Ethical dilemma in professional practice. By Muhammad Iqbal

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1 Ethical dilemma in professional practice By Muhammad Iqbal Nursing Ethics: Unit-VII

2 Objectives Define dilemma and professional obligation Identify common areas of negligence and nurses liability in these areas. Discuss nurses advocacy in various scenarios and clinical cases related to: a. life support equipment b. selling body parts c. risk management and occupational hazards d. documentation of nursing care e. employment issues f. medical malpractice lawsuit

3 Key Terms Dilemma: A difficult situation that seems to have no satisfactory solution. Profession: is an occupation requiring special education and training. Professional Obligation: is an act or course of action to which a person is morally or legally bound.

4 Negligence: is a misconduct or practice that is below the standard expected of a reasonable and prudent person. OR Failure to use the degree of care that is required by law to protect others from harm. Malpractice: is unsafe practice which is done by a professional. Crime: An act committed in violation of public (criminal) law and punishable by fine or imprisonment.

5 Crimes are classified into two as felony and misdemeanor. Felony: is a crime of a serious nature such as murder. Misdemeanor: is a crime of less serious nature. For example, a nurse slaps a patient s face. Tort: deals with civil law in which a wrong is committed against a person or a person s property. Examples are like touching, threatening, etc.

6 Assault: is an attempt or threat to touch another person unjustifiably. For example, to threat someone by gesturing with a slap or fist. Battery: is a willful touching of a person that may or may not cause injury. For example, touching a person or person s clothes that is embarrassing or that cause injury.

7 False Imprisonment: is the unjustifiable detention of a person without legal warrant to confine the person. Defamation: False Communication regarding a person which disgraces or injures the person s reputation. Defamation may either be Libel or slander Libel: is defamation in the written form. Slander: is defamation in the oral form.

8 Areas of negligence and Nurses liability Negligence and nurses liability are usually involved with tort law. Tort deals with civil law. Nurses need to know the situations and areas where negligent actions are likely to occur. Taking measures to prevent such problems are very important. it s also important to know unintentional and intentional tort.

9 Unintentional Tort Unintentional tort is done without intention. Examples: Negligence Malpractice Four elements must be present for a case of nursing malpractice to be proven. such as duty, breach of duty, causation, and harm

10 Intentional Tort Intentional tort is done with intention. Examples of intentional torts are: Assault Battery False Imprisonment Invasion of Privacy Defamation

11 Nursing advocacy Nursing advocacy is to support and talk on behalf of client. Advocacy is an integral part of nursing. The goal of nursing advocate is to protect the patient s rights. The Nurse who understands the advocacy role promotes, protects and thereby advocates patients interests and rights an attempt to make them recover their health. Where that is not possible, the nurse make patients as comfortable and free of pain and suffering as possible. To act as an advocate, the nurse needs an understanding of the ethical issues in nursing and health care, as well as knowledge of the laws and regulations that affect nursing practice and the health of society.

12 Cont. A nurse can advocate for patients in different situations like life support equipments, selling or donating body parts, etc. to support their interests. Ethical values and concerns need to be clarified. Nurse as an advocate gives patients information, support, and mediating to influence others. Merits and demerits of any procedure involving ethical issues are discussed with patients. Life support equipments like Hemodialysis machines, Ventilator, etc

13 Documentation The client s medical chart is a legal document and can be needed in court as evidence. Therefore, nurses need to record accurate and complete documentation of the nursing care provided to patients. Insufficient or inaccurate assessments and documentation can hinder proper diagnosis and treatment and may result harm to the client. Failure to keeping proper documentation record can constitute negligence and be the basis for tort liability.

14 Risk management and Occupational Hazards Risk: Probability that something undesirable will result from exposure to a hazard. Risk Management: Using risk assessment and other information to determine options and make decisions about reducing or eliminating risks. Hazard: Something that can cause health, economic, or environmental damage.

15 Cont In health care organizations hazards and risks may harm patients. To avoid such situation, a nurse is liable to do risk assessment and eliminate or minimize health hazards and risks. For example, proper light is necessary to prevent patient from falling. Similarly, smoking is strictly prohibited near a patient receiving oxygen to prevent fire. In such situations, a nurse can advocate for the clients to protect them.

16 Medical Malpractice Medical malpractice occurs when a medical professional makes a mistake or fails to exercise an accepted degree of skill which results in an injury or death. Nurses need to advocate for his/her patient s health, safety, and rights to avoid harm. Nurses are not expected simply to follow doctors orders. For example, a health professional is doing a procedure wrong that may harm the patient, the nurse can stop him/her to do so.

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