End-of-life care is fraught with various dilemmas and requires practitioners to observe the standards of ethics strictly. The American Nurse Association (ANA) offers clear ethical guidelines to be followed across the healthcare continuum, including hospice settings. Observing its first provision in caring for a hospice patient involves refraining from any stigmatization and prejudice with regard to medical needs and requests, decision-making approaches, and spiritual characteristics.
The first provision of the ANA’s ethics-related guide seeks to establish respectful care for all patients as a standard. The ANA makes Provision 1 centered on the nurse’s ability to demonstrate “compassion and respect” for all people’s “dignity, worth, and uniqueness” (Rutgers School of Nursing, 2019, p. 1). These attitudes to care and interpersonal communication are anticipated to be practiced regardless of the patient’s socio-economic situation, health-related variables, or personality-level characteristics. Respecting human dignity under any medical circumstances, as well as recognizing each healthcare client’s need for care/assistance and self-determination, should be practiced in hospice settings and any other institutions.
To provide hospice care in accordance with Provision 1, the nurse must avoid stigmatization on the basis of medical requests and details of a patient’s condition. Since Provision 1 directs nurses to care for patients respectfully, following it is incompatible with any stigmatizing remarks, including disrespectful or non-empathetic responses to requests for more pain medication (Copeland, 2020). From prior research, hospice nurses’ ambiguous attitudes to patients’ drug-seeking behaviors are crucial contributors to unresolved ethical dilemmas in end-of-life nursing (Copeland, 2020). Next, practicing palliative care in line with Provision 1 entails the absence of disrespect and suboptimal care quality when managing a hospice patient with peculiar conditions. Depending on the diagnosis and unfavorable life circumstances, individuals might exhibit wound myiasis, dementia-related aggressiveness, scatolia, and other needs that hospice professionals can find repulsive (Waidyaratne et al., 2021). Nevertheless, to fulfill the said provision, the hospice nurse should practice supportive care without enabling the condition’s details to interfere with the care recipient’s perceived worth and the right to respectful communication.
Along with the uniqueness-related and self-determination-related portions of Provision 1, the hospice nurse must practice care without prejudice to a patient’s preferred decision-making method. If coming from a collectivist culture with strong family values, a hospice patient might prefer to rely on his/her immediate social network to make supportive care decisions and formulate preferences as a group. The nurse’s disapproval of such approaches should not affect the care and the readiness to comply with the family’s requests as long as they are implementable and would not cause any harm to the care recipient.
In a similar manner, implementing Provision 1 into hospice care involves demonstrating respect for a patient’s spiritual needs and identity regardless of whether the care professionals practice the same religion and attitudes to death. Aside from the absence of prejudice demonstrated through verbal and non-verbal means, practicing respect often involves supporting a care recipient in seeking prayer, carrying religious jewelry, and using religious symbols/equipment in the setting (Pentaris, 2018). Consequently, ignoring a patient’s religious identity and letting the nurse’s own values interfere with care planning and attitudes toward a client are incompatible with Provision 1.
To sum up, the first ANA provision requires palliative nurses to engage in respectful and non-discriminatory practice when caring for a hospice patient. Such populations’ dignity should be preserved carefully, which involves providing information and assistance without prejudice of any kind. Avoiding disrespectful treatment and preferential attitudes to patients’ requests depending on their socio-economic, cultural, and health-related characteristics is central to offering ethically appropriate care.
References
Copeland, D. (2020). Drug-seeking: A literature review (and an exemplar of stigmatization in nursing). Nursing Inquiry, 27(1), 1-11. Web.
Pentaris, P. (2018). Religious literacy in hospice care: Challenges and controversies. Routledge.
Rutgers School of Nursing. (2019). American Nurses Association code of ethics for nurses. Web.
Waidyaratne, G., Zhou, S., O’Neil, T., & Marks, A. (2021). Management of wound myiasis in the hospice and palliative medicine setting. Journal of Palliative Medicine, 24(5), 797-800. Web.