week 3 resp 2
Original instructions:
- brieflyriefly describe moral distress and moral residue. In your particular health care setting how do individuals experience moral distress and moral residue? Have you? Discuss at least three examples. Include how these relate to autonomy and justice.
- Have you noticed healthcare professionals ignoring these concepts at work or failing to report their concerns to the appropriate person? What strategies combat moral distress and residue for health providers?
- Health information management present new ethics challenges for healthcare professionals. For example, computers allow people to be anonymous and forget about ethics. Using the information in Chapter 7, choose an example where one can forget ethics when using a computer. Then, explain how your example violates autonomy, beneficence, nonmaleficence, and justice.
- IBM Watson is touted as being the best thing for medicine in the future. However, it also causes concern and even fear for some individuals. Discuss at least two ethical concerns that physicians have about IBM Watson. Discuss two patient ethics concerns about this technology.
Peer posting to respond to:
Moral Distress and Moral Residue
Moral distress arises when healthcare professionals know the right action to take but are prevented from doing so due to institutional constraints, leading to feelings of frustration and powerlessness. Moral residue refers to the lingering feelings of guilt and inadequacy that remain after the initial distressing situation has passed, often accumulating over time and potentially leading to burnout.
Experiences in My Healthcare Setting
Where I work, moral distress and moral residue manifest in several ways, including:
- Staffing Issues: Nurses often experience moral distress when they cannot provide the level of care they believe is necessary due to being understaffed. For instance, if a nurse is assigned too many patients, they might not be able to spend adequate time with each one, resulting in suboptimal care and moral residue as they feel guilty about not meeting their professional standards. This relates to the principle of justice, as it involves fair distribution of nursing resources and autonomy, as nurses cannot exercise their professional judgment fully.
- End-of-Life Care: Moral distress can occur when there is a conflict between a patient’s or family’s wishes and the medical team’s recommendations. For example, continuing aggressive treatment for a terminally ill patient despite it being against the medical advice can cause distress. This situation often leaves healthcare providers feeling morally compromised, impacting their sense of professional integrity and leaving a moral residue. This directly relates to autonomy, respecting the patient’s or family’s decisions, justice, and ensuring fair treatment based on medical needs.
- Inadequate Breaks: Nurses at our facility sometimes face moral distress when they cannot take their legally mandated breaks due to high patient acuity or staffing shortages. This affects their ability to provide safe and effective care, leading to moral residue as they struggle with professional inadequacy and personal exhaustion. This issue ties into justice, as it involves equitable working conditions and autonomy, as it restricts nurses’ ability to care for themselves adequately.
Ignoring Moral Distress and Residue
I have noticed that some healthcare professionals ignore or fail to report these concerns due to fear of retaliation or believing nothing will change. For example, during periods of high workload, some nurses may not voice their concerns about inadequate staffing or breaks, leading to increased moral distress and residue over time.
Strategies to Combat Moral Distress and Residue
- Ethics Rounds: Regular ethics rounds can provide a forum for healthcare professionals to discuss morally distressing situations, share experiences, and seek guidance from ethics committees.
- Support Groups: Establishing support groups where nurses can discuss their experiences and feelings in a safe environment can help mitigate the effects of moral residue.
- Policy Advocacy: Encouraging healthcare professionals to participate in policy advocacy efforts can empower them to influence changes that address the root causes of moral distress, such as inadequate staffing.
Ethical Challenges in Health Information Management
Example of Ethical Lapse Using Computers
A potential ethical lapse in health information management is the unauthorized access and sharing of patient information. For instance, a healthcare professional might look up a patient’s medical history out of personal curiosity and share it with others without consent. This violates several ethical principles:
- Autonomy: The patient’s right to control their personal information is breached.
- Beneficence: The action does not benefit the patient and can cause harm.
- Nonmaleficence: Unauthorized information sharing can lead to emotional or reputational harm to the patient.
- Justice: It is unfair to the patient, who trusted the healthcare system to protect their private information.
Ethical Concerns About IBM Watson
Physician Concerns
- Data Privacy: Physicians are concerned about the security and privacy of patient data used by IBM Watson. The risk of data breaches or misuse of sensitive information can undermine patient trust and violate ethical principles.
- Clinical Judgment: There is apprehension that reliance on IBM Watson might erode physicians’ clinical judgment and autonomy, as they might feel pressured to follow the machine’s recommendations without critical evaluation.
Patient Concerns
- Informed Consent: Patients may be concerned about how their data is used and whether they have given proper informed consent. They need to understand how IBM Watson operates and its implications for their treatment.
- Bias and Equity: Patients might worry about potential biases in the algorithms used by IBM Watson, which could lead to inequitable treatment outcomes. Ensuring fairness and justice in AI-driven decisions is crucial to maintaining trust in the healthcare system.
References
American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements. Silver Spring, MD: American Nurses Association.
Chinn, P. L., & Kramer, M. K. (2013). Integrated theory & knowledge development in nursingLinks to an external site. (8th ed.). Mosby.
Epstein, E. G., & Delgado, S. (2010). Understanding and addressing moral distress. Online Journal of Issues in Nursing, 15(3).
Morrison, E. E., & Furlong, B. (2019). Health care ethics: Critical issues for the 21st century (4th ed.). Jones & Bartlett Learning.
Pozgar, G. D. (2020). Legal and Ethical Issues for Health Professionals (5th ed.). Burlington, MA: Jones & Bartlett Learning.
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