Fundamentals of Nursing Q 385
In the United States, access to health care usually depends on a client’s ability to pay for health care, either through insurance or by paying cash. The client the nurse is caring for needs a liver transplant to survive. This client has been out of work for several months and does not have insurance or enough cash. A discussion about the ethics of this situation would involve predominantly the principle of:
A. Accountability, because you as the nurse are accountable for the well being of this client.
B. Respect of autonomy, because this client’s autonomy will be violated if he does not receive the liver transplant.
C. Ethics of care, because the caring thing that a nurse could provide this patient is resources for a liver transplant.
D. Justice, because the first and greatest question in this situation is how to determine the just distribution of resources.
Correct Answer: D. Justice, because the first and greatest question in this situation is how to determine the just distribution of resources
Justice refers to fairness. Health care providers agree to strive for justice in health care. The term often is used during discussions about resources. Decisions about who should receive available organs are always difficult. All patients have a right to be treated fair and equally by others. Justice involves how people are treated when their interest competes with others. A current hot topic that addresses this is the lack of healthcare insurance for some. Another example is with patients in rural settings who may not have access to the same healthcare services that are offered in metropolitan areas.
Option A: As a nurse, it’s inherent that accountability for all aspects of care aligns with responsible decision-making. The use of authority must be professional and about all aspects of individualism and patient, ethical concerns. Nursing decisions must be well thought, planned, and purposefully implemented responsibly. Any delegation of nursing activities or functions must be done with respect for the action and the ultimate results to occur.
Option B: Each patient has the right to make their own decisions based on their own beliefs and values. This is known as autonomy. A patient’s need for autonomy may conflict with care guidelines or suggestions that nurses or other healthcare workers believe is best. A person has a right to refuse medications, treatment, surgery, or other medical interventions regardless of what benefit may come from it.
Option C: The patient should always be a first and primary concern. The nurse must recognize the need for the patient to include their individual thought into care practices. Any conflict of interest, whether belonging to external organizations, or the nurse’s habits or ideals that conflict with the act of being a nurse, should be shared and addressed to not impact patient care.