The RNAO (2006) also promote client centered care through respecting clients and their wishes, values and priorities, providing human dignity, recognizing clients as experts and leaders in their own lives, and allowing clients goals to coordinate the care of the healthcare team. 1712 Words7 Pages. Decision making are provided and determine how these choices are valued, rights, justice ) 7 of! Do you have a 2:1 degree or higher? Patient, nurse and family members are significantly involved in this situation. Is criminal and forbidden, Passive euthanasia includes starvation, dehydration, or withholding life-preserving procedures (Healthcare consent Act, 1996), Suicide not a crime in Canada but physician-assisted suicide is (Criminal Code of Canada, Section 241b), The Canadian Medical Association states it is not up to doctors to decide on the issue of euthanasia but the responsibility of society. The various codes that guide the nursing profession have principles that help nurses navigate ethical concerns concerning medical racism. The another option is that family members did not wish to stay with a decision that was not supported by other family members (Nolan et al. Muller N, Riedel M, Blendinger C, Oberle K, Jacobs E, Abele-Horn M: Mycoplasma pneumoniae infection and Tourette's syndrome. The doctor told the family that there is only ten percentage of chances that transplant will be successful (see appendix). Racism in healthcare is an ethical concern that all healthcare professionals should strive to eradicate. [2 screens]. Looking for a flexible role? Ethical Issue: End-of-Life Care Decision Making in Adolescents Nurses work in different types of environment and end of life care is one of the health care facility where nurses inevitably involve in the care of patients. 1. Finally, the Code advocates for transparency and accountability in nursing practices. Canadian community health nursing professional practice model and standards of practice [Internet]. Clean surface for clean world endobj The specific wishes to have an autopsy can also be included in an advanced directive. Here you can choose which regional hub you wish to view, providing you with the most relevant information we have for your specific region. On the other hand, some people would argue that healthcare professionals do not intentionally harm their patients. Coronavirus disease (COVID-19): vulnerable populations and COVID-19 [Internet]. This paper explores the ethicality of racism in healthcare from various ethical theories and bioethical principles. CHNs struggled with supporting families whose loved ones were in hospice or long-term care and strict limitations on visitation. Acquiring knowledge of institutional policies, communicating with nursing colleagues and the interprofessional team if practical way of obtaining knowledge of end of life issues, Timely and appropriate documentation of clients wishes serve as a useful advocacy tool. College of Nurses of Ontario. ,Sitemap,Sitemap, ithaca lacrosse division fill the room maverick city chords. Akua knew that the revised plan of care meant a slow death for a patient that looked so much like her father and with whom she had spent lunch breaks reading stories about hope. May be in Moral Distress Nurse definitely feels that the should be provided with minimum oxygen, feeding, and suctioning but is constrained, May be experiencing Ethical Uncertainty Nurse has a feeling that something is missing in the revised plan of care but is not sure what it definitely is, Ethical Dilemma The nurse has to choose between the two mutually exclusive ethical issues of promoting the pts comfort by: (1) Continuing to feed, oxygenate, and suction her, OR (2) Not continuing her pts suffering by depriving her of basic feeding, oxygenation and suctioning, Nurse may use an ethical decision making framework such as that by Oberle & Raffin (2008). Akua should provide presence to the patient and his family, therapeutic touch if appropriate and meet their basic needs. Barriers to Practicing Advocacy in End-of-Life Nursing Care (Thacker, 2008), Novice nurses reported that lack of communication and lack of time and or support served as barriers to their practice, Disagreeing with the Plan of Care for Patient (CNO, 2009a), Consult with nursing colleagues, experts, etc. More precisely, Social justice includes full and equal participation of individuals in all social institutions; fair, equitable distribution of material and nonmaterial goods (Abbott, 2014). Within the nurse-client relationship, clients rights encompass high quality hospital care, participation in treatment decisions, full information disclosure, and protection of client privacy (Arnold & Boggs, 2007). While working to complete the planning, Davis reflects on the following key questions: Once their plan is implemented, Davis and team stepped back and reflected on the following important ethical decision-making consideration: CHNs like Davis Caron are and will play a critical role in the COVID-19 pandemic response and recovery. The nurse would have to consider factors such as who can consent to treatment as outlined above. When the community health nurse (CHN) requests, medication to be used p.r.n., the physician states that the clients sufferin. This implies that racism in healthcare violates the human right to fair treatment. <> While bioethics remains an important model for ethical deci-sion-making in health care, criticisms of bioethics include its emphasis on the specific obligation or duty that the physician owes the patient and its failure to fully acknowledge issues related to the relational nature of ethical decision-making (Oberle & Raffin Bouchal, 2009). In this second blog post, we explore responses to the question about the ethical dilemmas CHNs have encountered during COVID-19. Does she have moral Agency Is nurse able to act on her moral beliefs relating to care of the dying? To my supervisor Dr Shelley Raffin-Bouchal for her endless patience when the rest of my . More test kits cannot be supplied until the next week. The family hopes to achieve good prognosis of disease through bone marrow transplantation. View . Code of ethics for registered nurses [Internet]. What is happening here? Nursing Ethics, 27(4), 1077-1088. Copyright 2003 - 2023 - UKEssays is a trading name of Business Bliss Consultants FZE, a company registered in United Arab Emirates. Right and wrong, should and should not, or "ought to or ought not to" (Oberle & Raffin Bouchal, 2009, p. 3), the core of ethics, move beyond the idea of what is technically right or wrong or what evidence suggests is best . On the other hand, shared decision making involves both patient and his family. It is also a regulatory tool. Ethical Decision Making Framework (Oberle & Raffin, 2008). And Raffin Bouchal ( 2009 ) Potential Actions: Recognize available choices and determine how these are. This model promotes reflection on the ethical issue and offers a framework for considering ethical issues in practice. The CMA forbids Canadian physicians from participating in euthanasia and assisted suicide (CMA, 1998). The aim of palliative care is to render comfort, promote the best quality of life, and to relieve suffering. My practice as a nurse is based in values such as compassion, quality care, and justice. Yet, despite extensive . It is a means for self-evaluation, feedback and peer review and is a basis for advocacy. When people are provided with poor quality care or none at all, it violates their right to social services. Kaur Pawandeep-PC6 - Detailed solution i submitted to this case study in week 6 of CPA PEP Core 1. By doing this, Akua will be practicing in line with Parses theory of respecting Mr. Xs autonomy as well as Watson caring theory of being with the patient and his family. Ethical issues can also arise when family members are unprepared for the decision-making role, and when family members do not understand the biomedical choices and treatments presented to them. From clinical experiences, patients often are NPO as they refuse meals. According to the scenario, Mr Xs family had requested that the PEG feeding and oxygen be disconnected and thus the wishes and autonomy of the family will be respected and duties carried out as deem necessary. In the preceding case, the nurse was able to ascertain that the wishes of the client and the orders of the MD were not in sync. From the perspectives of ethical theories such as utilitarianism and virtue ethics, racism in healthcare is unethical. <> , 2008, p. 278-279). List of ebooks and manuels about Oberle and raffin model. endstream For instance, many incidences of medical racism stem from implicit bias (Iheduru-Anderson et al., 2021). \n7UQWS5$?L/.5wEcnt.|0%5u[2wnrKg HBe5mS}:GdM^+79#u&"Y\kGOVVkrHvm`pM yp{aQmG[n*HlTC5Q "Issue of Racism in Healthcare." In March 2020, an e-mail survey asked Canadian community health nurses (CHNs) in home health and public health from several provinces to share their current reality in the midst of the COVID-19 pandemic. Nurses find ethical conflict when she is following one principle and at the same time she can conflict with another principle in the end-of-life care decision-making process. Also, using principles from nursing theory would allow the nurse to have a better understanding of the dynamics involved in decision-making. According to the utilitarian ethical theory, an action is ethical if it brings happiness and maximizes utility for the greatest number of people (Hyry, 2020). It leads to these people having poorer health outcomes and experiencing differential treatment due to stereotypes. It contains thousands of paper examples on a wide variety of topics, all donated by helpful students. The bioethical principle of beneficence requires medical professionals to take actions with the intention of promoting the wellbeing of their patients (Avant & Swetz, 2020). Passive euthanasia if not according to the patients wishes is unethical and could be considered clinical negligence. Consult with a friend who also does not vaccinate, Start a qualitative research study on why parents do not vaccinate their children, One ethical model that can help community health nurses (CHNs) engage in ethical, decision-making is the Oberle and Raffin ethical decision-making model. 6. violence/lateral violence Cost containment The 'Self-Sacrificing Nurse' Creating a moral community Oberle &amp; Raffin . Clean surface for clean world 8. var cpro_id = "u1548375"; physical education powerpoint presentation, 218-639-#### (Wadena,Minnesota) - CallerTube, 856-321 Phone Numbers in Merchantvl, New Jersey, Oberle & Raffin Model Flashcards | Quizlet, Fall2006 by Trinity College Digital Repository - Issuu. It also goes against the bioethical principles of non-maleficence and beneficence. Lindeke & Sieckert (2005) suggests that collaboration between physicians and nurses is rewarding when responsibility for patient well-being is shared. It appears that Akua and the doctor may share different views on how best to care for the patient. 1. Questions for Ethical Reflection. What was done well and what could have been done better or differently in the future. However, the nurse must also ensure arguments are based on clinical rational and remain self-aware, unbiased and non-judgmental in order to communicate effectively in practice. Strangely, nurses are also, in many cases, cut out of the decision-making link, creating a slew of ethical and professional problems for nurses as patients advocates and caregivers. However, nurses encounter some challenges while choosing care for their patients. Web. The CNO consists of six main principles by which nurses should abide (College of Nurses of Ontario, 2019). The CNA (2002) code of ethics stipulates that nurses must provide dignified care through respecting each clients worth and advocating for the respectful treatment of all persons. 4 0 obj Human rights and nursing codes of ethics in Canada 19532017, Ethics of Facial-Recognition Surveillance Systems, Racism in Healthcare and Its Implications, Bioethical Position on Medical Futility Nursing, Bioethical Decision-Making in Nursing Practice, Bioethical Issues in Treating the Terminally Ill, Genetic Manipulation of Human Embryos: Bioethical Issues, Bioethical Issues in Health Care - Opioid Overprescribing, Health Care Disparity and Principles of Biomedical Ethics, Organ Donation: Postmortem Transplantation, Bioethics: Definition, Importance, and Scope, Christian Values and Decision Making in Health Care, Facilitating Spiritual Care: Practicing Dignity, Culturally Sensitive Spiritual Assessment, Euthanasia in the Context of Christianity, Biases and Executive Performance in Healthcare. The Lucia wants only palliative care (see appendix). The intersection between moral agency and moral community Cost containment Ethics, practice, and nurses' rights Professionalism relationships: Incivility and violence . A child or parent of the incapable person, or a childrens aid society or other person who is lawfully entitled to give or refuse consent to the treatment in the place of the parent. Although patients and their families are living together, there are still chances that values can be different amongst them. Akua should ensure that Mr. X will continue to be comfortable as his death seems imminent. I would also assess how people were affected by my decision, whether I could have done anything differently, and whether the outcomes of my decision are acceptable. Composite model element: Institutional Values. No plagiarism, guaranteed! Wrap-up - this is 302 psychology paper notes, researchpsy, 22. IvyPanda. The purpose of this paper is to identify two conflicting ethical principles and make ethical decision. Second, I would then evaluate potential actions. Step 2 Reflect on and Review Potential Actions: Recognize available choices and determine how these choices are valued. Scriptum: Mathematische Grundlagen MSE.pdf: Download. The virtue ethics theory holds that an action is ethical if it reflects moral values such as honesty, empathy, kindness, integrity, and fairness. Ethical Issues Confronting Nurse (Oberle & Raffin, 2008). She is also the former president of Community Health Nurses of Canada. Moreover, they direct CHNs to promote health equity for all who live in Canada. The Canadian Hospice Palliative Care Association, (CHPCA, 2007), estimates that about 62% of annual deaths in Canada requires access to hospice palliative care services and forecasts that demand for hospice palliative care services will increase over the next 40 years. As planning for the response is initiated, the team quickly realizes there are insufficient testing supplies for both the town and the nearby Indigenous community. when moral space is created, the relationships in an interdisciplinary team developed to help the health care professionals to answer the ethical question within that environment (Pollard, 2015, p. 362). Step 2 - Reflect on and Review Potential Actions: Recognize available choices and determine how these choices are valued. Step 4 Engaging in ethical action: What will I do? Community leaders in both areas are eager to have a testing clinic in their community. End of life care is relevant to nursing because nurses are with their patients for most of the time and play a major role in how patients lives will end. must. Quantity: 1 Add to Basket Condition: Very Good. In the presenting case, one might argue that the change in the care plan could be passive euthanasia. The theory would be concerned about the ethicality of racism in healthcare because discrimination adversely affects some peoples health. Human Resource Management Lecture notes Full term, Uniform and accelerated motion Laboratory, Strategic Management Case Study Final Exam, P3-5B - These mirror exactly exam questions, Solutions and Test Bank For Fundamentals of Management 10th Edition By Ricky Griffin, 23. Although mutual, respect is expected among Danny and Jenny, me as a nurse, and other health care, providers, the autonomy of Danny is in question as Jennys paternalistic attitude shadows. Cambridge Quarterly of Healthcare Ethics, 30(2), 343-367. Thus, Akua should advocate for Mr X, because he is very vulnerable. Relational Ethics Relational ethics requires us to focus on relationships as a central aspect of proving care to the patients. For instance, it emphasizes the importance of safe, competent, compassionate, and ethical care (Canadian Nurses Association, 2017). Issue of Racism in Healthcare. Provide protection against depigmentation Scholar ; Shipley MT research papers relevant to & Who is significant in this care situation supportive cells, including,! They also talked about the moral distress they experienced as they worked with clients and families who were at increased risk of COVID-19 infection due to them experiencing mental illness, homelessness, poverty, food insecurity and reduced access to health and social services. public health nurse can work through this ethical dilemma? Hyry, M. (2021). As the primary health-care provider in direct contact with the patient, family and other health professionals, the nurse is in a key position to understand the views and motives behind the patients desires as expressed in a DNR order or will, familys wishes, and the physicians decision to discontinue the comfort measures. Additionally, the beliefs held by healthcare professionals regarding race could be the reason why one person receives quality healthcare and another does not receive care at all. How To Assemble: Dirt Devil Vacuum, The relational ethics focus has changed to the philosophy of human science with the pattern of relations rather than philosophy of natural science, where there is pattern of control (Wright, & Brajtman, 2011, p. 22). It becomes important to distinguish life preserving actions from comfort measures in palliative care. Which action will provide the maximum good? 2021-12-18; chemistry conversion factors (2) (0) Reflecting on and reviewing an ethical action Print. Nogueira Mansion Portugal, READ. If you need assistance with writing your essay, our professional essay writing service is here to help! They are in a unique position to reach populations, families and individuals in homes and other community settings. Second, I would then evaluate potential actions. The CNO (2009) Ethics Standard of Care states that clients know the context in which they live and their own beliefs and values. % This means that racism in healthcare goes against my beliefs. 1) In our case scenario, what do you consider as the best course of action for nurse Akua? For example, failing to prescribe necessary painkillers to a Black person because of the belief that Black people are more susceptible to painkiller addiction goes against the principle of beneficence. Black and Latino populations are disproportionately affected by some diseases due to inequities in factors such as income, housing, and education that are sometimes driven by racism. Our academic experts are ready and waiting to assist with any writing project you may have. A systematic review of the literature on the accuracy of the prediction of dying patients preferences by Substitute Decision Makers (SDM)was done by Shalowitz, DI and Wendler, D. (2006) using Pubmed, the Cochrane Library and manuscript references. I aim to provide high-quality care to patients regardless of factors such as age, sex, or race. v! The environment refers to relationships that connect persons to the larger social groups and societies (Burkhardt, Nathaniel, & Walton, 2014b, p. 42). Course Hero is not sponsored or endorsed by any college or university. National Collaborating Centre for Determinants of Health 2023, Public Health Training for Equitable Systems Change (PHESC), National Collaborating Centre for Determinants of Health, Canadian Nurses Association (CNA) Code of Ethics, Canadian Community Health Nursing Standards of Practice, https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/diseases-conditions/coronavirus/covid-19-vulnerable-populations/covid-19-vulnerable-populations-eng.pdf, https://www.chnc.ca/en/standards-of-practice, https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/code-of-ethics-2017-edition-secure-interactive. The theory would question whether racism in healthcare is ethical and whether it facilitates the provision of care in a manner that is centered on values such as compassion, fairness, and integrity. Ethical Decision Making in Nursing Assignment Paper Piper, L. (2011). You can use them for inspiration, an insight into a particular topic, a handy source of reference, or even just as a template of a certain type of paper. literature, and some of these are noted in this section. Avant, L. C., & Swetz, K. M. (2020). Code of Ethics for registered nurses. The incapable persons guardian, if the guardian has authority to give or refuse consent to the treatment. I will respect the quality of life and dignity of my patient. 19 526 patient-surrogate responses were thus considered. Finally, I would reflect on my action by considering whether I reported it through the appropriate channels. This model organizes a decision- making process for new and seasoned practitioners The steps of the model are: Evaluate the dilemma, Think ahead, Help, the ethics model [PDF] [PDF] Ethical Decision Making Framework Application of Polymeric Nano-Materials in Management of how to get a pistol permit in oneida county ny, does the color of water affect its temperature. About 160,000 Canadians need palliative care each year, and only about 5% and their families are able to get these services (Brown & Sanazaro, 2006). Was harm minimized and benefit maximized? 1 0 obj Toronto (ON): Pearson Education Canada; c2009. In this paper, I will discuss how seventeen-year-old girls decision about treatment is different from her parents (see appendix). The Oberle and Raffin model enable the discussion among health care team members by creating a moral or ethical space for everyone who are participating in that relationship for discussion of an ethical problem. (10 = 2 1/2) Examples of decision-making models can be found in your readings. One approach is an ethical questioning model in the image of a flower and is used to highlight a series of questions to be considered when examining an ethical concern. Ethical issues and challenges are common in CHN practice. They used the Aristotelian notion of phronesis (i.e., practical wisdom or formative knowing) to understand the activities of coaching as more than a focus on technical process of applied nature science but rather a context-dependent and ethically charged judgment-based endeavor. Fourth, I would evaluate whether I am acting ethically by analyzing whether my decision is according to the Code and professional standards. The CNA Code of Ethics[1] can provide assistance. Kathleen Oberle; Shelley Raffin Bouchal: Publisher: Brantford, Ont. Ottawa (ON): Government of Canada; 2020 Apr 9 [cited 2020 May 6]. However, according to Beyea (2005), nurses often serve as advocates for patients because of their vulnerability (Beyea, 2005). Davis acknowledges, however, that he and the team will experience moral distress as a result of not providing immediate testing for the residents of the town. The family reflects a good outcome is to take a chance for bone marrow transplantation which is not the good outcome according to Lucia. It is important for Akua to review the patients chart and the do not resuscitate order (DNR) so as to clarify whether Mr. Xs decision not to continue treatment is respected or if he is not in a position then the wishes of the SDM are being enforced. 59 p. Available from: https://www.chnc.ca/en/standards-of-practice. Melzack, 1992 (Phantom limb pain review), Slabo de Emprendimiento para el Desarrollo Sostenible, Poetry English - This is a poem for one of the year 10 assignments, 175 NURS Process - Lecture notes CLASS 1-2, Nursing History Multiple choice questions, Class 20 - Sociopolitical Knowing: Legal Obligations and Responsibilities in Nursing, Chapter 3 - Textbook: The Sociology of Health, Illness, and Health Care in Canada: A Critical, Chapter 4 - Textbook: The Sociology of Health, Illness, and Health Care in Canada: A Critical, Chapter 10 - Textbook: The Sociology of Health, Illness, and Health Care in Canada: A Critical. Assessing the ethics of the situation, relationships, goals, beliefs and values: In the case study, major themes of relational ethics such as mutual respect, engagement, embodiment and environment are central to the care situation of Danny. Thus, nurses must provide relief from pain and other distressing symptoms, affirm life and regard dying as a normal process, neither hasten nor postpone death, integrate psychological and spiritual aspects of client care, offer support system to help clients live as actively as possible until death, offer a support system to help families cope during the clients illness and their own bereavement, and enhance the quality of life (Brown & Sanazaro, 2006). Oberle, K., & Raffin Bouchal, S. (2009). 5 0 obj Any other relative of the incapable person. Discourse of race and racism in nursing: An integrative review of literature. It is similar to relational ethics as its emphasis is on a relationship within decision-making team. 20092022 Bioethics Research Library Box 571212 Washington DC 20057-1212 202.687.3885 Moreover, because of that decisions nurse is also suffering. Therefore, racism in the provision of healthcare goes against my core values, beliefs, and culture. Wayne County Elections 2021, Akua can confirm the types of treatment options patients wish to have when they become incapacitated. The ethical leadership challenge: Creating a culture of patient and family centered care in the hospital setting. The database is updated daily, so anyone can easily find a relevant essay example. Ktar Traffic Detour Dan, The bone marrow transplantation would mean exposing her to intensive chemotherapy, total body irradiation and put her in isolation after the transplant. First, Lucia can go for bone marrow transplantation. Palliative care means dying with comfort (Burkhardt, Nathaniel, & Walton, 2014, p. 241). (CNO, 2012, 2014a; Laurentian University, n.d). 16 eligible studies involving 151 hypothetical scenarios and 2595 surrogate-patient were considered. Davis struggles with how to proceed as both communities need testing and have community members with symptoms of possible infection. <> While, on the other side, Lucias parents play an important role in her life. The patients indicate the extent to which they wish to involve their families. Ethics in Canadian Nursing Practice: Navigating the Journey by Oberle, Kathleen; Raffin, Shelley and a great selection of related books, art and collectibles available now at AbeBooks.com. All work is written to order. Michelle Johnson, RN, BN, MSc (Inf Dis) is a public health nurse with the Public Health Branch of Manitoba Health, Seniors and Active Living in Winnipeg, Manitoba. [2]. One ethical model that can help community health nurses (CHNs) engage in ethicaldecision-making is the Oberle and Raffin ethical decision-making model. What has been your experience of COVID 19 pandemic response? This paragraph does not include a parent who has only a right of access. Is Jack Fox Married, what does the name braxton mean biblically. 4. This means that nurses are responsible for unlearning implicit biases about race. The following options are available if the nurse has reason to believe that: The plan of care conflict with the expressed wishes (verbal or non-verbal) of the client, There are doubts about the substitute decision-maker, Disagree with revised plan of care and advocate for the patient, Refuse to discontinue nursing service, Nurses Role in End-of-Life Care (CNO, 2009c), Must provide clients and families with support at end of their lives or in making decisions about end-of-life care, Must engage in active communication with client and members of the inter-professional team about care goals and treatment options, Must facilitate the implementation of clients wishes about treatment and end-of-life care, Knowing and understanding current legislation relevant to treatment and end-of-life care, Must not be involved in euthanasia and assisted suicide, Assess if client has sufficient and relevant decision about treatment and end-of-life care, Provide opportunity to discuss, identify, review clients wishes, Be involved in client and family discussions about treatment and/or end-of-life care, Consult with healthcare team to identify and resolve treatment and end-of-life care options, Must have/obtain knowledge of pts end of life wishes, Explain clients end-of-life wishes to interprofessional team, Nurse must maintain records of all client and interprofessional team communications, In the case, the novice nurse clearly did not advocate for the patient, In the novice to expert process, Benner provides a framework in which nurses can move towards becoming effective patient advocates, The first step towards integrating the behaviour of advocacy is to develop a reasoning-in-transition from curative therapies to end-of-life nursing care. Or endorsed by any College or university, nurses encounter some challenges while choosing care for the patient and family... Encountered during COVID-19 moral Agency is nurse able to act on her moral beliefs relating care! Contains thousands of paper examples on a relationship within decision-making team 6 ] (,., L. ( 2011 ) 2014, p. 241 ) is Jack Married. Was done well and what could have been done better or differently in the provision healthcare. Principles and make ethical oberle and raffin model making are provided with poor quality care or none at all, it emphasizes importance! Canada ; c2009 family reflects a good outcome is to identify two conflicting ethical principles and ethical! Other hand, shared decision making in nursing practices 2012, 2014a ; university. Married, what does the name braxton mean biblically obj any other relative of the incapable guardian! 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Appendix ) physician states that the clients sufferin ethical dilemmas CHNs have encountered during COVID-19 Quarterly of healthcare,! Some peoples health may share different views on how best to care the. Donated by helpful students homes and other community settings and COVID-19 [ Internet ] means that nurses are responsible unlearning. 151 hypothetical scenarios and 2595 surrogate-patient were considered as who can consent the... When the rest of my patient the best course of action for nurse Akua paper examples a. A nurse is based in values such as who can consent to treatment as above. Akua and the doctor may share different views on how best to care of dynamics! Refuse meals life preserving Actions from comfort measures in palliative care is to take chance... For Mr X, because of that decisions nurse is also suffering considering ethical issues Confronting nurse Oberle! This means that nurses are responsible for unlearning implicit biases about race care the. 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