HEM 1: Task 3- Position Paper
Kamaldeep Kaur
College of Health Professions, Western Governors University
D129: Advanced Professional Roles and Values
Deborah Dillard
A.
There are many ethical challenges nurses may experience in their practice, especially
when working for a large and complex healthcare organization such as a University associated
Level 1 Trauma, Burn, and BCT inpatient care facility centered in a metropolitan city. Due to the
nature of the complex patients that seek care at these organizations and the collaboration of
several specialties providing care, ethical dilemmas are bound to occur at some point in the
healthcare provider's career. This paper will discuss the ethical challenges associated with
patient autonomy and provider beneficence and nonmaleficence. The ANA Code of Ethics lists
9 provisions that must be followed by practicing nurses. The provisions listed below cover
autonomy, beneficence, and nonmaleficence in nursing practice.
Provision 3: The nurse promotes, advocates for, and protects the rights, health, and
safety of the patient.
Provision 8: The nurse collaborates with other health professionals and the public to
protect human rights, promote health diplomacy, and reduce health disparities.
, Provision 6: The nurse, through individual and collective effort, establishes, maintains,
and improves the ethical environment of the work setting and conditions of employment that are
conducive to safe, quality health care.
(American Nurses Association, 2015)
Provision 3 discusses how autonomy is demonstrated in nursing practice when the nurse
accepts the patient as a self-governing individual with rights to their own opinions, values and
beliefs. The practice of beneficence is covered in provision 8 as the nurse and the healthcare
team are responsible for acting in the best interest of the patient. The ethical practice of
beneficence encompasses charity and kindness in benefit of others; by promoting health
diplomacy and reducing health disparities the nurse is improving conditions and lives of
patients. Nonmaleficence is covered under provision 6 in which nurses must provide care that
reduces or minimizes risks to the patient and provides safe and quality health care.
Nonmaleficence is practiced individually and as a collective effort within large healthcare
organizations.
The right of autonomy allows patients to consent or refuse each medical therapy,
medication, and treatment they are offered based on accurate and honest information from their
healthcare providers. “Autonomy is the basis for informed consent, truth-telling, and
confidentiality” (Varkey, 2020, Highlights). Any violations to the practice of informed consent and
HIPAA or misconduct under the code of ethics places healthcare providers such as nurses and
doctors open to legal implications. Beneficence refers to the duty healthcare workers have “...to
refrain from maltreatment, minimize harm, and promote good towards patients” (Haddad &
Geiger, 2022, Clinical Significance). Beneficence can be misinterpreted by healthcare providers
and lead to the practice of ‘therapeutic privilege’ which is the act of withholding information from
patients due to the belief that disclosing the information would lead to negative patient outcomes
, or reactions (AMA Council on Ethical and Judicial Affairs, 2012). The ethical standard of
beneficence impacts all providers such as nurses, doctors, midlevel providers (PA’s and NP’s),
patient care technicians, and anyone else involved in direct patient care. Non-maleficence is a
patient's right to no harm; nurses must act in good faith and attempt to avoid causing harm to
patients despite physician orders and environmental stressors; this requires nurses to act as
patient advocates and support their right to autonomy. Non-maleficence and beneficence go
hand-in-hand as nurses may sometimes act in good faith but perform a wrong intervention or
therapy that ultimately causes patient harm. Non-maleficence is often the most difficult to uphold
in a court of law (Haddad & Geiger, 2022). According to the ANA, “In every role, nurses have
vested authority, and are accountable and responsible for the quality of their practice.
Additionally, nurses must always comply with and adhere to state nurse practice acts,
regulations, standards of care, and ANA’s Code of Ethics for Nurses with Interpretive Services”
(American Nurses Association, 2015).
Honesty vs. withholding information is a common occurrence in my current position as a
Blood Cancers and Cellular Therapies RN and it often infringes on the patient’s right to
autonomy. The patients I deal with have complex cancers and as a result of this they have
many complicated treatment regimens, symptoms, and side effects that intensely affect their
ability to perform activities of daily living and deeply impact their quality of life. Sometimes we
deal with family members who want healthcare providers to withhold pertinent medical
information from the patients and water down the truth of their illness from the patient (such as a
terminal diagnosis and adjusted life expectancy statistics). There have also been instances in
which the oncologists do not tell the patient whole truths related to their illness and therapies
which leads to beneficence and non-maleficence which includes therapeutic privilege.
According to the American Medical Association, “Withholding pertinent medical information from
Kamaldeep Kaur
College of Health Professions, Western Governors University
D129: Advanced Professional Roles and Values
Deborah Dillard
A.
There are many ethical challenges nurses may experience in their practice, especially
when working for a large and complex healthcare organization such as a University associated
Level 1 Trauma, Burn, and BCT inpatient care facility centered in a metropolitan city. Due to the
nature of the complex patients that seek care at these organizations and the collaboration of
several specialties providing care, ethical dilemmas are bound to occur at some point in the
healthcare provider's career. This paper will discuss the ethical challenges associated with
patient autonomy and provider beneficence and nonmaleficence. The ANA Code of Ethics lists
9 provisions that must be followed by practicing nurses. The provisions listed below cover
autonomy, beneficence, and nonmaleficence in nursing practice.
Provision 3: The nurse promotes, advocates for, and protects the rights, health, and
safety of the patient.
Provision 8: The nurse collaborates with other health professionals and the public to
protect human rights, promote health diplomacy, and reduce health disparities.
, Provision 6: The nurse, through individual and collective effort, establishes, maintains,
and improves the ethical environment of the work setting and conditions of employment that are
conducive to safe, quality health care.
(American Nurses Association, 2015)
Provision 3 discusses how autonomy is demonstrated in nursing practice when the nurse
accepts the patient as a self-governing individual with rights to their own opinions, values and
beliefs. The practice of beneficence is covered in provision 8 as the nurse and the healthcare
team are responsible for acting in the best interest of the patient. The ethical practice of
beneficence encompasses charity and kindness in benefit of others; by promoting health
diplomacy and reducing health disparities the nurse is improving conditions and lives of
patients. Nonmaleficence is covered under provision 6 in which nurses must provide care that
reduces or minimizes risks to the patient and provides safe and quality health care.
Nonmaleficence is practiced individually and as a collective effort within large healthcare
organizations.
The right of autonomy allows patients to consent or refuse each medical therapy,
medication, and treatment they are offered based on accurate and honest information from their
healthcare providers. “Autonomy is the basis for informed consent, truth-telling, and
confidentiality” (Varkey, 2020, Highlights). Any violations to the practice of informed consent and
HIPAA or misconduct under the code of ethics places healthcare providers such as nurses and
doctors open to legal implications. Beneficence refers to the duty healthcare workers have “...to
refrain from maltreatment, minimize harm, and promote good towards patients” (Haddad &
Geiger, 2022, Clinical Significance). Beneficence can be misinterpreted by healthcare providers
and lead to the practice of ‘therapeutic privilege’ which is the act of withholding information from
patients due to the belief that disclosing the information would lead to negative patient outcomes
, or reactions (AMA Council on Ethical and Judicial Affairs, 2012). The ethical standard of
beneficence impacts all providers such as nurses, doctors, midlevel providers (PA’s and NP’s),
patient care technicians, and anyone else involved in direct patient care. Non-maleficence is a
patient's right to no harm; nurses must act in good faith and attempt to avoid causing harm to
patients despite physician orders and environmental stressors; this requires nurses to act as
patient advocates and support their right to autonomy. Non-maleficence and beneficence go
hand-in-hand as nurses may sometimes act in good faith but perform a wrong intervention or
therapy that ultimately causes patient harm. Non-maleficence is often the most difficult to uphold
in a court of law (Haddad & Geiger, 2022). According to the ANA, “In every role, nurses have
vested authority, and are accountable and responsible for the quality of their practice.
Additionally, nurses must always comply with and adhere to state nurse practice acts,
regulations, standards of care, and ANA’s Code of Ethics for Nurses with Interpretive Services”
(American Nurses Association, 2015).
Honesty vs. withholding information is a common occurrence in my current position as a
Blood Cancers and Cellular Therapies RN and it often infringes on the patient’s right to
autonomy. The patients I deal with have complex cancers and as a result of this they have
many complicated treatment regimens, symptoms, and side effects that intensely affect their
ability to perform activities of daily living and deeply impact their quality of life. Sometimes we
deal with family members who want healthcare providers to withhold pertinent medical
information from the patients and water down the truth of their illness from the patient (such as a
terminal diagnosis and adjusted life expectancy statistics). There have also been instances in
which the oncologists do not tell the patient whole truths related to their illness and therapies
which leads to beneficence and non-maleficence which includes therapeutic privilege.
According to the American Medical Association, “Withholding pertinent medical information from
