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Nursing professionals everywhere have long struggled with ethical and legal challenges in patient care, with available literature showing that nurses today are bound to uphold the foundational moral virtues, duties and principles central to the profession while at the same time ensuring all legal obligations are met (Ulrich et al., 2010). However, as demonstrated by the following example involving own experience in the ER, some situations call for nursing professionals to assume unethical positions that are largely legal.
The experience in question involved a 26-year old male, who was rushed to the ER suffering from multiple gunshot wounds. He was accompanied by his wife and other family members, who provided background information on the events leading to the shooting as well as the patient’s medical history. Although the patient was losing a lot of blood due to his injuries, he was nevertheless conscious during the initial stages and even provided consent for the commencement of various medical interventions to save his life. However, the patient and family members were categorical that no blood transfusion was to be initiated as such an intervention was against their religious and cultural beliefs. Any blood given to the patient was to come from family members and not the ER’s blood bank, implying that the family had to undergo several tests to determine congruity of blood group. The patient died of excessive bleeding as tests were been done on family members.
In this example, the decision to respect the wishes of the patient and family members in any treatment plan is largely provided for in law. However, such a legally binding decision forced the ER team to desist from taking steps to improve the outcome of the patient (beneficence), leading to the patient’s death (Ulrich et al., 2010).
The controversial public healthcare issue discussed in this section relates to section 2713 of the Public Health Services Act under the Affordable Care Act, which centers on contraception and calls for health plans to cover birth control and other services with no extra cost-sharing for enrollees (Diamond, 2013). While this is a noble healthcare objective, critics argue that the section makes exception for religious employers such as churches but fails to consider religiously allied employers such as Catholic-run health institutions. As such, Catholic hospitals are required to comply with the mandate despite the fact that the Catholic Church does not sanction the use of contraceptives or any birth control method whatsoever.
The controversy has obvious sociopolitical ramifications as it is a largely political decision that is causing confusion within the society. While President Obama may have gained popularity due to this legislation, the Catholic population may feel confused and disoriented due to the fact that the Church is against the use of contraceptives. The controversy bears obvious economic ramifications in that the government and health insurance companies may end up making huge investments without having a major impact on the ground due to non-compliance. Lastly, the cultural/religious orientation of most Catholics is that God controls childbearing, implying that the mandate may not have any impact on their reproductive health.
Nursing professionals face myriad ethical and legal dilemmas when healthcare issues are politicized, with available literature demonstrating that such interference has curtailed the nurses’ propensity to promote the health of, and care for, individuals of all sections of society (Toiviainen, 2007). Most legal dilemmas revolve around issues of litigation and lack of equity in healthcare delivery, while most ethical dilemmas revolve around issues of individual freedom of choice, autonomy, discrimination, environmental safety and community partnerships.
References
Diamond, D. (2013). Obamacare’s birth control mandate: The most controversial legislation ever. Web.
Toiviainen, L. (2007). The globalization of nursing: Ethical, legal and political issues’ University of Surrey 2006: A summary of the deliberations of the concurrent working groups. Nursing Ethics, 14(2), 258-263.
Ulrich, C.M., Taylor, C., Soeken, K., O’Donell, P., Farrer, A., Denis, M., & Grady, C. (2010). Everyday ethics: Ethical issues and stress in nursing practice. Journal of Advanced Nursing, 66(11), 2510-2519.
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