Nurses often describe their role as the translator for complex medical terms that patients and families can understand. Patients bleed (not hemorrhage) and stop making urine (not anuric).
Yet nurses may not be as skilled at translating their concerns about an ethically challenging situation because they are unfamiliar with the language of ethics. The question I hear most often related to this topic is “Can patients demand everything?”
Sadly, there is no simple answer to this question, but it is important to look at it using words that convey some understanding of the ethical issue at stake. Patients are entitled to exercise their autonomy, meaning they have a right to determine which medical treatments they consent to and which they do not.
Consent depends on knowing all the risks, benefits, burdens and alternatives to the treatments. There is often a tension between a patient’s autonomy and paternalism from members of the health care team.
Paternalism refers to actions or attitudes that suggest someone knows better than the patient what is best for the patient. The overriding ethical principle behind paternalism is beneficence, or the desire to benefit and promote the welfare of other people.
When the question “Can they demand everything?” is asked, the underlying concern is whether the patient has enough information to truly consent to the treatment or if “everything” is a “good” thing.
Nurses have a duty to address both concerns.
First, nurses can ask patients to explain what they understand about the proposed treatment/procedure. Any gaps in understanding should be brought to the attention of the attending physician.
Second, nurses can help the patient define the “good” that will come from the procedure by reviewing the patient’s goals (restoration of health, return to independent living or better quality of life, for example). Agreeing on the goals of treatment is essential to respecting a patient’s autonomy and avoiding premature judgments about what you may think is best for a patient.
Lucia Wocial, PhD, RN
Clarian Health Nurse Ethicist
To join the Registered Nurses at Clarian, visit RN Job Opportunities Indiana
Yet nurses may not be as skilled at translating their concerns about an ethically challenging situation because they are unfamiliar with the language of ethics. The question I hear most often related to this topic is “Can patients demand everything?”
Sadly, there is no simple answer to this question, but it is important to look at it using words that convey some understanding of the ethical issue at stake. Patients are entitled to exercise their autonomy, meaning they have a right to determine which medical treatments they consent to and which they do not.
Consent depends on knowing all the risks, benefits, burdens and alternatives to the treatments. There is often a tension between a patient’s autonomy and paternalism from members of the health care team.
Paternalism refers to actions or attitudes that suggest someone knows better than the patient what is best for the patient. The overriding ethical principle behind paternalism is beneficence, or the desire to benefit and promote the welfare of other people.
When the question “Can they demand everything?” is asked, the underlying concern is whether the patient has enough information to truly consent to the treatment or if “everything” is a “good” thing.
Nurses have a duty to address both concerns.
First, nurses can ask patients to explain what they understand about the proposed treatment/procedure. Any gaps in understanding should be brought to the attention of the attending physician.
Second, nurses can help the patient define the “good” that will come from the procedure by reviewing the patient’s goals (restoration of health, return to independent living or better quality of life, for example). Agreeing on the goals of treatment is essential to respecting a patient’s autonomy and avoiding premature judgments about what you may think is best for a patient.
Lucia Wocial, PhD, RN
Clarian Health Nurse Ethicist
To join the Registered Nurses at Clarian, visit RN Job Opportunities Indiana
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