Grounds for Nurses Abject - Term Paper Example

Ethical and Legal Issues in Nursing Care of AIDS Victims AIDS is a highly morbid condition that is now widely spreading worldwide. The scarcity of cure during the progression of AIDS seems to create wary awareness in health care personnel, especially for registered nurses who are front liners in care--the ones in close care contact in medical areas. Accordingly, health professionals are medically bound in providing interventions appropriate to patients with HIV infections; “a virtuous act...affirming the moral mission of health care” (“Legal and Ethical Issues,” 2005). Majority of obligations that health personnel have to uphold are related to treatment of patients, regardless of the condition of the latter upon treatment; yet, there are still remnants of fear in the disposition of most nurses. In a research conducted by Reis, Heisler, Amowitz, Moreland, Mafeni and Anyamele (2005), out of 1,021 samples, 9 % of the health personnel tendered their refusal to deliver care, while only a small fraction do not care whether patients are HIV positive or not. In these scenarios, there is the decided notion that nurses may utilize their legal and ethical rights to protect themselves from harm, at the expense of AIDS patients. Although the presence of ethical and legal parameters ensure minimal oversights in care of AIDS patient, these measures may, in return, serve as solid grounds for nurses’ abject refusal in performing close care for AIDS victims. Influence of Attitudes and Values in Provisions of Care Nurses’ standard in patient care dictates the ethical values they follow in giving optimal care. These ethical obligations are appropriately affirmed in health policies in legal systems created by the State, rooted on “international human rights norms...(for) standard of health care” (United Nations Office on Drugs and Crimes, 2006). Values incorporation is significant in AIDS patients, for they are already shunned by society and need the medical understanding of health professionals in dealing with the blow of their condition. Common principles retained in delivering optimal nursing care are “autonomy, nonmalefeasance, beneficence, and justice” (Singh & Banerjee, 2004). Individual rights of patients are guarded, hence, they have the autonomy to decide the care they deem better for them--nurses are obligated to explain the risks involved in every decision made. While beneficence dictates nurses to always “do good,” they must also “avoid harm” or nonmalefeasance. Above all, objective equity must prevail (Corexcel, 2004). This means absence of bias or personal preferences in health service, hence, the justice in care. Like other fields of profession, nurses also have sets of rights that look after their welfare while on service. Consequently, application of core principles in care clashes with rights of nurses as individuals. Legally, nurses have the responsibility in safeguarding the status of their own health and others (Department of Health, 2005). There is implication that such duty may entail refusal of nurses to care for AIDS patients for fear of contagion in the area. They have the option to refuse, in cases wherein they are in circumstances that violate “moral standards of the profession” (Congress of Nursing Practice and Economics, 2006). In this, core values that secure the rights of AIDS victims are in direct conflict with protective rights of nurses to protect themselves. In here lies the ethical and legal dilemma in providing measures of care to contagious patients. Laws are formulated to shield both nurses and patients; however, as medical professionals, nurses are extensively obligated to risk their own health to save others. The principle of justice ensures fair treatment at all cost, yet, nurses are not fairly considered--their lives are threatened with continued contact with AIDS patients. In spite of these, the extent of deciding for their own personal welfare is never an act that coincides with the value of beneficence and justice. Refusals on the part of nurses may in turn result in damaging impact, endangering the condition of AIDS patients--eventually doing harm to them. Patients must be top priorities, while nurses are ethically accountable to ensure such altruistic purpose, at their own expense. Promotion of Health and Management of Ethical and Legal Issues in Care The priority in care has recently shifted from treatment to prevention of diseases. In this, nurses are key instruments for AIDS victims to get quality service. There should be “fairness in access of treatment and care” (World Health Organization, 2004). Discriminative attitude toward this type of disease must not color the kind of services given. If not give the opportunity to receive quality services, health professionals are already breaking the standard legal and ethical code of justice of treatment. According to Rennie and Behets (2006), the primary method in promoting health is the creation of policies in routine HIV-screening. This must be bounded on legitimate ethical regulations by the State. As agents who perform HIV screening, the role of nurses is very important, for they must know the regulatory standards of voluntary screening, in order to protect the patient’s rights of AIDS victim. In this, nurses must be sufficiently knowledgeable both in clinical and ethical aspects of nursing care to avoid conflicting issue. If confronted with constant fear for own safety, moral obligations dictate optimal care for patients regardless of their status. In addition, the skills acquired during practice, such as "decision-making capabilities and clinical judgment" for assessment should also be enacted during probabilities of disease contraction (Corexcel, 2004). More importantly, the source for such refusal must be identified. Most of the time, anxiety stems from unsecured environmental structure and unreliable safety equipments, hence, nurses are fearful for their health in such situations. By eliminating this, nurses are better able to cope up with the stress and little reason to avoid care for AIDS patients. The option for refusal, therefore, diminishes when situations are secured enough for their practice. Other Sources of Legal and Ethical Issues in Various Health Settings Aside from the controversy of the right to refuse care for highly contagious patient, the ethical consideration of confidentiality in patients with AIDS is debated. Others insist that the public has the right to know if individuals are HIV contagious or not, while medical practitioners are held accountable on their duty to protect the welfare of the patients--including confidentiality aspects. The law seeks to protect the human rights privilege of AIDS victims (Lashley & Durham, 2010). In the face of public safety, such proposition may increase the threat to communities if information is not made public--paving way to discrimination that the victims may face. The breach in confidentiality is deemed ethically correct in situations wherein imminent threat is at hand (Dickens & Cook, 2000). It is within the discretion of health care professionals to objectively identify when it is appropriate to breach the core values, especially if public welfare is at stake. In accord, ethical and legal issues are strictly intertwined together. Like the issue on confidentiality, the right to refuse is also dependent on the moral commitment of nurses to act. Hence, the grounds for ethical and legal actions may consent to give nurses options for care, but these also delineate the extent of the options--personal welfare is only secondary to patient and public welfare. Conclusion All in all, the issue on refusal to provide care falls under moral option, and not an obligation. Nurses, as logical beings, are given the opportunity to assess the situation and determine whether they can provide services optimally or not. In the case of failure for maximum service, they are protected by their right to keep themselves safe from harm--in the absence of personal preference. Actual danger must exist, for if not, nurses have weak grounds in justifying the decision to refuse. Core values and legal directives in health care may not be intentionally biased, as regulations created to safeguard both the rights of health providers and recipients--with consumers as number one priority. In handling situational conflicts, nurses have to revert on the foundation in nursing practice, this way, decisions may be more definite and resistant to prejudice. References Congress of Nursing Practice and Economics. (2006). Risk and responsibility. Retrieved from http://198.65.98.170/MainMenuCategories/EthicsStandards/Ethics-Position-Statements/RiskandResponsibility.aspx Corexcel. (2004). Legal issues in nursing: Ethics. Retrieved from http://www.corexcel.com/courses4/Legal_Issues_in_Nursing_Course_Handout.p df Department of Health. (2005). HIV infected health workers: Guidance on management and patient notification. London: COI Communications. Dickens, B.M., & Cook, R.J. (2000). Law and ethics in conflict over cofidentiality? International Journal of Gynecology and Obstetrics, 70, 385-391. Lashley, F.R & Durham, J.D. (2010). The Person with HIV/AIDS: Nursing Perspective. New York, NY: Springer Publishing Company. Legal and ethical issues raised by HIV/AIDS: Literature review. (2005). Retrieved from http://www.aidslex.org/site_documents/T000E.pdf Reis, C., Heisler, L.L., Amowitz, R.S., Moreland, J.O., Mafeni, C., Anyamele, V.I. (2007). Discriminatory attitudes and practices by health workers toward patients with HIV/AIDS in Nigeria. Retrieved from http://www.plosmedicine.org/ article/info%3Adoi%2F10.1371%2Fjournal.pmed.0020246 Rennie, R., & Behets, F. (2006). Desperately seeking targets: The ethics of routine HIV testing in low income countries. Bull World Health Organ, 84 (1). Singh, Z., & Banerjee, A. (2004). HIV/AIDS: Social and Ethical Issues. MJAFI, 60, 107-108. United Nations Office on Drugs and Crimes (2006). HIV/AIDS prevention, care, treatment and support in prison settings. New York: United Nations. World Health Organization. (2004). Guidance on ethics and equitable access to HIV treatment and care. Retrieved from http://www.who.int/ethics/en/ethics_equity_HIV_e.pdf Read More