Assignment #2

Term Paper

Nursing ethical and legal consideration within the contemporary world practice

There is an increasing volume of media and literature attention to the ethical issues in society today. Often in legal and medical television shows like ‘ER’, characters are shown being in ethical dilemmas as well as facing decisions. For real, the nurses are confronted with such an increasing number of ethical decisions in their practice day after day. With the unparalleled advancement in technology, bio-medical and nursing research, together with the current environment in healthcare, nurses have to be cognizant of their personal and professional views of ethics (Johnstone, 2015). Within this paper, a perspective of the objective of bioethics and specifically nursing ethics is going to be explored.

Ethics refers to customs or character in every society; there are particular norms and customs that develop over a period of time. Ethics thus suggest some code of acceptable conduct or behavior and it includes study of the social morality and philosophical reflection on its practices. Nursing ethics and bioethics can be considered within the same philosophical framework but they differ in application and approach. Bioethics focuses on the identification of the ethical concerns in scientific and medical research (Johnstone, 2015). Nursing ethics isn’t really a sub-class of medical ethics, but it is distinct and has its own literature, application and context. It refers to principles that govern the conduct of the nurses in regards to the families, associates, patients and society in large. It is a practice discipline that purposes to offer guidance to the nurses on how to act and decide morally in the framework of their working setting (Johnstone, 2015). Usually, nurses have got a unique relationship with the patients. They have a more direct link and thus a more ethically calling relationship. A Gallop poll placed the nurses above the teachers, medical doctors and even the clergy in regard to the profession with the most ethical and honest characteristic (Johnstone, 2015).

According to Ethics and issues in contemporary nursing, authors Burkhardt and Nathaniel proposed the idea that the purpose of nursing ethics needs to be the evaluation of the ethical issues that are specific to nursing. It incorporates protection of the rights of patients and deontological autonomy principles, nonmalfience, confidentiality and justice, beneficence, and it offers some practical guidelines on the process of making decisions in practice setting, despite differences in ideologies or individuals. As stated by the ‘American nurse today’ there is important developments in the healthcare delivery and society, which impact the perception of nursing ethics. Currently with the rapid advancements in technology and contemporary healthcare environment, the nurses have to deal with the increased number of complex and new ethical dilemmas. There are times when such issues are previously not well known and within any time the nursing practitioner is able to be confronted with the particularities which are not yet considered for in technology or in science (Burkhardt & Nathaniel, 2013).

In healthcare delivery and society, the nursing profession is advancing. Having a nursing license does not guarantee ethical or moral practice. The American Nurses Association, in response to the healthcare and social needs, has come up with the code of ethics that guides the nursing profession. This code articulates the moral obligations and duties of nursing, but ultimately the individual nurse is responsible to abide by these set laws. Over the recent times, the media has been identifying enormous case settlements, like those of smokers, and consequently, malpractice costs of insurance have gone high. Though nurses are known to be making decisions based on ethics, they have to also be aware of legal consequences. The laws of the land are still very paramount and even the decisions that are based on the professional code of ethics might not really be defendable in the court of law. The nurses are thus encouraged to chart for lawyers and not the doctors (Dossey et al, 2012).

According to Burkhardt & Nathaniel (2013), progression of the managed health care, and attention being on the cost efficiency and containment, has significantly influenced the patient care. Burkhardt & Nathaniel illustrate to their readers that the development of the organizations that manage health and the for-profit centers has resulted in the restrictions on the patient’s access to health care and even withholding expensive therapies. New procedures and technologies are quite expensive to execute and implement but they might be needed to lure the patients and the medical staff. The resource distribution and allocation together with the rationing of the health care is reflective of a business instead of patient focus and care.

The EMTALA program of 1986 was put in place to ensure that there is access to health screening for everybody who present without considering their paying ability. The number of individuals requiring and seeking medical attention without the ability to pay and with no insurance is indeed rising, causing some shift in the healthcare delivery, because of the legal mandate to offer health care to all (Burkhardt & Nathaniel, 2013). In a hectic emergency room, on any particular night, ‘regulars’, pungent homeless and drug seekers are found. Such people still deserve care and dignity, regardless of the beliefs and feelings of the nurse. Burkhardt and Nathaniel voiced that limited resources and system abuse affects the perspective of the nurses on the issue of ethical care. The people in a society really have the right to health care, but the policy makers seem to actually disregard the ability of the heath systems with limited resources to offer that health care, potentially to detriment of other people. Due to this, there has been significant closures and downsizing of the health care centers (Dossey et al, 2012).

Modern globalization is another dimension of influencing the objective of the nursing ethics with the changes in population of patients. Immigration in US, especially from the Latin-American nations is increasing, with Hispanic population being the greatest minority group.

Professional practice of nursing has been drastically impacted by recent implementation of health insurance and accountability act that was effected in 2003. This particular Act makes ethical obligations for respect of the patient health privacy and information legally accountable. The health care providers have to now take some active steps in the protection against the unauthorized disclosures and uses of the personal medical data or else be held in breach of the criminally or confidentiality liable (Dossey et al, 2012).

Nurses have a professional responsibility and duty to safeguard the confidentiality of the patient information and to offer protection to the privacy and rights of the patients. The protection of these patients’ rights is very crucial with the advancement in the nursing informatics, medical record storage and computerized documentation. According to the new law on privacy has a downside: through the inhibition of the access to patients’ information, relatives that seek information on the health status of their loved one can be very frustrated. For example, a lady’s mother was recently admitted in a hospital and ventilated mechanically which rendered her unable to offer permission to reveal the information. The other parties then could not find out the prognosis and seriousness of her health condition. In addition, inability to offer information could delay or inhibit patient treatment, as the health insurance providers mostly choose to decide the authorization of treatment. Previously nurses were able to supply the information which included injuries, vital signs and the condition of the patient (Munhall, 2012).

It is undeniable that concerns about the ratio of nurses to patients are indeed a critical issue in today’s professional practice. A recent study revealed the staffing patterns which limit the access of patients to the nursing care since the issue was very ‘personally disturbing’ to the nurses. Other studies reveal that lower ratio of the licensed nurses to the patients raises the positive outcomes through reducing the rates of infection, complications and death. Through ensuring of sufficient levels of staffing and the appropriate workloads, such regulations do improve not just the patient care, but also the nursing satisfaction and work conditions.

Due to the cost containment and the scarce allocation of results, the nurses are faced with the ethical justice challenges in the modern fiscal environment within the healthcare (Munhall, 2012). Provision of adequate health care and maintenance of professional nursing practice is very difficult in the cost-constrained environments. The nurses are expected to offer high quality patient care on the basis of similar or even fewer resources (Munhall, 2012).

Finally, the nursing profession is challenged by the issue of end-of-life care to aging people and increase in the life-extending technology. Patient self-determination acts offer avenues for predetermination of health care while the patient can’t do so. It then provides the advance directives on withholding resuscitation and measures to extend life (Munhall, 2012). Though this ensures the patient’s right to autonomy, medical or family refusal to comply with such directives us using excuse of benefiting that patient can be.

Conclusion             With the unprecedented advancements in health science and technology, the nursing profession encounters many ethical issues (Scientific America, 2012). The nursing respect of people’s rights and ethic of care, together with the basic moral principles of justice, autonomy and confidentiality offer a framework for the ethics decision-making and analysis (Munhall, 2012). Continued provision of the ethical and competent care in the face of today’s issues in practice portrays commitment of nursing profession to the nursing ethics




Burkhardt, M. A., & Nathaniel, A. (2013). Ethics and issues in contemporary nursing.       Cengage Learning.

Dossey, B. M., Certificate, C. D. I. N. C., Keegan, L., & Co-Director International Nurse             Coach Association. (2012). Holistic nursing. Jones & Bartlett Publishers.

Johnstone, M. J. (2015). Bioethics: a nursing perspective. Elsevier Health Sciences.

Munhall, P. L. (2012). Nursing research. Jones & Bartlett Learning.