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It is critical for nurses to respect clients’ autonomy in making decisions. However, for the decision to be autonomous it must have several distinct characteristics. Individuals should have the capacity of undertaking decisions on their own. Autonomous individuals have the capacity to govern themselves in a manner that is free and rational. Autonomous actions are actions that are free from external intervention or control. The individual is solely responsible in choosing the preferable alternative. In addition, autonomous action must be authentic. The actions of the individual should be in accordance with the individual’s desires, values, and principles. In addition, in making an autonomous decision the individual must reflect and evaluate the decisions in a conscious and coherent manner.
Miss Corrine Worthen refuses to perform kidney dialysis on a double amputee due to various complications that the patient experienced while undergoing the exercise in the past. The patient suffered from cardiac arrest and severe hemorrhaging while undergoing treatment. These conditions are acute health problems that may lead to the death of the patient. Miss Worthen was of the opinion that continuation of dialysis was detrimental to the health of the patient. Therefore, she asks the head nurse to reassign her to another patient due to the compassion she felt for the patient. The head nurse granted her request. However, on a later date, the head nurse requests her to undertake dialysis on the patient. She vehemently refuses to undertake dialysis on the patient despite the insistence of the head nurse and the patient’s family. According to the family failure to do dialysis would lead to the death of the patient and the family wants to keep the patient alive.
Nurses have the obligation of providing care to patients. However, in some instances the nurse has justification of refusing to offer treatment to a patient if she has personal opposition to the treatment. Dialysis made the patient suffer from life threatening complications. This was the main reason that made Miss Worthen refuse to continue giving the treatment. Miss Worthen has teleological justification of refusing to treat the patient. Therefore, she may argue that in refusing to treat the patient, she ensures that the patient does not face life-threatening consequences due to dialysis. Dialysis of the patient in the past led to severe hemorrhaging and cardiac arrest.
Therefore, Miss Worthen’s assumes her refusal treat the patient is in the best interest of the patient. Consequences of the treatment may result in the patient suffering an extremely painful death. Miss is sure that treatment would result in death since the complications occurred on two previous occasions. In addition, Miss Worthen feels pity for the double amputee who has already undergone so much suffering due to double amputation.
Miss Worthen thinks that it is morally wrong for a person to undertake a procedure that would certainly lead to inflicting pain on the other party. This is regardless of the insistence of the other party. In addition, the patient does not make the autonomous decision of seeking treatment. The patient’s family is responsible for making the decision. The patient family wants the patient to be kept alive and were of the view that failure to dialyze the patient would lead to death of the patient. Miss Worthen rejects the insistence by the family to keep the patient alive regardless of the pain she may undergo just to be kept alive. According to Miss Worthen the patient would ultimately die. However, dialysis would make death come sooner but in a more painful way.
Miss Worthen does not have deontological justification in refusing to treat the patient. Miss Worthen has a moral obligation of respecting the client’s autonomous decision of seeking treatment despite the complication that the client experienced in undergoing that treatment in the past. According to Kant, the nurses have a moral obligation to respect the autonomous decision of the clients. Kant hypothesizes that rational moral agents, are ends-in-themselves. Therefore, an individual must respect the independence of the moral agents by treating them as end-in-themselves. Thus, Miss Worthen has an obligation of treating the client by respecting his independent decision. Kant further argues that violating the decisions of the clients is to treat them as a means. This is wrong since the individual “uses” the clients to achieve their individual objectives to the detriment of the wishes of the client.
Miss Worthen refuses to treat the client due to personal reasons. This makes her selfish in not heeding to the client’s need to be treated. Therefore, Miss Worthen is “using” the client to fulfill her own goals. The general assumption taken is the patient made the autonomous decision of seeking treatment. However, it is not clear whether the patient made the autonomous decision of seeking the initial treatment, or the family made the decision. Thus, whether the patient or the family made the initial decision of seeking treatment Miss Worthen does not have deontological justification in refusing to treat the patient.
The head nurse was wrong in firing Miss Worthen. The head nurse wrongly interpreted the code of Professional Ethics for nurses. The code of ethics states that if a nurse has personal reasons for objecting to offer treatment of a patient, the nurse refuse in advance, so that other arrangements may be made on the patient’s nursing care. Miss Worthen had refused to treat the patient several months earlier, due to the complications the patient was experiencing. This gives the patient’s family and the head nurse enough time to look for other means of providing nursing care to the patient. In addition, the code of ethics states that, in case of emergency, the nurse should provide the best possible care. In this case, the best care is “no care” at all.