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Nov 28, 2019 in Nursing

Conflicts that Exist between Ethics and the Law in Nursing

Nurses can come across many dilemmas, ethical or legal in nature, in their profession. However, many nurses are not proficient at solving such problems and, for this reason, end up destitute. Moreover, a problem in nursing conduct and ethics can develop. In today's situations, it is more than just a nursing necessity. Every nurse should be equipped with some means to shield themselves from the malpractice and understand its damaging results on their profession. Nursing, at every level and in entire areas of the profession, follows certain ethical strategies and functions under regulatory and governmental statutes. Entire guidelines and statute are laid down by the quality concern of patient care. Habitually, the interplay between law and ethics is complicated. However, according to Kathleen Fenner in "Law and Ethics in Nursing", proficient nursing ethics can travel within a legal boundary and is probable to be lawfully defensible. Thus the nature and the peculiarities of conflict that exists between ethics and the law in nursing require close scrutiny. 

Law and ethics in nursing have proved to conflict due to various activities that a nurse is supposed to carry out while practicing his or her profession. According to Chin and Kramer, in making professional decisions, nurses can be engrossed between two conflicting sets of decisions, one arising from the profession mission, and the other originating from legal suppliers. Nurses, together with another health care professionals,  can become entwined with either criminal or civil justice systems like when nurses experienced criminal accomplishment by not renewing nursing license in the time expected. Other nurses’ actions that can be regulated by the criminal law can include substance abuse, particularly in the situations when nurses acquire treatments procedurally in clinical background.

 
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Moreover, Gastmans  points out that nurses experience diverse circumstances on the day-to-day basis categorized as ethically correct or legally offensive or vice versa. Conditions like abortion, euthanasia, and death by their nature can incur nurses’ dilemma. Instances of conditions that might be outlined as those provoking conflict between nursing ethics and laws are diverse and numerous. One of such conditions can be nurse’s giving patients the improper medication and consequently, failing to report the occurrence or concealing the occasion to protect professionals from any legal action. This event raises the pertinent questions placed on both legal and ethical issues. The second occasion that can be ethical rather than legal is the patients’ allowance for continuing smoking marijuana for medicinal reason. Another occasion that can emerge contiguous ethical and legal boundary focuses on forcing patients to accept an issue not in support of his or her willingness or bereft of informed accord.

In addition, nurses must differentiate between morality and law since an exploit can be legal though immoral. An order to take on resuscitation for any dying customer might be legal though questions may still be raised on whether the action is moral. Correspondingly, an action might be moral, though illegal. Some conflict that might arise between law and ethics create circumstances which should be regulated by nurses.  It is important to note that there are no dynamic objectives that could be reached with various services like therapy facilities. Together with the nursing code of ethics it could be unethical for such practitioners to charge amenities rendered. At the same time, nurse remains legally expected to provide services to their customers comprehensively. Similarly, conflict in the nursing practice might stem from patient’s prospects and beliefs as the client’s refusal for blood transfusion to be exercised.

In most instances, acquiescence with the professional and legal obligation may seem harmful, improper or invalid. In other moments, nurses’ driving away from compliance when the regulation appears a contradicting ethic. On the other hand, nurses cannot serve to the detriment of their personal worth and/or the clients’ welfare even if the system detailing regulations are imperfect. For instance, nurses can fail to tolerate their professional responsibility for revealing confidential information. Similarly, conflicts that exist between ethics and law can result in the decision-making period relating to the dying or disabled persons, as well as issues regarding one’s right to life. 

Additionally, Gastmans highlighted that there are many instances when conflict between law and ethics manifests and revolves around such values as truthfulness, fairness, patient’s well-being, patient’s choice, confidentiality and privacy of life, upholding the commitment of patients, nursing professionals, settings and nursing colleagues. These standards remain important to be shared by the community; however, when two values are appropriate in any situation but supportive of diverging progression of action, conflicts might arise.

On the other hand, the code of ethics claims that nursing practice is to meet the patient’s needs and comply with ecological service that might produce conflicts between law and ethics. The likelihood of conflict between a nurse’s ethical duty and her legal obligation might put nurses at substantial professional risk. There are inadequate strategies for solving dilemmas protuberant in a nursing exercise. Sometimes codes of ethics nosedive to provide the legal defense for the nurses acting as the patient’s support and might be too concrete to relate with steadiness. Contrariwise, the government might not allow nurses to join other people or exercise in an individual manner. 

However, laws reverse nursing practice, particularly relating their responsibilities and client's care. The Code of Ethics expects nurses to obey the decisions made by customers as long as it has a knowledgeable consent. When patients or families turn down the providers’ treatments or recommendations, this can cause conflicts and moral predicament for nurses. A moral predicament stems from the case when two concise moral values can be applied to; however, they equally support inconsistent action sources.

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According to Storch, conflicts can arise when nurses face unreasonable loads, conscientious objection, personal danger, concerns regarding personal competence. Irrational burdens appear when the nurse’s ability to provide safe care as well as satisfy the Practice Standard is destabilized by unreasonable expectations, resources inadequacy, or personal wellbeing threats. Nurses are not expected to desert their customers and are not to place themselves in organizations where the care delivery could visit irrational hazard to their personal protection. Such conflicts entail situations such as communicable disease, violence, physical, and sexual abuse. In terms of individual competence, nurses are required to practice consistently and competently and to acquire fresh skills and knowledge within their professional area.

Furthermore, nurses cannot be forced to offer care that is exceeding his or her level of capability. In remote cases, the nurse can confront situations where he or she is needed to provide care that is exceeds his or her ability. In such circumstances, the nurse must always provide care that they have experienced giving. In terms of reliable objection, when individual care creates conflicts with the nurse’s religious or moral beliefs, nurses must consult his or her manager and desist from offering care. Personal judgment or biases that struggle with client’s lifestyle must not form any grounds for meticulous objection.

Historically, nurses have used the professional practice code to solve conflicts that can arise between laws and ethics through reverential communication. Guidance is provided by the Nursing Practice Code of conduct. The code originates from the shared confidence that nurses’ primary roles comprise of ailments prevention. The code of conduct ease the suffering for patients and guarantee the promotion, safeguarding and restoration of the client's health in the caring of groups, individuals, communities, and families.  Moreover, healthcare organizations are anticipated to reward multidisciplinary consciences committees that benefit counseling and education. As well, nurses are required to support ethical matters. Application of work ethics in nursing aims at allowing one to utter their personal views; it avails caregivers of sustenance and lowers the organizational and legal risks. The values of the profession may aid nurses understand professional nursing care, availing the emblem of the nursing experience assurance to the communal; delineating the essential ethical values for professional conduct; controlling the professionals in the mission for self-control; and, safeguarding that nurses maintain in track with their role of caring.

To sum up, nurses must apply principles to nursing practice in making the ethical decision that requires their attention by distinguishing the client’s right to safety, competence, and the ethical care. However, in some places, the nurse’s personal values and rights might reverse the customer’s desire to receive healthcare. As such, nurses must regulate the facts, negotiate the quandary and clarify the problem. In addition, nurses are required to implement available choices, to develop a strategy and the appliance of this strategy. The prescribed ethical and legal standards set in the nursing practice must not be disregarded on grounds of sustaining patient welfare. A segment of nurses might sometimes disrupt formal ethical and legal standards leading to conflict between the legal and moral obligations. It is important to assure that their schedules are stranded in sound legal and judicial judgments instead of preconception and rationalization or self-interest.

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