Week 6: Discussion Board Posting and 2 replies

Integrate one nursing ethical principle the advanced practice nurse could use in the decision-making process for a potentially lifesaving procedures of who should be saved first, who lives, and who dies regarding allocation of scarce resources during a pandemic

student 1 Taylsen

Good morning, Professor and class. I apologize for the previous format. Here is a corrected version. Thanks.

                      Integrating Ethical Principles Advanced Practice Nurses Could Use in Potentially Life Saving Situations

             The International Council of Nurses delivered the first code of ethics, which was approved by the Council of National Representatives (CNR) on July 10, 1953. CNR represents the organization deliberative entity, with bi-yearly meetings in different parts of the world to address ethical principles, perform necessary updates, and delve deep into reflections pertaining ethical codes in nursing (Oguisso et al., 2019). Like mentioned, bi-yearly reunions allow this body of deliberation to identify submerging issues in the ethics of nursing. Nevertheless, the ethical responsibilities in nursing have remained relatively constant thorough the years. The attached study provides a list with the content of the first International Code of Ethics for Nurses, with the three main responsibilities topping the list: “to preserve life, to alleviate suffering and to promote health” (Oguisso et al., 2019, p. 6). In life saving situations, nurses are mainly driven by principles concerning the preservation of life. The devastating effects of the pandemic certainly placed nurses in very difficult situations regarding decision-making of who should be saved first, who lives or dies given the lack of resources worldwide. For this reason, different factors are to be examined that would not impede the nurses’ adherence to ethical principles. A key factor refers to the availability and management of human resources because, given the adequate access of these means, minimization of the problem concerning a health care crisis where nurses are forced to withdraw care form the mostly ill and poorly prognosed is possible. “Failure to provide sufficient resources may compromise the right to healthcare, especially the right of critically ill patients in a situation like that caused by COVID-19” (Falcó et al., 2021, p.183).

                                                         Who Gets to Live When Allocating Scarce Resources?

           A crucial factor in making tough life or death decisions during a pandemic with scarce resources are directly correlated to ethical principles of beneficence and respect for autonomy. Patients who needed to be admitted to the ICU, for instance, had to be extensively reviewed by the interdisciplinary team (the advanced nurse included) in order to make a decision whether to transfer the patient or let them go. This posed a huge challenge for healthcare professionals given the lack of knowledge of the disease, the lack of knowledge (oftentimes) of the patient’ wishes and the level of uncertainty associated with the complications caused by the virus. Criteria such as age, past medical history and fragility were all part of the guidelines to follow when confronted with ambiguous situations (Falcó et al., 2021). As a result, patients who were younger, lack comorbidities and had a better prognosis were more likely to survive because, for them, ventilators and the use of certain medications were available. Nurses had to stick to the guidelines provided by scientific societies and official organizations in order to label these patients based on acuity. Research shows that, when allocating scarce resources between two critically ill patients, triage policies aim to allocate to the individual with the best chances of survival (Buckwalter & Peterson, 2020). Again, the ethical principle of life preservation is clearly demonstrated here, ultimately aiming for the greater good, although it can be very saddening for the families of those with no chance of survival.

                                                                                        References

Buckwalter, W., & Peterson, A. (2020). Public attitudes toward allocating scarce resources in the COVID-19 pandemic. Plos One, 15(11), 1–20. https://doi.org/10.1371/journal.pone.0240651 (Links to an external site.)

Falcó, P. A., Zuriguel, P. E., Via, C. G., Bosch, A. A., & Bonetti, L. (2021). Ethical conflict during COVID‐19 pandemic: The case of Spanish and Italian intensive care units. International Nursing Review, 68(2), 181–188. https://doi.org/10.1111/inr.12645 (Links to an external site.)

Oguisso, T., Hiromi-Takashi, M., Fernandes de Freitas, G., Barrionuevo-Bonini, B., & Araújo da Silva, T. (2019). First international code of ethics for nurses. Texto & Contexto Enfermagem, 28, 1–11. https://doi.org/10.1590/1980-265X-TCE-2018-0140

student 2 Catalina

Good afternoon class and professor,

       The four fundamental concepts of healthcare ethics are justice, autonomy, beneficence, and nonmaleficence. When selecting who should be saved first, who should live, and who should die in connection to the distribution of limited resources during a pandemic, advanced practice nurses may use the nursing ethical concept of justice. Justice is defined as the provision of appropriate, unbiased, and equitable care to all patients. Justice entails more than just equality; it entails treating patients according to specific requirements under specified circumstances, without regard for the patients’ income, rank, or race (Rooddehghan et al., 2019). By adding the ethical principle of justice, nurse practitioners can focus on prioritizing patient care and making timely decisions based on patients’ needs. Healthcare practitioners on the front lines of assisting people during pandemics face a variety of professional responsibilities that might lead to ethical quandaries—addressing ethical concerns when organizing treatment and preparing for pandemic work may be advantageous (Muñoz-Rubilar et al., 2022).

                                                                                                  References 

Muñoz-Rubilar, C. A., Carrillos, C. P., Mundal, I. P., Cuevas, C. D. L., & Lara-Cabrera, M. L. (2022, February 10). The duty to care and nurses’ well-being during a pandemic. Nursing Ethics, 29(3), 527–539. https://doi.org/10.1177/09697330211041746

Rooddehghan, Z., Nikbakht nasrabadi, A., Parsa Yekta, Z., & Salehiparsa yekta, M. (2019, December 1). Patient favoritism as a barrier to justice in health care: A qualitative study. Health, Spirituality and Medical Ethics, 6(4), 29–35. https://doi.org/10.29252/jhsme.6.4.29