Ethical Considerations in Nursing

Ethical Considerations and Principles

• Advocacy: Nurses are responsible for speaking up for their patients, particularly those with limited capacity for self-advocacy, such as older adults.
• Autonomy: Older adults have the right to make their own decisions, even if those decisions differ from the recommendations of their family or healthcare providers.
• Beneficence/Nonmaleficence: Nurses must act in the best interests of their patients and avoid causing harm. This principle is particularly relevant when caring for older adults who may be more vulnerable to adverse drug reactions or other complications.
• Confidentiality: Nurses are obligated to protect the privacy of their patients, even when there are pressures to reveal information to family members or other involved parties.
• Fidelity: Nurses must be faithful to their commitments to their patients and maintain a strong professional bond.
• Fiduciary Responsibility: Nurses are entrusted with the well-being of their patients and are bound to act in their best interests without personal gain.
• Justice: All patients should have access to the same quality of care, regardless of their age, social or financial status.
• Quality and Sanctity of Life: Nurses are responsible for respecting the dignity and quality of life of their patients, recognizing the unique factors that may affect the well-being of older adults
• Reciprocity: Nurses must engage in a reciprocal relationship with their patients, promoting trust and understanding.
• Veracity: Nurses must be truthful and transparent with their patients, especially regarding their diagnosis and treatment options.

Issues to Consider When Caring for Older Adults

• Conflicts of Interest: Caregivers should be aware of potential conflicts of interest, such as family members advocating for the patient while also benefiting financially from decisions made.
• Confidentiality: Nurses should respect the privacy of their older adult patients and ensure that their information is only shared with those who have a legitimate right to know.
• Decision-Making Capacity: It is important to assess an older adult's capacity to make their own decisions, as this may vary depending on their cognitive abilities.

Legal Risks for Gerontological Nurses

• Malpractice: Nurses must ensure they are providing competent care to their older adult patients and documenting their actions thoroughly to minimize legal risks.
• Confidentiality: Nurses should be careful about sharing sensitive information about their patients.
• Patient Consent: Patients must give informed consent before any treatment or procedure.
• Patient Competency: Nurses should assess the competency of their patients to ensure they are capable of understanding their treatment options.
• Staff Supervision: Nursing supervisors have responsibilities to oversee their staff and ensure they are providing safe and effective care.
• Medications: Nurses must be aware of the risks associated with medications in older adults, including drug interactions, polypharmacy, and adverse drug events.
• Restraints: The use of restraints should be a last resort and used only when necessary to prevent harm to the patient or others.
• Telephone Orders: Telephone orders should be sparingly used and documented accurately.
• Do Not Resuscitate Orders: Nurses should ensure that DNR orders are well-defined and followed in the event of a medical emergency.
• Advance Directives: Nurses should educate patients and families about advance directives and ensure that patients have the opportunity to make their wishes known.
• Issues related to death and dying: Nurses should provide sensitive and compassionate care to patients nearing the end of life.
• Elder Abuse: Nurses are legally obligated to report any suspicion of elder abuse to the appropriate authorities.

Benefits and Privileges of Senior Citizens in the Philippines

• RA 7432 (Senior Citizens Act of 1992): Ensures senior citizens are able to contribute to national building, and provides benefits and privileges.
• RA 8425 (National Anti-Poverty Commission, 1997): Includes creating initiatives to provide support to senior citizens.
• RA 344 (Accessibility Law of 1982): Guarantees accessibility to buildings and facilities for seniors, including those with mobility limitations.
• RA 9994 (Expanded Senior Citizen Act of 2010): Grants additional benefits and privileges to seniors, enhancing provisions established by RA 7432.
• RA 10155 (General Appropriations Act of 2012): Requires government agencies to allocate funds for seniors and individuals with disabilities.
• RA 10645 (Mandatory Philhealth Coverage for Senior Citizens, 2014): Mandates Philhealth coverage for all senior citizens, regardless of income level.
• RA 10868 (Centenarians Act of 2016): Celebrates centenarians and provides financial incentives.

Explore the critical ethical principles that guide nursing practice, particularly concerning older adults. This quiz covers advocacy, autonomy, beneficence, confidentiality, fidelity, and fiduciary responsibilities. Test your understanding of how these principles apply in real-world nursing scenarios.