Introduction
Futile care acknowledges that the patient has reached a point in their sickness where medical care is not beneficial. Most healthcare professionals face the ethical dilemma of determining when to withdraw futile care. The main controversies in medical futility entail the disagreements between the families and the medical practitioners about the purpose of the treatment and the withholding of medical care (Rainer et al., 2018). The paper aims to analyze the nurses’ legal and ethical responsibilities regarding futile care, basing arguments on ethical considerations and accountable decision-making.
Nurse’s Legal Responsibility on Futile Care
Nurses are the primary caregivers to patients, and part of their tasks include communicating the fundamentals of the treatment process. According to the patient-centered healthcare paradigm, nurses are obligated to involve the sick in the treatment process (Morata, 2018). Medical laws require nurses to ensure that all relevant stakeholders to the treatment procedures are brought on board to receive accurate information about the patient’s prognosis (Baharudin, 2020). Nurses are also responsible for elaborating treatment options and offering emotional and clinical support to patients and families. Nurses are required to adhere to the professional guidelines that are hinged on laws like patient consent and respect the patient’s decision after explaining the prognosis, treatment options, and the goal for any medical procedure elucidated (Kaps et al., 2021). When the patient decides to withdraw from the futile care, the nurses need to record the patient’s consent with the respective signatures.
Nurse’s Ethical Responsibility on Futile Care
Nurses are obligated to abide by various medical futility ethical guidelines. Ethical guidelines bound nurses to respect the patient’s autonomy, provide honest and accurate information, and advocate for the patient and the family’s best interests (Baharudin, 2020). Patient autonomy entails the right to make decisions about the medical care they receive, even when the medical practitioners are in opposition. Honest and accurate information will enable patients and other stakeholders to make the best decision. It entails transparency in the prognosis by elucidating both benefits and potential risks associated with the treatment approach and palliative care options. Lastly, it is the nurse’s ethical responsibility to advocate for the patient’s right to receive the most beneficial care, even when it means accepting the inevitability of death through withholding futile care.
Taking a Position with Explanation
Based on my research, I infer futile care to be of no benefit to the patient and a waste of resources, which results in inflated medical bills. It is the administration of treatment and medical care approaches to improve the patient’s health outcomes. However, it is merely prolonging the dying process and sometimes increases the patient’s suffering (Morata, 2018). My position on this topic is that futile care is of no help. However, actions to withdraw treatment need to be in accordance with the patient-centered approach, which advocates for the autonomy of the sick after discussing the treatment goals and their achievability.
Various factors are implementable in determining medical futility. Firstly, the prognosis will evaluate the ability to achieve treatment goals. If the stipulations of the prognosis are a terminal illness, futile care will merely result in high expenses without improved health conditions. Secondly, if the treatment negatively affects the patient’s quality of life by inducing terminal suffering, it is not beneficial. There is no need to administer medication that prolongs the dying process while subjecting the patient to more pain. Thirdly, the cost of treatment can be a factor in determining the futility of medical care. If the price of medication is too high and the resulting outcome has no benefit to the improvement of the patient’s health, administering it is no point. Lastly, patients’ wishes are to be at the center of decision-making regarding futile care (Kaps et al., 2021). Having explained the prognosis and everything related to the treatment alternatives, including benefits and risks, if the patient decides that they do not want medication administration, there is no point in forcing them to change their mind.
Steps of Ethical Decision-Making Model for the Position
The implementation of Thomas White’s four-step ethical decision-making model guided the abovementioned position. It is suitable because it combines a problem-centered approach with the stakeholder involvement conjecture in designing the path to solving the controversies related to medical futility (Rainer et al., 2018). This model facilitates understanding the dilemma and involving the right stakeholders in the resolution, such as the patients and the family members. Below is an outline of the four steps:
Gathering the Facts
Research on the evolution of futile care and the development of medical jurisprudence is done in this section. It also entailed researching the need to explain all information about the prognosis. The facts enhanced the decision-making process on the position I took on the topic by outing the factors to be considered in determining futile care and adherence to the patient-centered care approach.
Definition of Ethical Issue
I inferred from the facts and evaluated the possibility of futile care being in the patient’s best interest. The impact of the position was based on whether futile care is what the patient wishes. Moreover, this step entailed the evaluation of the ethicality of withdrawal of treatment based on written patient consent and family interest.
Identifying Relevant Stakeholders
Stakeholder involvement in the ethical decision-making process should be achieved. It entails considering the patient’s input, family, medical team, and organization to ensure informed decision-making. At this stage, concepts such as patient autonomy were critically applied.
Application of Ethical Principles
The goal was the implementation of the principle of beneficence. It entails advocating for the best interests of the patient. The quest to determine the futility of medical care was necessary. I took the position that futile care is of no benefit to the patient, and withholding treatment is in the best interest of the sick if the prognosis outlines that the condition will not improve, treatment will result in severe suffering, if the cost of treatment is high with no health improvement outcomes and if the patient wishes for treatment withdrawal.
Nurse Accountability to Futile Care
Nurses are obligated to communicate patient medication information, including when medical care is considered futile. If nurses adhere to the stipulations of the position explained above, they will be acting with patients’ autonomy while, at the same time, applying the patient-centered approach. Primarily, the effects of my position on nurses include ensuring that they practice their medical expertise efficiently while at the same time respecting the rights of the patients. My position entrusts nurses as advocates for quality healthcare, advisors, and administrators of medical help, only with the patient’s consent. Futile care puts nurses at the frontline of ethical and legal accountability. They must adhere to various factors to be safe for medical ethics (Rostami et al., 2019). Among the ways nurses can be held accountable concerning futile care include failure to communicate prognosis or being opaque on the diagnosis. Moreover, nurses can be held responsible if they fail to acknowledge patient autonomy and consent to medication, including decisions on matters related to futile care.
Conclusion
Accountability is a crucial element in nursing due to the legal and ethical responsibilities the profession holds. Nurses are crucial healthcare providers whose roles and responsibilities are based on the well-being of learners. The legal and ethical responsibilities applied to the practitioners are vital when considering futile care. My opposition to futile care focuses on the need to uphold the well-being of patients by following ethical and legal guidelines of practice.
References
Baharudin, S. A. (2020). The laws in medical futility: A comparative study between the Malaysian, English, American, Indonesian, and Islamic law. Indonesian Comparative Law Review, 2(2), 126-134. Web.
Kaps, B., Chen, H. A., Kopf, G. S., & Encandela, J. (2021). Perspectives on the effectiveness of a medical futility policy. The Journal of Clinical Ethics, 32(1), 48-60. Web.
Morata, L. (2018). An evolutionary concept analysis of futility in health care. Journal of Advanced Nursing, 74(6), 1289-1300. Web.
Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446-3461. Web.
Rostami, S., Esmaeali, R., Jafari, H., & Cherati, J. Y. (2019). Perception of futile care and caring behaviors of nurses in intensive care units. Nursing Ethics, 26(1), 248-255. Web.