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Doug Mann LPN, LNC

Medical and Nursing Ethics

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Medical & nursing ethics

by Doug Mann, posted 8 December 2005
Professional ethics in the fields of medicine and nursing can be boiled down to two imperatives: to do no harm, and to assist patients/clients to maximize health capabilities.
The client / patient has a right to expect that a physician / nurse has the necessary skill and knowledge to meet or exceed professional standards in the areas where they claim to have expertise. For example, physicians should be informed of accessible, authoritative, and long-standing recommendations for the diagnosis and treatment of diseases for which they assume the responsibility to treat (e.g., standards of care can be accessed online through sources such as medline, Centers for Disease Control, National Institute for Clinical Excellence, etc.).
Physicians have a duty to obtain informed consent for treatment, which can only be meaningful if the patient /client "...has been informed regarding his or her diagnosis, prognosis, the risks and benefits, and consequences for a full range of available medical interventions..." (see paragraph below). When a loss of decision-making ability can be anticipated, the physican has a solemn obligation to assist patients in formulating advanced directives for medical care. It is the physician's responsibility to ensure that:
"(1) the patient has decision-making capacity; (2) the patient has been informed regarding his or her diagnosis, prognosis, the risks benefits, and consequences for a full range of available medical interventions, including the option of no therapy; (3) the patient has recieved from the physician professional recommendations regarding the medical choices available, including the use of life sustaining therapy, based on knowledge of both the medical situation and the values and goals of the patient." - Standards for the Diagnosis and Care of Patients with Chronic Obstructive Pulmonary Disease, Official statement of the American Thoracic Society, Medical section of the American Lung Association, approved by the ATS Board of Directors, March 1995.  American Journal of Respiratory and Critical Care Medicine, vol. 152, page 5114. (1995)
For a nurse, the ethical basis for decision-making is her / his role as a patient advocate. "Standards of nursing practice" adopted by the American Nursing Association in 1973 describes nursing as an autonomous health profession in developing, implementing, and evaluating plans of care. A plan of nursing care is based upon systematic and continuous observations about health status that are accessible, communicated, and recorded. A plan of nursing care must involve the patient to the greatest extent possible in setting goals, priorities, and criteria used to evaluate the effectiveness of the plan. The objective of any nursing action is to "...assist the client/patient to maximize his health capabilities." - Source: Sloan, Gale  Nursing and Malpractice Risks: Understanding the law. Western Schools., Inc. 1991