Honesty and Withholding Information in Nursing

The work of an advanced nurse practitioner presents a complex system of rules and priorities to be followed for the delivery of high-quality services. Healthcare in its historical advancement is such a social institution in which many bioethical ideas were incepted and developed. To solve the problems that confront the medical sphere, health care workers are forced to consider philosophy and ethics, thus confirming that modern society needs ethics and philosophy.

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At the same time, being entitled to take responsibility for patients’ well-being and life, advanced nurse practitioners get involved in a legal sphere where they are expected to act according to law. However, the specific nature of work with the ill imposes a variety of controversial issues addressing, among others, an opposition between honesty and withholding information about a patient’s health condition. This polarity involves ethical, legal, and moral concerns that affect nursing practice and have to be addressed from the point of view of moral principles and laws to eliminate incompetence and improve the working conditions for advanced nurse practitioners.

Ethical Dilemma

Any moral problems that a nurse faces in his or her practice are subject to a philosophical discussion. The issue acutely arises in the process of work in emergency and intensive care units where the patients are at the most level of risk. Despite controversy in morality, dishonesty in nursing should be viewed as a violation of a philosophical principle of advocacy that guarantees the provision of human rights to be protected and safeguarded (Nickitas, Middaugh, & Aries, 2014).

According to the principle, nurses have to act as competent leaders, educators, and practitioners providing high-quality services respecting patients’ need for awareness about their health condition. The principle dictates the solution to the problem because a nurse is expected to be compassionate and supportive and eliminate suffering in critical states, thus remaining honest with the client and their family (Nickitas, Middaugh, & Aries, 2014). Complying their practice with the main principles of ethics, nurses will be able to analyze each situation within its context and make just and competent decisions.

As any other sphere of professional activity, healthcare is regulated by some authoritative bodies and documents. Nursing practice in the USA is conducted under the guidance of boards of nursing that are “authorized to enforce the Nurse Practice Act (NPA) and develop administrative rules” and regulations (Nickitas et al., 2014, p. 91). According to the document, nurses have to prioritize a patient and their health conditions in any situation providing patients with protection from inadequate care. The violation of the regulations established by a Board of Nursing is subjected to penalizing and disciplinary actions (Westrick, 2013). Thus, there exists a system of regulatory approaches aimed at controlling the advanced nurse practitioners’ quality of services.

The decision of the problem concerning honesty and incomplete information disclosure to a patient is not easy to find. There is little attention paid to the problem in literature and academic circles. However, it is possible to achieve clarity in professional actions’ direction when following the specifically formulated codes that postulate the rules of nurses’ professional activity. Nurses and Midwives Code (NMC) is a document developed for nurse practitioners’ to abide by in their everyday practice (Chadwick & Gallagher, 2016). According to NMC, it is a nurse’s “professional duty to put the interests of the people … first and to act to protect them” (Chadwick & Gallagher, 2016, p. 49). Within this framework, being honest with a patient and his or her family is one of the priorities that influence the quality of nurses’ work.

The Code includes a specific section addressing the issue of honesty in nursing practice. It requires specialists to “act with honesty and integrity at all times” without discrimination (Chadwick & Gallagher, 2016, p. 59). Acting otherwise would be a violation of the rules listed in the document and will lead to disciplinary procedures constituting a civil act. However, if the withholding of information leads to professional negligence and harmful effect on a patient’s health, it might be addressed as a criminal act (Westrick, 2013). Therefore, it is vital for a nurse to perform honestly and responsibly in his or her workplace.

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Moral Issue and the Recommendations for its Resolution

The dilemma of choice between being honest and keeping information from a patient constitutes a serious moral issue for advance nursing practice as a demanding profession. Firstly, to ensure lawful and ethical performance within the framework of the influence, a professional nurse has to carry out all the procedure following the NPA that prioritizes patients’ interests. Secondly, an advanced nurse practitioner has to be driven by the ethical and philosophical principles of advocacy. Lastly, it is essential to perform within the regulations and rules of NMC that refer to honesty with a client as an observation of primary human rights. To eliminate the acuteness of dilemma, it is essential to develop a system of theoretical and practical approaches aimed at training for academic purposes.

Conclusion

Concluding the discussion, the ethical and legal dilemma of honesty and withholding information for ma patient in nursing practice is a relevant professional issue that is addressed in many laws and codes. From the ethical perspective, a nurse who performs dishonestly violates the basic principle of advocacy, which ensures the patient’s safety. Legally, a nurse who withholds important information about a client’s health condition is exposed to the violation of nursing codes. In case of improper treatment of the information that leads to negligence, an issue might be addressed by the regulatory bodies. Adhering to the rules and principles of nursing would guarantee both patients’ safety and the resolution of professionals’ moral distress.

References

Chadwick, R., & Gallagher, A. (2016). Ethics and nursing practice (2nd ed.). New York, NY: Macmillan International Higher Education.

Nickitas, D.M., Middaugh, & D.J. Aries. (2014). Policy and politics for nurses and other health professionals (2nd ed.). Burlington, MA: Jones and Bartlett.

Westrick, S.J. (2013). Essential of nursing law and ethics (2nd ed.). Burlington, MA: Jones and Bartlett.

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