Introduction
Negotiating ethical conflicts is part of a nurse’s everyday duties. However, this does not mean that all nurses can make effective ethical decisions. The judgment may be impaired by a variety of factors, including personal beliefs, lack of information about a patient’s culture, moral distress from having to make difficult choices, and more. In addition, workplace policies and regulations may obstruct the decision-making process, for instance, if there are specified procedures for certain cases that may not be ethically right for individual patients. Nevertheless, there is a set of practices that the nurses should apply to ethical decision-making to ensure successful negotiation of conflicts.
Respecting Patient’s Privacy and Confidentiality
The American Nurses Association (ANA, 2015) recommends the nurses to ensure that patient’s right to privacy and confidentiality of information are preserved at all times throughout the care process. This is especially relevant to the challenges posed by telehealth technologies and the use of technology for storing and transferring patients’ data.
According to the ANA (2015), the patients should be given the right “to decide to whom, and under what circumstances, their individually identifiable health information will be disclosed” (p. 1). Moreover, the patients should be notified of any case when the information must be disclosed to third parties (ANA, 2015). Disclosure of any private information without the patient’s consent may lead to undesired consequences, including the patient’s moral distress, which could worsen the existing ethical conflict.
Considering Patient’s Cultural Values and Beliefs
One of the main challenges that nurses of the 21st Century face are the need to treat patients’ from different and often unfamiliar cultural backgrounds (McClimens, Brewster, & Lewis, 2014). When an ethical conflict arises, nurses may decide to treat it from the perspective of their own culture, which may, in some cases, contradict the patient’s cultural values and beliefs. McClimens et al. (2014) stress the importance of considering the patients’ culture in the decision-making process: “Recognising and respecting cultural diversity is essential to ensure that individual patients’ needs are met” (p. 52).
One of the ways to gather appropriate information regarding the patient’s cultural values and beliefs is by assessing the twelve domains of the Purnell Model for Cultural Competence, which include characteristics such as communication, family roles, death rituals, spirituality, and more (McClimens et al., 2014). The care provided to a person should not contradict his or her cultural values and traditions, as identified by the assessment.
Holding Family Conferences
According to Wood (2014), one of the ways to address ethical dilemmas and moral distress is to hold a family conference. This practice should not contradict the previous two recommendations regarding the patient’s privacy and culture. As long as the patient gives consent to disclose information to his or her family and including the family in the decision-making process does not conflict with the patient’s cultural values, holding family conferences may be a good way to resolve any ethical dilemmas in care. This option should also be used if the patient is unable to provide the information needed to ensure positive ethical care, for instance, if he or she is unconscious or incapable of communicating clearly. In this case, the patient’s family becomes a source of cultural information, which can be utilized in the decision-making process.
Conclusion
Overall, the best way to negotiate ethical conflicts in nursing is by using the patient-centered approach. Ensuring that the decisions made by the nurse or the doctors do not violate the patient’s privacy or cultural values will help to avoid moral distress and improve the quality of care by offering an individual approach to each person.
References
American Nurses Association (ANA). (2015). American Nurses Association Position Statement on privacy and confidentiality.
McClimens, A., Brewster, J., & Lewis, R. (2014). Recognising and respecting patients’ cultural diversity. Nursing Standard, 28(28), 45-52.
Wood, D. (2014). 10 best practices for addressing ethical issues and moral distress.