As a profession, nursing focuses on details that include harm prevention, caregiving, and protecting the clients’ dignity. In addition, it defends and promotes the caregivers’ objective of upholding the clients’ rights. Within the nursing profession, nurses have to apply eight main principles, which they should adhere to as they work. These principles include “truthfulness, autonomy, justice, fidelity, non-maleficence, respect, paternalism, privacy, and anonymity” (Timby, 2009, p. 83). The practicing nurses should adhere to the governmental and organizational laws that apply to the nursing profession. This paper looks at cases in which ethics and laws in nursing contradict coupled with how nurses can navigate such scenarios.
Ethics and law in Nursing Profession
Regardless of level or area of specialization, it is mandatory for all practicing nurses to operate and follow ethical guidelines set by regulatory and governmental laws. However, the line between ethics and laws in the profession is blurred in most cases. Nevertheless, if observed within the confines of the regulatory law, nursing standards remain legally defensible. Robley (2009) explains that in their profession, nurses often encounter many issues both ethical and legal in nature. However, some nurses may not be ready to respond to such challenges because they are unprepared for such events, which test their behavior.
The set laws act as a map for the nurses whereby any change from the already established policies attracts a harsh reprimand. On the other hand, unlike the laws, ethics cannot be defined by a set standard and they are immeasurable. They mainly rely on an individual outlook on issues and they are impossible to restrict or place as correct or incorrect. In most cases, a nurse contravenes the law through imminent or potential actions in which s/he may have been involved in an issue that resulted in a legal action (Timby, 2009). In nursing, legal questions may also arise in cases where an illegal behavior is committed in the event of misconduct or negligence, which connects the caregiver to a criminal behavior.
In their daily work, nurses come across different cases that may be classified as either legally questionable or ethically correct. In cases that revolve around euthanasia, the demise of a patient, or abortion, nurses automatically face hard decisions. A good example of a scenario that stands out relating to the nursing ethics and laws is a case where a nurse fails to report the fact that s/he administered wrong medication to a patient to protect him/herself from reprimand and legal actions. According to Robley (2009), such situations raise many questions that border on both law and ethics. Another nursing dilemma that may lean more towards ethical as compared to legal is a patient that needs a prescription of illegal drugs like marijuana for medication. Lastly, another case of an issue that may arise that borders ethical and legal lines is when a patient is forced to assume or partake in things devoid or against his/her wishes.
Existing Issues that Border Ethics and law in Nursing Profession
During their work, nurses are often caught between two opposing sets of demands. One demand stems from legal requirements and the other from the profession’s objectives. Regardless of the level or area of specialization, healthcare professionals may be involved in either criminal or civil justice systems; for example, when a nurse is charged for failing to renew his/her practicing license in time (Timby, 2009). In addition, cases where nurses offer or obtain medication illegally outside the confines of clinical stipulations also present scenarios that border criminal law.
Health care professionals should differentiate between ethics and law since an action can be unethical, but legal and vice versa. For example, the issue of reviving a dying patient draws controversy because while it may be legal, the ethicality of the practice is dubitable. On the other hand, one problem that might arise between law and ethics is when the caregiver notices that the current medication procedures or services are ineffective, for example, therapy services. However, under the professional ethics code, it is illegal to charge for the ineffective services (Robley, 2009). Similarly, nurses are legally mandated to indiscriminate when offering services to patients. In addition, the nursing profession is riddled with controversies due to varying beliefs courtesy of multiculturalism. For instance, blood transfusion might be unacceptable in some cultures, thus affecting the delivery of quality care to patients in such settings.
In most situations, the caregivers following their professional obligations may seem as unfair, biased, or invalid. In some instances, nurses stray from total adherence mainly when they perceive the law to be conflicting with their beliefs. Sometimes, healthcare providers may not be willing to discard their patient’s well-being or individual beliefs in a bid to adhere to the administrative system laws. For example, Kjervik and Brous (2010) point out that not all of them may remain bound by professional regulations while giving private or confidential information. In addition, problems may arise between ethics and law when making choices regarding disability, right to life, and incompetence.
Ways Nurses can handle Conflicts
Instances that often show the thin line between law and ethics mostly center on ideologies such as the patients’ well-being, trust, decisions, fairness, practice environment, nursing colleagues, confidentiality, the nursing profession, perspective towards life, and individual self-drive. When a situation applies to a given belief, but concurrently holds on to a different mitigation, a friction may occur (Iglesias & Vallejo, 2014).
A detailed description exists within the nursing code of practice on the nursing objective of catering to patient needs and reacting to environmental pressures that may promote drifts between law and ethics. Kjervik and Brous (2010) explain that the chances of friction between a nurse’s legal duty to his/her patient/employer and his/her ethical duties to the client may push the caregiver to consider the professional risk.
Unfortunately, policymakers have not come up with proper guidelines on how nurses should handle the conflicts that arise in the course of executing their duties.
The referred codes of ethics in some cases fail to offer any legal cover for caregivers and they may be too rigid to apply (Cady, 2012). In addition, the set guidelines may restrict nurses from offering differing services based on the patients’ backgrounds and beliefs. Such laws go against the nursing practice laws and ethics that mandate equality for patients. Iglesias and Vallejo (2014) explain that when the patient’s family rejects a caregiver’s medication or suggestions, it sparks a possible moral problem and conflict for the caregiver.
Ways through which Nurses have dealt with Ethics and Law issue historically
Nurses face a dilemma when facing some situations like cases where their lives are in danger or forced to execute some duties outside their mandate. The unreasonable burden on caregivers shows when their ability to exhibit satisfactory standards of practice and safe care are interfered with by threats of health, lack of resources, and impossible expectations (Park, 2009). In such instances, the nurses are not mandated to place themselves in danger for the sake of care delivery. This assertion means that they can avoid situations that expose them to personal harms. In line with individual competence, nurses are expected to continue practicing continuously and competently in a bid to gain relevant skills and knowledge within the area of expertise (Cady, 2012).
In addition, there has never been a law that forces nurses to offer health care that is above his/her area of expertise. In case that nurses are required to do more than their competence level, then they should try their best to seek assistance. In cases where the needed health care is in conflict with the nurses’ beliefs or conscience, then they should talk to their employer and try their best to refrain from engaging in such cases (Kjervik & Brous, 2010). In health care, conscientious objections should not be based on personal judgment or biases that contradict with the patients’ way of life.
Nurses have “historically used the nursing code of practice to solve the problems that often arise between law and ethics through the guidance offered by the practice code of conduct as well as respectful dialogue” (Timby, 2009, p. 112). The code borrows from the universally shared belief that the nurses’ core objectives encompass the protecting, restoring, and enhancing the clients’ well-being, ailments prevention, and lessening of the patients’ suffering within the caring of communities, families, groups, and individuals (Cady, 2012).
In addition, throughout history, the management of healthcare facilities is supposed to come up with mechanisms on hoe to handle dilemmas in the workplace as a way of supporting nurses. It opens a channel on which divergent perspectives can be aired, provide support for the healthcare professionals, and lessen the institutional, legal challenges often-involved (Kjervik & Brous, 2010). The profession standard can help the caregivers in understanding the nursing behavior by detailing the relevant ethical standards required for professionals, guaranteeing that the nurses maintain their initial objective of caring for the clients, and offering a sign of the nursing profession’s commitments to the public (Park, 2009).
While making ethical decisions, nurses are expected to go for alternatives that do not contravene the set ethical standards and law. However, such choices should ensure that patients get the maximum care and safety. Unfortunately, even the best options available may infringe on the patients’ rights or the nurses’ values. Therefore, nurses should highlight and evaluate the facts that give rise to the dilemma, analyze the available options and form a countermeasure, single out the problem, and implement the formulated mitigation strategy. The standard ethical and legal policies established within the nursing practice should never be neglected on the justification of upholding the patients’ well-being. Nurses often base their arguments of going against the set ethical and legal standards on the conflict that arise between their legal or moral obligation and their deeply founded values. Therefore, it is important to ensure that their behaviors revolve around the right legal judgments, as opposed to self-interest or biases that the caregiver might hold.
Cady, R. (2012). Healthcare reform after the Supreme Court ruling: Implications for nurse executives. JONA’S Healthcare Law, Ethics, and Regulation, 14(3), 81-84.
Iglesias, M., & Vallejo, R. (2014). Nurse attitudes in relation to health care ethics and legal regulations for nursing. Acta Bioethica, 20(2), 255-264.
Kjervik, M., & Brous, E. (2010). Law and ethics in advanced practice nursing. New York, NY: Springer.
Park, M. (2009). Ethical issues in nursing practice. Journal of Nursing Law, 13(3), 68-77.
Robley, L. (2009). Reigniting the debate over assisted suicide. Nursing Critical Care, 4(5), 15-17.
Timby, B. (2009). Fundamental nursing skills and concepts. Baltimore, MD: Lippincott Williams & Wilkins.