Introduction
In the research conducted by Özbaş et al. (2021), the topic of morality and ethics in oncology nurses was discussed. The study was published in 2021, meaning the research’s ethical subject is relevant. The research was found in a scholarly database and was published in a European Journal. The key people involved in the story are the nurses and oncology patients who need continuous medical treatment. The authors state that through team coordination and cooperation, healthcare professionals in cancer clinics strive to prolong life, improve quality of life, assist patients and their families, promote a dignified death, and ease care issues. To achieve this aim, oncology nurses must integrate physical, psychological, social, and spiritual care and deliver excellent and ongoing treatment.
Discussion
The study revealed four major topics. The first topic, connected to the failure of care quality, involves the inability to offer holistic care and competence issues (not feeling competent in oncology practice). The second subject focuses on biological ethical dilemmas that are frequent in oncology. The third subject is treatment and care practices, which include futile therapies, a lack of legislation for DNR and decisions to restrict life-prolonging therapy, nurses’ limited informational authority, and issues with educational procedures on the patient. The last subject addresses problems originating from the administration of the health care system and institutions, as well as the necessity for legislation to promote ethical judgments.
A doctor issues a Do-Not-Resuscitate (DNR) order, which advises healthcare personnel not to conduct cardiopulmonary resuscitation (CPR) if a patient ceases breathing or their heart stops beating. The DNR contains no instructions for any additional therapy and is only valid when a physician consults with the patient. Ethical considerations may arise when it is unclear if a patient is competent to choose a DNR. If the patient is cognizant and can make informed decisions, the decision for a DNR order is always addressed with them (Kelly et al., 2021). If the patient becomes incompetent, their power of attorney (POA), health care agent, or family member may be authorized to make a DNR choice on their behalf. If a patient is known to be terminally sick, they may already have a DNR order or an advanced directive/living will. The order will be implemented after this paperwork is completed for the institution. For instance, if the patient and physician have agreed to a DNR order, the family should not have the authority to change it once the patient has deteriorated and cannot make decisions.
The subject discussed in the paper is treatment and care practices, which include the subthemes of fruitless therapies, a lack of legislation for do-not-resuscitate (DNR) and choices to restrict life-prolonging therapy (DLT), nurses’ limited informational authority, and patient education. Participants were taken aback by the idea that ineffective therapies delay death, violate human dignity, and result in catastrophic healthcare expenses that affect the patient’s family and the national economy due to the benefit-burden balance dilemma. I think that the absence of legislative control governing DNR practice and the requirement for CPR practice causes nurses to conclude that they are injuring the patient, causing suffering, failing to achieve an honorable death, and, in the case of CPR practice, infringing on professional autonomy. Consequently, fear of being sued and breach of medical record integrity lead to moral distress in the event of DNR usage. Nurses participating in DNR are excluded from decision-making because they are frightened of being sued and so violate the concept of honesty.
Conclusion
Therefore, legal procedures for respecting the rights of patients and their families should be implemented as soon as possible for DNR applications, which are especially prevalent in the end phase of life and have been identified as a source of high levels of moral suffering.
References
Özbaş, A. A., Kovanci, M. S., & Köken, A. H. (2021). Moral distress in oncology nurses: A qualitative study. European Journal of Oncology Nursing, 54. Web.
Kelly, P. A., Baker, K. A., Hodges, K. M., Vuong, E. Y., Lee, J. C., Lockwood, S. W. (2021). Nurses’ perspectives on caring for patients with Do-Not-Resuscitate orders. American Journal of Nursing, 121(1), 26-36. Web.