ethical issues in nursing in the workplace

Ethical Issues in Nursing in the Workplace

Withholding of Artificial Nutrition and Hydration : Ethical Issues for Nursing

Introduction

Medically provided nutrition and hydration have become an increasingly familiar part of the health care professional 's experience . For many people , medical professionals as well as patients and their families the withholding or withdrawing of artificial ' hydration and nutrition raises particularly troubling ethical issues . Is providing hydration and nutrition by medical means to those who cannot accept them by mouth morally similar to providing food and water to the sick and therefore

br subject to the same ethical injunctions , or does providing nutrition and hydration by medical means constitute an invasive medical procedure which should be considered in light of the ethical principles applicable to the use of such medical interventions

Medically provided nutrition and hydration may , of course , be life-saving for those who have esophageal or gastrointestinal conditions which inhibit their ability to take food by mouth but who can , and choose to , live their lives with medically provided nutritional support Needless to say , such cases generally do not raise ethical concerns This discusses whether it can ever be consistent with a nurse 's professional ethical obligations for nutrition and hydration by medical means to be withheld or withdrawn and if so , under what circumstances

Significance for Nursing and Research Support

In the past , many health care decisions were made by the physicians However , with the rising responsibility and autonomy of nurses and clients , this unilateral decision-making is becoming an artifact of the past (Tschudin , 2003 ) Nurses and clients are becoming more and more involved in ongoing and recurrent dilemmas . Several factors have made nurses ' ethical choices necessary and immediate , including expanded technology and the rising status of nurses as active participants m the health care system , and ethical arena . Improved communication , more highly educated practitioners who recognize a dilemma when confronted with one , and an expanded consciousness of nursing 's responsibility and impact on society have also had an effect (Benner , 1991

According to Davis and Slater (1989 , one of the most persistent ethical questions is whether individuals have the right to seek their own death and whether others (health professionals included ) ought to assist them in dying . In the Davis and Slater (1989 ) study , a comparison was made between the beliefs of Australian and American nurses about their perceptions of the right of different hypothetical individuals to receive assistance with dying by withholding or withdrawing treatment In their study , American nurses believed that the patient would be treated more often than did the Australians . The American nurses were also more ambivalent about whether or not they ought to withhold food and fluid (Davis and Slater , 1989 ,

. 36 ) In addition , the American nurses were more apt to justify resources provided to the young than the elderly . Both acute care and long-term care nurses were studied

In the Wurzbach study (1996 , only American nurses practicing in long-term care were studied . There was general agreement that elders in the end stages...