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PROFESSIONAL ETHICSASSIGNMENT Ethical Dilemmas In Nursing IntroductionThe "care", which is regarded as the essence of nursing, is regarded as a moral authority of nursing in the idea of protecting human dignity. Nursing, which is said to have come from the need to meet human health needs by someone else, has been shaped according to social and religious values of the time. Sometimes a saint is sometimes described as a nun, sometimes a mother, sometimes a sister. Because of these sacred names, nursing is more based on religious values and is expected to have virtues such as benevolence, self-sacrifice, obedience, dignity, faithfulness and compassion. Nursing has caused this new - contemporary intentional, traditional nursing model to change. Because in traditional nursing model; Nurses, obedience to the doctors, obedience, and passive virtues such as, while in the contemporary nursing model; It is argued that the nurse is responsible for the active virtues of the nurse in accordance with the contemporary purpose of the nurse, such as respectful, patient, fair, loyal, courageous and conscientious behavior. These active virtues have gained importance for contemporary nursing. Especially when the nurse took on the role of "patient's advocate". Because caring, which is regarded as the morality of the nurses, has the essence of compassion, it causes the burden of protecting the rights of the nursing patient.In this context, it is suggested that a nurse who is in constant communication with the patient will notice the possible ethical problem more quickly. The nurse has the responsibility to communicate this possible ethical problem to the physician, and the physician has the obligation to not apply it if he believes the patient's intention is to harm the patient.Possible ethical dilemmas in nursing:Ethical dilemmas that nurses often experience or live in fulfilling the requirements of the contemporary nursing model; Moral and ethical values are conflicts of obligations and are mostly experienced at the moment of nursing care Because care, the values and expectations of the patient and the nurse are appropriate for the conflict of their own values and duties Apart from the ethical dilemmas faced at the time of patient care, it is stated that the ethical dilemmas experienced by the nurse due to his position. With a few case studies, we can make some ethical dilemmas that a nurse lived on the bedside more understandable.In the first case; The nurse is about to donate blood to the patient upon request. The patient asks if the blood belongs to a Muslim. The nurse-probably the answer. The patient says he will never allow blood to be inserted without being sure of it. The nurse wants to discuss this ethical dilemma with the patient's physician and tell the case to the physician. Instead of discussing the dilemma, the nurse insists on committing crimes and willingness to lie to the patient. In such a case, the nurse tries to find answers to some questions so that she can get rid of the ethical dilemma she has experienced. Should you lie to the patient for the sake of applying it? Is that right? What is the homework to fulfill?In the second case, the ethical dilemma experienced by the nurse is an example of the conflict between his assignments and his values. The prognosis is the reaction of the nurse who thinks that there are some problems with the patient's treatment of the worsening prognosis and that the patient has to talk to the doctor and opens the case to the responsible nurse. They reprove the nurse by saying that he does not have the authority - such as deciding whether he will be right. In this case, the nurse will tell her patient how everything is going well if she does not? Who is he responsible for?In another (Third) case, ethical dilemmas; The patient knows that everything has been talked to the physician before signing the proclamation for mastectomy. The patient complies with the necessary information by answering questions about alternative therapies. Because this information leads to a change in the decision about the treatment method that the patient accepts. When the patient opens his / her new decision to the doctor, the physician who is disturbed at the end complains to the nurse's superiors. And the nurse is accused of unnecessary explanation. In such a case, the nurse considers whether the patients have the authority and moral obligation to make an explanation when they ask questions about the treatment.As seen in each case, these ethical assignments of modern nursing understanding to the nurse can not prevent the nurse's burden of practice in practice although it causes the nurses to change the auxiliary roles. This is important in that it shows that there are some problems in the implementation of these changes in the purpose, position and function of the nursing. We can say that these problems-raising the age of the patient, understanding quality in patient care-are the inadequacies of ethical education, which seems to be the most basic reason.Because nurses and physicians have different independent functions, the codes of medicine and nursing ethics; Invites the physician and the nurse to cooperate in the face of moral and ethical obligations. According to them; The moral purpose of physicians and nurses is the same. For this reason, it is necessary to think together and discuss together to solve existing ethical dilemmas. Such co-operation or joint ethical decision-making that the hospital will benefit greatly; It is suggested that physicians and nurses will alleviate the moral and ethical burden of the patients, and that the parties will treat each other with gentleness. Nursing Ethics:It is suggested that in order to cope with such dilemmas that nurses are unhappy and frequent in their daily clinical practice, there is no code of professional ethics in which the values of the community they are in are taken into consideration and that adequate ethical training is not given. For this, firstly, the ethical principles of nursing should be determined; Adequate medical, nursing and vocational education programs should be regulated. As a result of a series of ethical studies aimed at determining the ethical principles that are important for nursing, The principles that are important for nursing ethics are; It was determined that the individual was respectful, useful, not behaving badly, righteousness, justice, and loyalty, and that the moral basis of the nursing was based on these principles. These ethical principles on which today's nursing is based oblige nurses with some ethical tasks and establish guidelines for their profession. For example: beneficence principle; He does his duty to do what is good for the nurse patient. Because, the privatized education of the nurses is enough to make them good for their patients and raise the situation in the hospital. The principle of non-maleficence is; Not to do anything to harm anyone, to avoid harm, as it is known, these two principles are the basis of traditional medicine and nursing ethics. The principle of autonomy, which is different from these principles and that protects human dignity; Each individual and his or her values and beliefs. Because everyone has the right to make decisions about their own life and to wait for the health worker to respect that decision. Justice principle; It is necessary that each individual be properly treated. It emphasizes the importance of taking care to equally allocate available resources, especially when making a care decision. The principle of loyalty is; Nurses are expected to be sincere and honest about their patients and to keep their promises.Nursing and Professional Ethics as a Profession:Society, physicians and nurses provide some privileges for their education. This recognized privilege gives the public the right to expect quality service from them. For this reason, nursing has the responsibility to respond to the health care needs of the community. However, it is known that there are some obstacles that affect the presentation of "quality health and care service" which is accepted as the main aim of nursing today, as mentioned above. Furthermore, sometimes nurses feel reluctant to obey a higher authority on behalf of patient care. This leads to an increase in their ethics. Because they think they are forced to do things they believe they are morally wrong, causing them to feel bad. For example; Ethical dilemmas that a nurse who does not endorse an abortion morally would have to deceive the patient for the sake of maintaining a treatment he can not refuse to participate in or practice. Nurses who are expected to show higher moral qualities than themselves do not like having to take a role in such deceptions. This is a sufficient motivation to increase their ethics. ConclusionThe importance of nurses' ethical education; The development of nursing ethics, the determination of the codes of nursing ethics in our country, the independence of the profession, and therefore the promotion of occupational status, will benefit nurses to gain their professional self-esteem. The only major danger in this case is; Is to consider that traditional nursing functions that provide a humane dimension to nursing are not necessary when trying to raise the occupational status.ReferencesAmerican Nurses' Association: Code for nurses with interpretive statements. No.64108, Kansas City, Missouri.British Medical Association: The Handbook of Medical Ethics. The University Press, Cambridge, 1986, pp. 37-38.Gillion, R.: Caring, men and women, nurses and doctors, and health care ethics. Journal of Institute of Medical Ethics.1992; 171-172.Gillion,R.: Nursing ethics and medical etihcs. Journal of Medical Ethics. 1986, 12;115-116,122.Jurchak.M.: Competence and the nurse-patient relationship. Critical Care Nursing Clinics of North America. 2:3, September 1990; 453-459.Ersoy, N., Altun, ?., Be?er, A.: Tendency of nurses to undertake the role of Patient advocate. Eubios Journal of Asian and International Bioethics. Vol. 7 (6), November 1997; 167-169.Mc Faden,CJ.:Medical Ethics. ed 5, F.A.. Davis Co., Philadelphia,1961,pp. 6-9, 39-40,432.Reich,WT.:Caring as extraordinary means. Second Opinion. July 1991; 46-55.Silva,MC.: Ethical Decision Making in Nursing Administration. Appleton & Lange , Norwalk,CT,1990,pp.3-6, 40-66, 81-94.Smerke,JM.: Ethical components of caring. Cricital Care Nursing Clinical of North America. 2:3, September,1990; 509-513.Stanley,T.: Nursing. In: Encyclopedia of Bioethics. Ed.: Reich Warren, The Free Press, Vol.: 3-4, New York, 1978, pp.1138 -1145.Taylor,C., Lillis, C., LeMone, P.: Fundamentals of Nursing. J.B.Lippincott Company, Philadelphia, 1989, pp. 58-78.Thompson, IE., Melina, KM. and Body, KM.: Nursing Ethics. Editon: 2, Churchil Livingstone, New York , 1988, pp.54-62.Veatch, RM.,Fry,ST.: Case Studies in Nursing Ethics. J.B. Lippincott, Philadelphia, 1987,pp. 184-190. ................
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