Sample Nursing Paper on An informed Consent Procedure in Nursing

Abstract

An ethical everyday nursing dilemma that I have dealt with in my nursing career would be that of informed consent. I have had many instances where I do not believe that the patient was ready or competent enough to sign his or her consent and the surgeon would have blown a gasket if I disagreed with witnessing the consent. There was an instance actually a week ago where a patient fractured her bone and was in such severe pain she had gotten heavily medicated. The surgeon came in that morning and went through the information about the operation she was going to perform. I knew at this point she was responsive but completely out of it. She later would not recall the events that took place that very day. I should have spoken up for her even though I knew that should not have the surgery. Things like this happen every day.

An informed consent procedure is a convenient application of mutual decision making between a patient and his surgeon. Moreover, nurses as they are patient’s advocates, have been trusted to fully understand the ethical and legal factors of the informed consent process. In professional nursing practice, ethical practices are cornerstones to the informed consent. However, before surgery, surgeons are the ones who have the ultimate responsibility for the informed consent. For the benefit of patient surgeons and knowledgeable nurses come together and have an ultimate completion of the informed consent. This paper will review questions to whether the right to informed consent is unconditional by observing the philosophical, legal, and ethical principles causing consent.

 

 

Patients have the right to independence and respect should always be given to them and steps to be taken for consent to be truly informed. However, there is no absolute right when it comes to the basis of ethical, philosophical, practical, and legal considerations.

Introduction

In a relationship between doctor and patient, the consent to investigation and treatment is considered the cornerstone. Consent in The Oxford Dictionary (1998) is described “permission for something to happen or agreement to do something”. The definition has not involved any understanding action that is agreed and the term for medical reasons “informed consent” implying “permission has been granted in full familiarity of possible consequences” is developed. According to General Medical Council (GMC), it is advisable to be able to understand and asses information as well as being able to communicate for informed consent.

Ethical principles

In medical ethics, there are four principles justice, autonomy, non-maleficence, and beneficence. When we consider the underlying consent autonomy is the major ethical principle. Patient’s determination on what to be investigated and treatment to go through with should be respected by the doctor. Patients rely on doctor’s information for consents to be informed. For the process to be valid faithfulness and honesty is vital. Making decisions to offer treatment or withhold treatment to the patients, the ethical principle of justice must be applied. Informed consent process is touched by this and is explored more when discussion of specified treatment is demanded.

Philosophical aspects

Not only is the issue of whether a right or principle is absolute involves ethical and legal aspects. It also involves the philosophical argument of absoluteness. Taking the example of freedom it cannot exist as an absolute principle because giving one person freedom will disregard the freedom of another person considerably. Freedom of person A to take any good will have an impact on person B’s freedom to get a property. In autonomy when these principles are applied the same problems appear. The total autonomy of one person will have negative effects on another person. A fair way of living is brought about by the modern democratic society by the designed laws and rules. Hence, this will restrict autonomy, this same restricted autonomy, on the other hand, assures the equal amount of it to all members of society. In the philosophical basis autonomy principle for the informed consent contradicts itself in its application to society. Autonomy is the major principle of ethical principle in informed consent there is no existence of absolute right to consent.

Legal framework

The surgeon can be charged with battery if he conducts a medical procedure without a legal informed consent. Example, if a doctor goes against the patient’s will he uses different treatment than the one the patient consented for and giving treatment knowingly with wrong information after consenting. The regulatory body (GMC) has set up guidance for consent. For a capable adult, they cannot consent for UK laws are adapting consents patients with permanent incapacity, minors, and patients who are suffering from mental illness.

For any investigation or treatment to take place an informed consent is required to be presented to a patient. Benefits, procedure, and risks are the main bases of an informed consent. Autonomy as a main ethical principle I maintain my stand that there is no absolute right to consent. It is a contradiction to consent and autonomy on a philosophical basis to an absolute right. In the UK several restrictions to the right to consent are set by the legal body. Statuary instrument that is mainly concerned is Mental capacity Act, Mental Health Act, and Public Health Act. For minors, patients with mental illness, and patients with incapacity, and patients with infectious diseases the right to consent is regulated by UK law. In special cases, their consents are not granted or rights to consent are restricted. It is mandatory in infectious diseases cases to have a disclosure to information with no consent. When it is expected for a patient to be in incapacity can set directives for their future treatment when they are still competent and also an LPA can be given the right to decide the treatment on behalf of the patient. Having a look at the practical aspects of consent it is evident that information given is often poorly understood. With the lack in being informed patients are giving consent. Meaning they can not give informed consent for the lack of proper understanding. It is challenging to give an absolute right to consent in practice if efforts to supply information that is vital for informed consent fails regularly. In summary, the right to patient’s autonomy is to be respected and action to be taken to make consent truly informed. In the basis of ethical, legal, philosophical and practical consideration however right to absolute consent is not valid.

 

References

Flanagin, A. (2009). Ethical Review of Studies and Informed Consent. AMA Manual of Style. doi:10.1093/jama/9780195176339.022.210

Davis, J. K. (2004). Precedent Autonomy and Subsequent Consent. Ethical Theory and Moral Practice, 7(3), 267-291. doi:10.1023/b:etta.0000042908.13784.00

Farrimond, H. (2013). Informed Consent. Doing Ethical Research, 109-125. doi:10.1007/978-1-137-29553-8_8