b'| CAREER GUIDEEthics in HealthcareSome decisions are easier than others By Krystina Ostermeyer RN, BSN, CDEA s healthcare workers, we are con- should be done? Is he or she being influenced to decide, sistently barraged with informationThere are four basic principles that wereor being influenced to make a poor that allows us to make decisions. Fordefined by Tom Beauchamp and Jamesdecision?example, after taking a blood pressure and find- Childress in their 1979 textbook Principles ofBeneficence involves the obligation to act ing it low, we choose to withhold a medicationBiomedical Ethics. Since it was published, itin the best interest of others. This can be done and notify the provider. This is an easy decision. has provided a compass for moral discussionby balancing risks and harms, rescuing those Some decisions arent as simple. For exam- about ethical issues. in harm, helping those with disabilities, and ple, a patient is admitted with multiple pres- defending the rights of others.sure ulcers. He has orders to ambulate TID,BASIC PRINCIPLES Non-maleficence is based on maxim pri-but refuses. Do we chart his refusal, as he hasAutonomy involves respect for the deci- mum non nocere, which is a Latin for first do autonomy to do so, or do attempt to force himsion of an adult who can make decisions. Inno harm. Taken from the Hippocratic Oath, to ambulate, as we know getting out of bedhealthcare, patients should have all the infor- non-maleficence urges healthcare workers to will help his pressure ulcers? mation before making an autonomous deci- not harm others in any way. Obviously, we Or a patient presents with mental statussion. Occasionally, we, as healthcare workers,dont want to kill anyone, but we also want to changes. He has had an acute CVA. He hasmust evaluate if a patient is able to make aease pain and suffering. We also want to con-no family that can be located, and his condi- sound decision. In these situations, askingtinually use resources to improve our knowl-tion is not improving. Code status cannot bethe following questions helps to gauge if deci- edge so that we can provide excellent care.determined, and the patient is unable to com- sion-making is sound: Justice involves the equal distribution of municate. Under normal circumstances, theDoes the person understand the situa- resources. It also pertains to the fair distri-provider would have a frank discussion abouttion, the consequences of their decisionbution of care according to need. Ideally, all code status and quality of life, recommendingas well as all the options? patients should be treated equally. Advocacy hospice care if the family desired. However,Will the person follow through with theof patients who arent treated equally is a ISTOCKthere is no one to make that decision. Whatdecision? facet of justice.www.elitecme.com |2020| CAREER GUIDE 13'