Respect for patient autonomy
In 1979, Beauchamp and Childress first put forward the four principles approach to biomedical ethics. They outlined how in order to act as a professional nurse and in the best interests of individual patients, the principles of autonomy, beneficence, non-maleficence, and justice must be upheld (Beauchamp and Childress, 2013). Autonomy has been given a number of general meanings e.g. freedoms of choice, self-governance, privacy, free-will (Beauchamp and Childress, 2002). However, in the context of healthcare, a patients’ decision is regarded as autonomous if they have the mental capacity to make the current decision- to either consent of refuse, have all of the relevant information to make the decision, and do so …show more content…
NMC (2015) in ‘The Code’ state that it is the professional responsibility of every nurse to communicate effectively and compassionately with all patients: to broadly “treat people as individuals and uphold their dignity”, “listen to and respond to their preferences and concerns (p.4), and “act in the best interests of people at all times” (p.5). Nurses have a professional responsibility for effective communication (Dougherty et al. 2015) which was set out in ‘Compassion in Practice’ (Department of Health- DH 2012) through the implementation of The ‘6 C’s’: care, compassion, competence, communication, courage, and commitment. These recommendations were as a direct result of The Francis Report (DH, 2013) which recommended the need for increased focus on a culture of compassion, care, and consideration in nursing (Dougherty et al. 2015). In the context of the six core NHS values, communication is “central to caring relationships…listening is as important as what [nurses] say and do” (DH, 2012, p.13); and “compassion: care based on empathy, dignity, and respect” (DH, 2012, p. 13) must work hand in hand with communication (Dougherty et al. 2015). It can be argued that if nurses do not have the ability to communicate effectively with their patients, the patients’ ability to make fully informed decisions regarding consent/refusal to treatment is compromised. Nurses’ poor communication …show more content…
A persons’ mental capacity can significantly impact their ability to communicate consent (Dougherty, 2015). The Mental Capacity Act- MCA (2005) stipulates that all persons must be assumed to have capacity (Human Rights Act, 1998) unless they: are unable to understand and weigh up the information relating to the choice they are making, cannot retain the information long enough to make a decision although they can understand it, are unable to communicate their decision by any means (BMA, 2007). If any of these are called into question, the MCA (2005) recommends a multi-disciplinary assessment of the patients’ mental capacity (Dougherty et al. 2015) which must take place for each new decision that is to be made. The person giving consent therefore may be the patient, another person who is authorised under a Lasting Power of Attorney by a court-appointed deputy- a person with authority to make treatment decisions on behalf of patients, or by the multi-disciplinary team acting in the best interests of the patient (DH, 2009). Although the individual may lack mental capacity, the MCA (2005) promotes the rights and autonomy of people by emphasising the need to work with patients, families and the multi-disciplinary team to ensure patients are involved in the decision making process of their care. (Griffith and Tengnah, 2008) ‘The Code’ (NMC, 2015) outlines
In 1979, Beauchamp and Childress first put forward the four principles approach to biomedical ethics. They outlined how in order to act as a professional nurse and in the best interests of individual patients, the principles of autonomy, beneficence, non-maleficence, and justice must be upheld (Beauchamp and Childress, 2013). Autonomy has been given a number of general meanings e.g. freedoms of choice, self-governance, privacy, free-will (Beauchamp and Childress, 2002). However, in the context of healthcare, a patients’ decision is regarded as autonomous if they have the mental capacity to make the current decision- to either consent of refuse, have all of the relevant information to make the decision, and do so …show more content…
NMC (2015) in ‘The Code’ state that it is the professional responsibility of every nurse to communicate effectively and compassionately with all patients: to broadly “treat people as individuals and uphold their dignity”, “listen to and respond to their preferences and concerns (p.4), and “act in the best interests of people at all times” (p.5). Nurses have a professional responsibility for effective communication (Dougherty et al. 2015) which was set out in ‘Compassion in Practice’ (Department of Health- DH 2012) through the implementation of The ‘6 C’s’: care, compassion, competence, communication, courage, and commitment. These recommendations were as a direct result of The Francis Report (DH, 2013) which recommended the need for increased focus on a culture of compassion, care, and consideration in nursing (Dougherty et al. 2015). In the context of the six core NHS values, communication is “central to caring relationships…listening is as important as what [nurses] say and do” (DH, 2012, p.13); and “compassion: care based on empathy, dignity, and respect” (DH, 2012, p. 13) must work hand in hand with communication (Dougherty et al. 2015). It can be argued that if nurses do not have the ability to communicate effectively with their patients, the patients’ ability to make fully informed decisions regarding consent/refusal to treatment is compromised. Nurses’ poor communication …show more content…
A persons’ mental capacity can significantly impact their ability to communicate consent (Dougherty, 2015). The Mental Capacity Act- MCA (2005) stipulates that all persons must be assumed to have capacity (Human Rights Act, 1998) unless they: are unable to understand and weigh up the information relating to the choice they are making, cannot retain the information long enough to make a decision although they can understand it, are unable to communicate their decision by any means (BMA, 2007). If any of these are called into question, the MCA (2005) recommends a multi-disciplinary assessment of the patients’ mental capacity (Dougherty et al. 2015) which must take place for each new decision that is to be made. The person giving consent therefore may be the patient, another person who is authorised under a Lasting Power of Attorney by a court-appointed deputy- a person with authority to make treatment decisions on behalf of patients, or by the multi-disciplinary team acting in the best interests of the patient (DH, 2009). Although the individual may lack mental capacity, the MCA (2005) promotes the rights and autonomy of people by emphasising the need to work with patients, families and the multi-disciplinary team to ensure patients are involved in the decision making process of their care. (Griffith and Tengnah, 2008) ‘The Code’ (NMC, 2015) outlines