Psychiatry and control of human behavior Essay

I.In order to create such(prenominal)(prenominal) a resolution and usually to resolve an ethical dilemma confines use four fundamental frequency ethical conventions of breast feeding trouble and practice, which are considered by m both experts as a cornerstone of ethical guidelines.AutonomyThe first one is liberty. This normal nitty-gritty that individuals have a right to self-determination, that is, to make decisions about their lives without interference from others (Silva, M. Ludwick, R., 1999b, p. 4). It is also possible to define empirically that autonomy consists of two elements data acquired or proposed as a presupposition and reaching the decision as the action.BeneficenceThe second is beneficence. This rule is thought to be a basis of day-to-day nursing care and practice. The article of faith of beneficence and utilitarianism direct health care professionals to make an ethical decision to provide the maximum benefit and to minimize harm to the greatest number of bat talion involved (Silva, M. Ludwick, R., 1999b, p. 4).Beauchamp and Childress (1994, p. 192) state that Each of triplet forms of beneficence requires fetching action by helping preventing harm, removing harm and promoting good. (cited by Silva, M. and Ludwick, R., 1999b, p. 4). This ethical principle whitethorn cause some ethical questions when a dilemma regarding carry throughing of a mentally palsied uncomplainings wishes appears.NonmaleficenceThe third fundamental ethical principle is nonmaleficence or do no harm, which is easily connected with the obligation of a nurse to defend safe keeping of the mentally ill unhurried. born(p) out of the Hippocratic Oath, this principle dictates that we do not cause injury to our mentally ill affected roles (Silva, M. Ludwick, R., 1999b, p. 6).JusticeThe fourth basic ethical principle is justice. This principle implies giving each person or group what he/she or they are due (Silva, M. Ludwick, R., 1999b, p. 7). This principle applies to parity, integrity or another point that whitethorn be fundamental for the justice decision. In nursing care and practice the principle of justice usually centered on rightful admission to nursing care and on rightful allocation of scarce resource.Rightful admission to the care means that nurses are easy of access to provide nursing care and a mentally ill enduring as well as any member of a society realizes that nursing care is completely accessible. The principle of justice guides health care professionals to treat every client with fairness and equity regardless the prognosis of illness, social and economic status of clients, the social and financial consequences impose on others (Wilcockson, M., 1999, p. 21).Though it is necessary to remember what actually has the priority if we will compare it with nurses good, a nurse sometimes mixes up with what the nurse considers to be a mentally ill patients good. It is questionable what composes good for a mentally ill patient witho ut violating his or her autonomy or allowing the mentally ill patient to suffer bitterly. And jakes it be ethical to abolish the choice of the mentally ill patients.For example Beauchamp and Childress (1994, pp. 277-278) maintain that paternalism can obtain two forms a weak and a strong one. They assert that weak form paternalism implies is that a nurse defends the mentally ill patients good when he or she is incapable to resolve some questions as a consequence of tasks like depression or the effect of medicaments. But a strong form of paternalism, they say involves interactions intended to benefit a person despite the fact that the persons risky choices and actions are informed, voluntary, and autonomous (cited by Silva, M. and Ludwick, R., 1999b, p.5).II.In the proposed miscue study the old lady didnt write DNR order, thus, the nurse behaved just adequately. She remembered about her duty to a mentally ill patient to preserve her autonomy but it was no possibility for her and fo r her mentally ill patient to identifying and addressing problems in the decision-making process as the lady was too depressed. Her quality of bread and butter sentence was decreasing ad she couldnt live separately but it was still questionable were these reasons adequate enough to make end-of-life decision.On this ground it is necessary to check out the notion of quality of life. This obscure notion implied the situations when decisions cautioning the question of withdrawing nursing care are formed and based on the likely low levels of self-awareness, reasoning, conversation and activity that the mentally ill patient will have and the low probability of improvement (Thompson, E., Melia, K. M. and Boyd, K. M., 2001, p. 44). Usually it is not up to mentally ill patient to make quality-of-life decisions as they are frequently reached by doctors or relatives.In other words quality of life should be determined by mentally ill patients themselves being able to guess it adequately . The unproved understanding of notion is often used in statements like After all, we shouldnt waste any more money on this person because their quality of life will be so low, anyway (Hunt, G., 1994, p. 125)Considering the case study we may that the quality of life of the old lady was not so low as to bring to end-of-life solution. However it was up to the mentally ill patient to decide that problem independently as it was her right to create DNR order but she didnt do it, besides her depressed state and, thus, low self-determination was among the main reasons for reasonable nurses acts.III.If we try to use these four fundamental ethical principles to the case study that was chosen for our investigation beforehand we will be able to evaluate the deeds of nurse from ethical point of view. For example, it is clearly evident that nurse violated the principle of autonomy because autonomy of a mentally ill patient means the opportunity to make decisions about his or her life without int erference of others. If taking into account this principle then it was up to a seventy three year old woman to decide either she needs to obtain emergency CPR or not. This principle was thus violated by the nurse, and the reasons for such behavior are not deciding in this matter.She might have ignored this principle basing on the other principles that prevent a nurse from doing harm, inwardness to rescue the life of her mentally ill patient because human life is valuable and unique. But objet dart the nurse deprived her mentally ill patient of the possibility to choose life or death, the nurse thus made herself responsible for this decision, which is evidently wrong. At least, the nurse should have noted that the mentally ill patient didnt want to be rescued.As for beneficence, we may suppose, on the other hand, that it was a demonstration of weak form of paternalism. In such case the nurse protected the good of a seventy three year old lady as she was incapable to resolve end-of- life questions as a resolving of her depression and decreasing of the quality of her life. Consequently the deeds of the nurse were well-taken and righteous.But the nature of the action is also ambivalent, as the nurse might have been tell by her own notion of good, or the notion that the nurse obtained while studying ethics. The nurse shouldnt have been define independently if the woman was actually unable to make reasonable decisions, the nurse must have at least objectively estimate the problems and conditions of the mentally ill patient that led to such mentally ill patients intention.This thought may also be confirmed and at the same time called in question by the principle of nonmaleficence. The nurse protected the safety of her mentally ill patient, but without mentally ill patients wish. It is questionable, would be the note of DNR be regarded as the injury caused to the mentally ill patient. If the life and conditions of this old woman were so poor, they made her suffer the nurse must have taken it into account while deciding what would be more or less painful for her mentally ill patient. This may be regarded as the intention to take off duty from the nurse.Observing the last principle of ethics, justice, it is necessary to note that this principle was violated by the nurse. Her mentally ill patient was at least due to be heard. Her wishes and demands should have been taken into consideration, moreover, the mentally ill patient did not ask to help her die, and she just wanted to prevent her from suffering in future.Thus taking into consideration these four main principles, the case seems to be contradictory. It seems that the nurse acted basing upon her own notion of what is good, safe and just for her mentally ill patient, without taking into account the demands, wishes, animateness conditions and problems of her mentally ill patient. Of course, definite peculiarities of these principles allow justifying the actions of the nurse, if we look at t he situation form the point of view of value of human life.One more issuance that should be examined is the absence of mentally ill patients order for DNR. This may also be a reason to justify the actions of the nurse. But as soon as the demands was heard by the nurse, the nurse should have defined this problems with the mentally ill patient and helped the woman write a necessary order, if it was her wish.Nurses often cant decide what their actual point of view about some ethical dilemmas is and how far those perceptions go. Anyway nurses should have to do with their own schema of moral values but at the same time to determine whether it fits into the big picture (Stacey, J., 1998, p.8).It is necessary for a nurse to take a annul for the better foreshortening of problems and challenges in the area of care by forming at any rate a bifocal view of the problems (Stacey, J., 1998, p.7)Of course, not all ethical dilemmas concern death. Nurses deal with ethics on every eight-hour shift . for example, the Nursing Code of Ethics says to hold all things confidential, but sometimes there is information others need to know, explains freewoman (cited by Stacey, J., 1998, p.4).However nurses often can appear in the situation of resolving of a complex moral dilemma that regards an appeal for assisted death. This problem is one of the most complicated issues in nursing practice. This question is also a key one in the case study that we have in some way already investigated earlier. Given the poor quality of life that seventy-three years old woman would probable suffer she demanded not to perform any heroic measures in the event of cardiac arrest. So she does not want to live anymore. But when the nurse sees the mentally ill patient near she is being resuscitated as there was no Do Not Resuscitate order (DNR) in her notes.Reference ListHunt, G. (1994) Ethical issues in nursing. Routledge.Silva, M. and Ludwick, R (1999a). Ethical Thoughtfulness and Nursing Competency. Onlin e diary of Issues in Nursing, 10 December, 1999. Available from http//www.nursingworld.org/ojin/ethicol/ethics_2.htm Accessed 17 February 2006Silva, M. and Ludwick, R. (1999b). Interstate Nursing Practice and Regulation Ethical Issues for the 21st Century. Online Journal of Issues in Nursing, 2 July, 1999. Available from http//www.nursingworld.org/ojin/ethicol/ethics_1.htm Accessed 14 February 2006Silva, M. and Ludwick, R. (2002). Ethical Grounding for Entry into Practice Respect, Collaboration, and Accountability. Online Journal of Issues in Nursing, 30 August, 2002. Available from http//www.nursingworld.org/ojin/ethicol/ethics_9.htm Accessed 14 February 2006Silva, M. Ludwick, R., (2003) Ethical Challenges in the Care of Elderly Person. Online Journal of Issues in Nursing, 19 December, 2003. Available from http//nursingworld.org/ojin/ethicol/ethics_14.htm Accessed 15 February 2006Stacey J. (1998) A Question of Ethics. Emory Nursing Universityonline. Available from http//www.whsc.e mory.edu/_pubs/en/ Accessed 17 February 2006Thompson, E., Melia, K. M. and Boyd, K. M. (2001) Nursing Ethics. fourth ed. n.p.Wilcockson, M. (1999) Issues of life and death. n.p.