may need to do is to respect the autonomy of the parties involved. This means that even when the nurse’s moral principles and beliefs do not agree with those of the patient, the choices of the patient are to be respected. It is an ethical obligation that the nurse should honour the individual’s right of autonomy. Nurses are also expected to tell their patients, fellow nurses and the physicians the truth (veracity). They are also expected to keep their promises (fidelity). These are the ones made to the patients or other health care professionals. Finally, nurses are allowed to violate the ethical principles but only in situations where justice demands.
Conclusion
The nursing profession may be characterised by situations that may not be straight forward but complex. These situations may challenge the nurse to question the laid down laws and code of ethics. Nurses may feel the need to act out of their obligations in order to do what they believe is the right thing. For example, a nurse may be required to perform an abortion in order to save the mother. However, such activities may be illegal and cost the nurse his or her job. Therefore, a nurse needs to understand how to act in such situations. Nurses need to be trained on how act when such situations present themselves so that they would act as expected. Therefore, all nurses should follow the standardised code of ethics.
References
Creel, E. (2010). Ethics in independent nurse consulting: Strategies for avoiding ethical quick sands. Nursing Ethics, 17(6), 769-776.
Huang, M. (2009). Nurse Practitioner’s ethical and legal dilemma: Caring for a young child without a parent in the school-based health center setting. Clinical Scholars Review, 2(1), 19-22.
Toren, O., & Wagner, N. (2010). Applying an ethical decision-making tool to a nurse management dilemma. Nursing Ethics, 17(3), 393-402.