Ethics and Law: Conflicts in the Nursing Field

Table of Contents

Introduction

Ethics refers to a metaphysical study area that examines engagements, principles, and choices that define the correct and mistaken decisions. On the other hand, laws are the obligatory procedures of conduct that are enforced by a particular authority. In most cases, the two concepts overlap. In the event of divergence, one has to identify and keenly examine the key lines that differentiate them. Laws and ethics are related. Nurses make ethical decisions that involve patient care, nurse-physician relations, or even actions that relate to coworkers. At times, they find themselves trapped in an ethical dilemma, especially when their moral obligations contradict the rulings of the land. The law may sometimes dictate otherwise when it comes to their responsibilities and duties to their patients, employers, the government, and sometimes to themselves. For instance, the government might prohibit nurses from treating some patients or even prescribe some medicines. This situation contradicts their ethical principles of attending to all patients without any discrimination. Nurses have realized that they do not have to be logicians who make decisions that fall within the nursing ethical codes. Rather, they need to understand the principles of ethics that guide their nursing practice. This paper seeks to identify and discuss the conflicts between ethics and laws. The goal is to show how nurses have handled such conflicts.

Conflicts between Ethics and the Law

The concern of ethics and the law complicates the process of decision-making for nurses. The nursing field requires nurses to balance the decisions they make based on the demands of their evidence-based practice, what the law mandates, and/or based on ethics. Conflicts arise when they face equally compelling reasons that are both for and against some courses of action that require them to make a decision. Such a decision might contradict either ethics or the law of the land. For instance, ethical standards dictate that nurses should devoted do their job of saving people lives, as opposed to taking it away. The act of killing is a vice. However, the law has created avenues where nurses are required to go against their conscience to take away people’s lives in case their health conditions have worsened.

A research by Welfel (2013) suggests that conflicts between ethics and the law have continued to rise in the nursing field because of the increasing complexity of care and technology. Many studies have sought to analyze ethical conflicts that are experienced, especially by the critical care nurses. The three main sources of conflicts revolve around the relationship between families and their patients, the provision of some special treatment, and the characteristics of a particular area in which the clinical team operates. In the case of the relationship with patients and their families, conflicts arise because of difficulties in ensuring that the right people administer an informed consent as the law stipulates. They also arise because of a failure in terms of respecting confidentiality, or even failure to protect the patient’s interest when the law grants other people the right to seek and retrieve a patient’s information that should otherwise be confidential.

The provision of certain specific treatments is another source of conflict whereby nurses experience a dilemma when they are requested to administer some special treatments to some patients, as opposed to others, in case pain management seems deficient or even when it becomes necessary to limit the usage of life-supporting procedures (Fisher, 2013). Conflicts also arise between ethics and law when the nurses fail to be fully involved in a decision-making process, especially when the law requires them to deny prescriptions to some patients. A number of situations that cause ethical conflicts usually highlight the difficulties that are involved in coming up with the best and adequate decision. Porter (2012) identifies three main types of ethical conflicts that the nurses often face within the clinical setting. They include ethical insecurity, moral anguish, and moral predicament. In the situation of moral insecurity, the professionals are normally unsure whether an ethical problem exists and whether it coincides with the provisions of the law. Hence, it is also possible for the problem to exist while it is unclear concerning the ethical principles and the laws that are be involved. Sometimes nurses may not agree with some given medical orders of the prescribed treatment, especially when the orders seem to counter their ethical standards (Wlodarczyk & Lazarewicz, 2011). This situation happens mostly in cases that involve the use of extraordinary methods such as lifesaving treatments for terminally and chronically ill patients. In such cases, the nurses might either refuse to heed to the laid medical law orders or even decline to attend to that particular patient.

How Nurses Manage the Conflicts

In the process of reducing the legal risks to keep their career on track, nurses have had to appreciate the role of the nursing law that addresses the legal issues that they need to uphold in the diverse clinical setting. To gain an expert insight to handle the conflicts, nursing officials try to understand a variety of nursing-related legal processes and their key roles when interacting with the patients. Additionally, they regularly assess the latest jurisdictive verdicts with legal standards while at the same time examining the latest nursing principles (Boone, King, Gresham, Wahl, & Suh, 2009). Besides, nurses have familiarized themselves with the permissible legal scope of the nursing practice consistently with their respective countries’ Nurse Practice Act, as well as the board of nursing protocols and rubrics.

Based on the provisions of the Nurse Practice Act, health officials have a legal responsibility of observing orders from any advanced physician. However, licensed professionals also possess the legitimate and ethical duty to use their judgment for the provision of care to the patient. In an attempt to deal with this issue, nurses interact with law stakeholders to find out whether the set rulings define when they should obey the orders and/or when they need to be let to act autonomously. The discussions have ensured that the law guides on the nurses’ day-to-day legal responsibilities with reference to specific procedures and functions to minimize the impact of the conflict between ethics and laws (Boone et al., 2009). Despite the evident conflict between professional ethics and the law, nurses have always showed their commitment to regulating their practices in an attempt to protect the interest of the patients and other stakeholders.

In situations where the government prohibits nurses from treating some people or hinders them from performing their duties in line with the stipulated ethical standards, nurses have responded to such prejudicial laws accordingly by seeking a clarification on when, why, and which patients need to be denied medication (Porter, 2012). In such situations, the nurses recognize the autonomy of the patient, the family members, and the government. Any government ruling must be in line with nurses’ ethical principle of caring. The fact that nursing is a self-regulatory profession, the government has the duty of ensuring that the profession regulates itself for the benefit of protecting the public. However, any decision from the government concerning nursing duties has to be made in collaboration with healthcare stakeholders to ensure that it does not go against the law and the nursing standards. It is crucial to note that has the mandate to apprehend any nursing official who takes advantage of a patient’s situation to either benefit financially or perform operations that are contrary to human rights stipulations.

Conclusion

Nurses operate in a field that changes constantly based on the prevailing health needs, law, and technology. Hence, they strive to be up to date with the technological advancements in terms of equipment and procedures to enable them make the best decisions that minimize conflicts with the state laws. Conflict is one among the inevitable aspects of life. Nurses have not been exempted from facing conflicts when it comes to upholding ethical standards and the law. When clashes between the professional beliefs and the law are not adequately dealt with, the result largely affects the patient care. A state in which the government actively undermines the core ethical principles of nursing practice has to be questioned because such a move is against nurses’ ethical guidelines of providing care to all patients, irrespective of gender, race, age, and status. Hence, there is an urgent need for governments to respect and preserve nurses’ integrity and ethics, instead of establishing laws that harm patients and health officials.

Reference List

Boone, B., King, M., Gresham, L., Wahl, P., & Suh, E. (2008). Conflict Management Training and Nurse-Physician Collaborative Behaviors. Journal for Nurses in Staff Development (JNSD), 24(4), 168-175.

Fisher, M. (2013). The ethics of conditional confidentiality. Oxford: Oxford University Press.

Porter, S. (2012). Review: Conflict management styles used by nurses in Jordan. Journal of Research in Nursing, 19(1), 54-55.

Welfel, E. (2013). Ethics in counseling and psychotherapy. Belmont, CA: Brooks/Cole, Cengage Learning.

Wlodarczyk, D., & Lazarewicz, M. (2011). Frequency and burden with ethical conflicts and burnout in nurses. Nursing Ethics, 18(6), 847-861.

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