Ethical principles in Mental Health Nursing

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Steve Farley 0903/ 0312768 NM 1504 professional and ethical practice

This assignment will explain the principle of autonomy and its effect on the professional practise, of nursing. It will also show an example of how the principle has influenced the delivery of care, and will summarise with an understanding of the principle of autonomy. It will focus on the method of care given by both a doctor and a nurse in a clinical setting, and the contradicting styles of delivery. A brief explanation of deontological and utilitarianism values, will support the witnessed experience of the values placed on autonomy in a modern setting.

The account will take an example witnessed from an adult vascular surgery setting, by the author, and include supporting references from extended reading around the subject of autonomy in the health care environment.

In compliance with the, Nursing and Midwifery Council, code of conduct, (2002), Relating to client confidentiality, the names and locations of involved people have been changed, and for the purpose of this account the client will be called Clive.

To appreciate the issues of ethics, and particularly autonomy, in the health care environment, it is important for the nurse to be aware of the fundamental interpretation of its true meaning. (Beauchamp and Childress 2002). The word autonomy comes from the Greek autos  (“self ”) and nomos (“rule,” “governance”, or “law”). Its literal interpretation means the right of personal freedom of action. (Oxford Dictionary 2003). It will become evident from this account that the value of being autonomous is governed by a number of factors, some of which the individual has no control over. To act autonomously can also be defined in its simplest term has having the right to decide what happens to your self.

There are occasions in nursing, where the practitioner is faced between a problem and a dilemma. (Katz 1984). A problem can be solved, but a dilemma could be the choice between two or more equally impossible positions. (Berg, et al 2001). The nurse is often called upon to help his patient make an informed decision. This requires the knowledge of the theories, principles, and codes of ethical issues relating to the area specifically at the need for consent for treatments. (Beauchamp and Childress 2001).  

Clive is a 56-year-old gentleman that was admitted to the surgical ward for a Splenectomy. He has had no previous surgical interventions and this would be his first extended stay in a hospital as an adult. He has ultimate confidence in the National Health Service, and has supported the hospital for many years, acting as a fundraiser. Clive further more believes that it is the Doctors duty to make decisions in his best interest and he is happy to follow the “Doctors Orders”, an observation made clear by the work of (Schneider 1998). This extended trust given by Clive to his Doctor may lead to a degree of vulnerability on his part as discussed by (Baie 1986). Arguably though the trusting stance is central to the doctor patient relationship, and can lead to an enriched view of beneficence (Rogers 1999).

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It has become evident that some patients wish to know very little about the treatment which is being proposed, but in its capacity of governance, the General Medical Council encourages doctors to explain to patients the importance of knowing the options open to them and states that detailed information should always be provided. (General Medical Council 2004).

Being so liberal with his consent dramatically affected Clive’s delivery of treatment. He was not given the detailed explanations of the process of the operation the effects of the analgesic treatment, required for its commencement, the explanation of likelihood of post ...

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