A good patient-nurse relationship is characterized by a modicum of trust and cooperation between the two parties. The patient respects the expertise that the health professional brings them and tries their best to follow the prescribed activities. The nurse, on the other hand, respects the patient’s autonomy, gets them involved in decision-making processes related to their health, and respects their choices (Fernández-Ballesteros et al., 2019).
The nursing code of ethics describes a good or a bad relationship in terms of several paradigms, including rights, virtues, and the principles of the greater good. From a rights perspective, there are dilemmas regarding the patient’s authority over their own bodies versus the nurse’s greater medical expertise. The virtues of personal autonomy versus life and principles versus survival also come into consideration (Fernández-Ballesteros et al., 2019). My experience has taught me that respect and mutual understanding form the foundation of any healthy relationship. When it comes to patients, treating them as experts in their own bodies can lead to better responses and increased receptivity to the nurse as an expert in medicine, rather than an opposing force.
Extreme cases serve to test the precipices of a healthy and mutually beneficial bond between the two parties. When irreconcilable issues arise, the patient must weigh their own autonomy against the expertise and trust they have placed in the healthcare professional. Paternalism in medicine is described as the practice of putting the professional opinion of a healthcare worker over the wants and desires of the patient. The conflict between paternalism and autonomy lies in the fact that a patient may not always be in a state of mind that allows them to make informed decisions about their health. Additionally, broader societal, ethical, and familial considerations need to be taken into account (Fernández-Ballesteros et al., 2019).
Goldman’s arguments for and against paternalism are described as follows: the nurse places a greater emphasis on the collective common good and the patient’s survival (For); the patient may not consider their own survival as a supreme value (Against) (Fernández-Ballesteros et al., 2019). Religious beliefs or a desire to escape suffering may be viewed as legitimate reasons to seek an end to one’s life. A good nurse-patient relationship, as described above, would tackle Goldman’s dilemma together, reviewing all available treatment options and procedures before making a decision. Ultimately, though, if the patient is lucid and capable of making decisions about their health, they would be the ones to decide their own fate, making autonomy a more respected virtue over all other considerations.
Reference
Fernández-Ballesteros, R., Sánchez-Izquierdo, M., Olmos, R., Huici, C., Ribera Casado, J.M., & Cruz Jentoft, A. (2019). Paternalism vs. autonomy: Are they alternative types of formal care?. Frontiers in Psychology, 10, 1460.
