LEGAL ASPECT OF CONSENT IN NURSING - Essay Example

?Legal Aspect of Consent in Nursing Nurses are required to obtain the consent of the patient before invoking any medical intervention otherwise suchan act would be seen as assault and battery. The law requires that nurses obtain explicit consent from a patient who fulfils certain conditions so that the nurses are clear from blame. In case that explicit consent is not available, implied consent or authorisation by primary care givers can be utilised. Legal stipulations require that nurses need to acquire consent before any major medical procedures are carried out. Legally, a person should be in senses, of the legal age of consent and able to form decisions if they are to provide consent. However, it may not be possible for the patient to make decisions if they are not of the legal age of consent, are out of senses or are affected enough not to make sane decision. In such cases, the next of kin are responsible for providing explicit consent for medical procedures. In any of these scenarios, it is the nurse’s responsibility to ensure total confidentiality as a part of essential ethical practice. Confidential information available to nurses may be used against the subject individual who was gained consent from. A breach of confidentiality may occur if the nurse provides information on the patient willingly or unwillingly to any unconcerned party without the patient’s consent. Nursing entails a number of different ethical and moral responsibilities much like other professions. One of the key ethical responsibilities of nurses is to ensure that consent is obtained prior to performing any routines on a patient as described by Gallagher and Hodge (2012, p38). Carvalho et al. (2011, p12) detail that it is the responsibility of nurses involved to ensure that all stakeholders including the patient and his care givers are on board in terms of consent to avoid problematic situations later. In addition to the conventional roles of nurses as carers of patients, the roles of nurses and their ethical responsibilities have been on the increase. Parahoo (2006, p469) outlines how consent is also involved in nursing research, where it is essential to obtain the patient’s or their care giver’s consent after being properly informed on how the obtained information will be utilised. The Royal College of Nursing (2011, p5) mandates that it must also be taken to note that the ethical dimensions of informed consent in nursing have given way in certain areas to legal principles and codes. Healthcare has required extensive ethical involvement since various procedures are risky, invasive as well as needless at times. Informed consent has been an increasing part of the healthcare sector given the need to protect the interests of the patients. The initial development as ethical guidelines has given way over time to legal practices. This has ensured that patients get to choose what kind of treatment they want to undertake for any medical condition. However, informed consent is not without its complications. Bosek and Savage (2006) relate instances where the patient is unable to express himself or herself such as in the state of a coma or in an emergency where the patient is unconscious. In such cases, legal guidelines and practices exist to ensure that the patient’s rights are not encroached upon in the name of necessary and indispensable action. Dimond (2009, p140) provides that this ensures that patients who are unable to speak for themselves still have their rights looked after in the realm of healthcare. Essentially informed consent and its legal and professional aspects tend to protect the interests and rights of both the nurse and the patient alike. The patient is provided with rights to choose treatment and following the applicable laws allows the nurses to avoid professional as well as legal ramifications. It is the primary responsibility of the nurse under the law to ensure that the patient is fully informed before any medical procedures begin. Wood and Wainright (2007, p35) explain that the nurse is under obligation to inform the patient on what the procedures would require and what kinds of consequences the patient would have to deal with. Under the law, it is the duty of the nurse to ensure that the person providing consent is mentally able and fit to do so. Patients suffering from Alzheimer’s or Parkinson’s may not be able to provide consent since their mental competence is in doubt. Applebaum (2007) provides that there are two methods to deal with such situations; either consent is gained prior to the onset of such symptoms or applicable laws are used to determine the state of mental incompetence and further treatment is prescribed if the patient is found to be mentally incompetent to provide consent. The Mental Capacity Act (2005) serves as the primary guideline in order to classify if a patient is capable enough of providing consent after being provided with the information regarding treatment. Another situation arises when dealing with children who are legally under the age of consent. In order to treat children, consent has to be obtained nonetheless but from legal custodians rather than from the children themselves. James and Cornock (2008, p45) argue that young persons under the legal age of consent can provide consent through their parents in the majority of cases. However, in certain instances, there may be complications such as the child’s dispute with the parents or dealing with children in orphanages. In such instances, the law provides clear and comprehensive guidelines with regards to dealing with children disputing with their parents. Bahadur et al. (2001, p191) argue that children under the legal care of custodians other than the parents such as adopted guardians etc. can provide consent required to deal with medical procedures. Moreover, children not under the care of such custodians such as children in orphanages are dealt with using legal guidelines provided by the Court of Protection as well as the Office of the Public Guardian. Medical consent may not only be required in the case of a living patient but may also be required for dead patients such as for organ donation. It is again the duty of the nurse to inform the patient as to what the applicable rules and guidelines are under the legal framework to enable a person to donate organs. Ethical concerns must be given preference since there are dangers that the donated organs may be sold on the black market or abused otherwise if the issue is not dealt with ethically. The patient must provide consent in written form such as through a living will to allow for organ removal after death. This stands in contrast to living patients donating organs such as kidneys since the patient’s consent can be obtained and used with immediate effect. Euthanasia is another controversial part of nurse’s medical routines that has been in the limelight for some time. Both Smart (2009, p100) and Otlowski (1997, p175-177) argue that it is illegal to assist a person to commit suicide in the United Kingdom under the law and so medical professionals of any sort assisting such activities are clearly in breach of the law. On another note, nurses have extensive confidential information relating to patients and such information should not be released without the patient’s consent in any possible form. Any breach of confidentiality on the part of the nurse, whether intentional or unintentional, can have dire consequences for the patient involved leading to a major ethical failure on the part of the nurse. References Applebaum, P.S. (2007). Assessment of Patients' Competence to Consent to Treatment. The New England Journal of Medicine, 357,(18). Bahadur, G., Whelan, J., Ralph, D. & Hindmarsh, P. (2001). Gaining consent to freeze spermatozoa from adolescents with cancer: legal, ethical and practical aspects. Human Reproduction, 16(1), pp.188-93. Bosek, M.S.D., & Savage, T.A. (2006). The Ethical Component of Nursing Education: Integrating Ethics into Clinical Experiences. (1st ed). Lippincott Williams & Wilkins. Carvalho, S., Reeves, M., & Orford, J. ( 2011). Fundamental Aspects of Legal, Ethical & Professional Issues (Fundamental Aspects of Nursing). Quay Books. Dimond, B.C. (2009). Legal Aspects of Consent (Legal Aspects of Healthcare). (2nd ed). Quay Books. Gallagher, A., & Hodge, S. (2012). Ethics, Law and Professional Issues: A Practice-Based Approach for Health Professionals. London: Palgrave Macmillan. James, E., & Cornock, M.A. (2008). The legal status of the term 'next of kin'. Nursing Standard, 22(44), pp.45-48. Otlowski, M. (1997). Voluntary Euthanasia and the Common Law. Oxford: Oxford University Press. Parahoo, K. (2006). Nursing researh: principles, process and issues. (2nd ed). Basingstoke: Palgrave Macmillan. Royal College of Nursing. (2011). Informed Consent. [pdf] Available from: http://www.rcn.org.uk/__data/assets/pdf_file/0010/78607/002267.pdf [Accessed 27th June 2013]. Smartt, U. (2009). Euthanasia and the Law. Criminal Law & Justice Weekly, 173(7), p.100. Wood, J., & Wainwright, P. (2007). Cardiopulmonary resuscitation: nurses and the law. Nursing Standard, 22(4), pp.35-40. Read More