wk3 resp1

Original discussion instructions:

• riefly 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 post:

rinciples of Healthcare Ethics for Organizations

Moral Distress and Moral Residue

Moral distress occurs when healthcare professionals know the ethically appropriate action to take but are constrained from taking it, leading to feelings of frustration and helplessness. Moral residue refers to the lingering feelings and emotional impact that remain after the initial moral distress has passed, often accumulating over time (Morrison & Furlong, 2019).

In my healthcare setting, as a home health nurse, individuals experience moral distress and moral residue in several ways. Here are three examples:

Inadequate Resources: Nurses often face situations where they cannot provide the level of care they know is necessary due to limited resources. For instance, a nurse might be aware that a patient requires more frequent visits or specific medical supplies that are not available due to budget constraints. This situation relates to the principles of autonomy and justice, as patients are not receiving the care they deserve, compromising their right to self-determination and equal treatment.

Confidentiality vs. Patient Safety: There are times when maintaining patient confidentiality conflicts with ensuring patient safety. For example, a nurse might know that disclosing certain patient information to a family member could prevent harm, but doing so would violate the patient’s privacy rights. This dilemma can leave a lasting emotional impact on the nurse, relating to autonomy (respecting the patient’s right to privacy) and nonmaleficence (the duty to do no harm).

End-of-Life Decisions: Nurses may experience moral distress when they are required to follow family wishes that conflict with the patient’s previously stated end-of-life preferences. This can create a situation where the nurse feels they are not honoring the patient’s autonomy and may feel morally distressed by participating in the care they believe is not in the patient’s best interest.

Ignoring Moral Distress and Moral Residue

In my experience, I have noticed healthcare professionals sometimes ignore these concepts or fail to report their concerns. This often happens due to fear of retaliation, feeling powerless, or believing that reporting will not lead to change. To combat moral distress and residue, healthcare providers can adopt several strategies:

Ethics Committees: Establishing or utilizing existing ethics committees can provide a platform for discussing ethical dilemmas and finding support.

Open Communication: Encouraging open communication within teams can help address concerns before they escalate.

Education and Training: Regular training on ethical decision-making and stress management can empower healthcare professionals to handle moral distress effectively.

Health Information Management and Ethical Challenges

Health information management presents new ethical challenges, especially with the use of computers and electronic health records (EHRs). For example, a healthcare professional might inadvertently or deliberately access a patient’s EHR without a legitimate need to know, violating the patient’s privacy. This act violates:

Autonomy: Breaches the patient’s right to control their personal health information.

Beneficence: Fails to act in the best interest of the patient.

Nonmaleficence: Potentially causes harm by exposing sensitive information.

Justice: Undermines fairness and equality by treating patient information carelessly.

Ethical Concerns with IBM Watson

IBM Watson is promoted as a revolutionary tool for medicine, but it raises ethical concerns among physicians and patients.

Two concerns from physicians

Reliability and Accountability: Physicians worry about the accuracy of Watson’s recommendations and who is accountable if the AI provides incorrect or harmful advice.

Job Displacement: There is a fear that AI could replace human judgment and expertise, potentially leading to job losses for medical professionals.

Two patient ethics concerns

Privacy: Patients might be concerned about how their data is used and whether it remains confidential.

Autonomy: There is a concern that AI could undermine the patient-physician relationship, potentially reducing patients’ involvement in their own care decisions.

References

Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press.

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

Papastavrou, E., Efstathiou, G., & Andreou, C. (2016). Coping with moral distress in healthcare practice: Some implications for professional practice. Journal of Clinical Nursing, 25(17-18), 2558-2568. https://doi.org/10.1111/jocn.13299

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