Ethical Issues Paper

NURS 412 Ethic, Law, Economics, Policy

Purpose of Assignment
The purpose of the assignment is to provide the student with an opportunity to analyze an ethical
issue in nursing. The student will analyze an ethical dilemma, make a decision, and support the
decision with literature to include the American Nurses Association (ANA) Code of Ethics for
Nurses.
Student Approach to Assignment
I approached this assignment by including a discussion of end-of-life care and giving a scenario
of an ethical issue related to end-of-life care. I also identified sections from the American Nurses
Association Code of Ethics guide me in resolving this dilemma, and I recognized present
cultural, legal and political factors involved with this dilemma. I used a MORAL model to
determine the best outcome of the dilemma.
Reason for Inclusion of this Assignment in the Portfolio
This project about ethical issues should be included in my portfolio because ethical issues
challenge health care professionals. Today, healthcare workers are facing the choice of making
the moral decisions and deciding if they are ethically correct and apply to medical practices and
policies. This assignment helps me to represent who I am as a nurse when advocating for
patient’s rights, health, and safety.
Critical thinking
 Uses decision-making skills in making clinical or professional judgments
In my paper, I use decision-making skills to make a professional judgment. For example, in the
situation of Ms. S, a 95-years-old Chinese woman with end-stage intestinal cancer, the patient
chose to end-of-life care. However, her daughter, as Ms. S’s medical decision maker, wanted all
possible treatments for her mother. I used the evidence of the patient’s wish and her declining
physical and mental function to make the professional judgment that I supported the patient’s
choice of end-of-life.

Communication
 Accesses and utilizes data and information from a wide range of sources to enhance
patient and professional communication
In my paper, I had many different research sources to enhance professional communication. For
example, I provided American Nurse Association (ANA) to support the code of ethics point. I
also provided sources about Chinese cultural practice to describe the culture sensitivities to help
me in communicating with the patient and her daughter. I also provided researches about the
benefits of end-of-life care to support that patient’s decision was the best outcome for the
patients.
Research
 Applies research-based knowledge from nursing as the basis for culturally sensitive
practice
In my paper, I found a lot of researches to support the practice of cultural sensitivity. For
example, I researched on Caring Connection website to discover in Chinese health beliefs in
order to understand more about their viewed of palliative care to improve cultural
competence in end-of-life care. This is a decision that should be determine by the family in
their culture practice. It also provided me with information about the cultural sensitivities
related to their behavior toward to health care which led me to avoid talking about death with
the patient and her family.
Professionalism
 Understands the effect of legal and regulatory processes on nursing practice and health
care delivery
Law and regulation guide nursing practice to provide patients with safety and enforce
necessary disciplinary actions. In my paper, I identify that American Nurse Association
(ANA) explains that nurses should have respect for human’ dignity, worth, and rights of all
individuals. I followed the ANA ethical practice regarding patient’s safety and care to protect
my patient’s right and dignity. For example, I was asked to obtain a signature for a consent to
have a procedure. During my assessment the patient appeared to be confused and he was not
legally able to make a decision for himself. Patient did not have a POA. I reached out to the
patient’s family members and asked the doctor to explain the procedure to them in order for
me to obtain consent.

 Demonstrates accountability for one’s own professional practice as well as limits to

one’s own scope of practice
Nurses should demonstrate a standardization and accountability within the scope of nursing
practice. In my ethical issue paper, I was taking responsibility for my action to take care of
my patient Ms. S. I practiced my professional nursing care to comfort her by providing pain
medication, and I also provided the end-of-life care nursing education for her family and
guided them to discuss it with her doctor instead of giving my decision, which is out of my
scope of practice. In another example, I was taking care of a stroke patient. The patient and
his family requested me to reviewe the MRI result for them. I politely refused and educated
them that it is beyond my clinical expertise.
 Applies an ethical decision-making framework and legal guidelines to clinical situations
that incorporate moral concepts, professional ethics, and advocacy for patient well-
being and preferences

In my paper, the ethical problems involved right to end-of-life care, which included respect
for moral beliefs, and advocating for patient’s comfort and own desire. This situation was an
ethical issue conflict. I applied an ethical decision model and the legal guidelines that state
that it is the nursing practice’s obligation to do what the patient feel is best for them. For
 example, I had a patient with a diagnosis of advance stage of cancer. The patient was told no
treatment was recommended at this point. The patient insisted on getting a second opinion.
The doctors signed off on the patient. Per ANA polices and guideline, patient has the right
to choose the type of treatment they want. I gave the patient information and links from
other resources to seek second opinion.

Culture
 Demonstrates sensitivity to personal and cultural definitions of health, and how these
beliefs influence an individual’s reactions to the illness experience and end of life

In my paper, I recognized of my patient’s cultural background and age. My patient was a 95

years-old Chinese female patient and, using my cultural sensitivity, I was aware that she
believed discussing death could bring bed luck, and she also believed that death is rebirth in
the future. My patient’s choice of end of life care is influence by her Chinese cultural beliefs.
Culture believes and attitudes are what define individual from one another. For instance, I
was taking care of an African woman who just had a baby. I saw the family stretching the
new born baby’s limbs and reciting prayers while the baby is crying. I expressed my concern
for the baby’s safety. The mother replied, what I witness was a traditional African ritual that
must be performed when a baby boy was born. I didn’t like what I saw, buy I had to respect
their traditional belief.

 Integrates knowledge of cultural diversity in performing nursing interventions

Even though it is challenging for nurses to deliver culturally competent services, I perform
nursing intervention based on my cultural awareness, knowledge and skills. In my paper, I
discussed diversity between patients from sexual orientation, age, cultural background and
race. My nursing intervention is based on the individual assessment by understanding culture,
sexual orientation, and more. For instance, I was taking care of a transgender from male to
female. Her mannerism was different, she was very particular in the way she wanted me to
refer to her. I addressed her as a female by calling her Mrs. I treated her with dignity and
respect regardless of my cultural and personal believes. I provided care the same way as I do
with other patients.

 Considers the impact of research outcomes and, the effects of health and social policies,
on persons from diverse backgrounds
The dilemma in my paper was the critical illness of a Chinese elder had suffering from end
stage cancer and pain. Also, Chinese people believed in dying in peacefully and to have old
age consider good death in their cultural background. The social policies support the end-of-
life care when people have an incurable terminal condition. End-of -life care was considered
improvement in my patient’s quality of life with less depression and feeling more in control
which is evidenced in research outcomes. The decision of end-of-life is the best outcome care
for my patient.