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Original directions:In a second paragraph based on this week’s reading what theory of healthcare ethics applies to your personal values and how will you use this theory in advanced practice? Provide an example.

In a third paragraph briefly discuss the four principles of health care ethics and which one of these most closely aligns with your personal values as a health provider

peer to respond to:

Introduction

Hello classmates! My name is Sarah Barney. I live in the Salt Lake City area, where I work as a nurse practitioner for an employer-sponsored health plan. I am also the medical director for an affiliated employee wellness and immunization clinic. I have been involved in nursing since I became an RN at age 20. I worked in trauma, respiratory, and neurocritical care for much of my career, and those years provided many ethical dilemmas as we grappled with issues of how much care to provide, who should make care decisions, and when life support measures should be discontinued. My future career plans are unclear. I expect to retire from full-time employment within the next ten years, but I would like to continue some involvement in healthcare part-time or as a volunteer. My husband and I have four adult children and two grandchildren. I look forward to some flexibility to spend more time with them.

Theories of Healthcare Ethics

                Some theories of healthcare ethics described by Morrison and Furlong (2019) intuitively feel comfortable, and others instinctively uncomfortable. My values don’t align with ideas of consequentialism or the greatest good for the greatest number because marginalized and disadvantaged people seem likely to be harmed. Egoism, or the focus on oneself, does not align with my belief in the caring nature of nursing. Although I can see benefits with some aspects of natural law and deontology, the theory of virtue ethics aligns most closely with my values. I have experienced the effects of professional socialization as I have developed as an advanced practice nurse over many years and have, hopefully, developed some practical wisdom (Morrison & Furlong, 2019). Chinn and Kramer (2013) present this idea as character development, an essential factor in ethical decision-making. I find that wisdom is required in my current role to navigate the tension between appropriate care, how it should be provided, and the proper role of the health plan. I sometimes find myself straddling the provider role with my responsibilities in developing and administering health plan benefits to our patient population.

Principles of Healthcare Ethics

                Healthcare ethics is embodied in four underlying principles: 1) nonmaleficence, or the intent to avoid harm; 2) beneficence, or the intent to do good only; 3) autonomy, the focus on a patient’s prerogative to make decisions about their care; and 4) justice, the right to be treated fairly (Morrison & Furlong, 2019). To me, the idea of justice is appealing. Still, it encompasses so many subtypes of justice and varying types of rights that it is difficult for me to find clear guidance from the complexity of this principle. The intent of nonmaleficence and beneficence is generally noble, but applying these principles seems subjective and can potentially be paternalistic (Morrison & Furlong, 2019). Considering these complexities, I feel that the principle of autonomy most closely aligns with my values. This seems to partner well with virtue ethics by acknowledging a patient’s “self” and their opportunity to achieve their highest good.

References

Chinn, P. L., & Kramer, M. K. (2013). Integrated theory & knowledge development in nursing (8th ed.). Mosby.

Morrison, E. E., & Furlong, B. (2019). Health care ethics: Critical issues for the 21st century (4th ed.). Jones & Bartlett Learning.

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