CHALLENGES OF NON MALIFICENCE AND BENEFICENCE

Running Head: CHALLENGES OF NONMALIFICENCE AND BENEFICENCE 1

CHALLENGES OF NONMALIFICENCE AND BENEFICENCE 2

Challenges of Nonmaleficence and Beneficence

The patient is a sixty-three years old lady who has been suffering from high levels of glucose in her blood for a very long time. The patient is lying in bed with the agony of chronic diabetic ketoacidosis, which is a critical issue of type one diabetes, and it’s not as common as type two diabetes. The disease is irreversible, and it occurs when an individual’s blood sugar is extremely above normal and acid chemicals called ketones to increase to harmful levels in your body. The disease has caused too much suffering to the patient that she has suggested that she preferred not to continue taking her medication. (Jahn, 2011) defines nonmaleficence as the principle which guides the nurse in their practices to ensure that each activity and decision made concerning the care provided to the patient cause no harm or at least not without the nurse’s intention. On the other hand, the principle of beneficence sets out moral obligation such as kindness, generosity, mercy, and charity, which all together encourage nurses during their practices to do good. With this, I mind the situation with my client, as described above, left me into an ethical dilemma concerning the principle of nonmaleficence and beneficence. For instance, the specific aim of the treatment that is insulin therapy, electrolyte, as well as fluid replacement, is to ensure that the client does not develop complications such as ketoacidosis, electrolyte imbalance, and dehydration respectively. As her caregiver and a professional nurse, I understand that stopping her medication, especially insulin therapy could lead to the development of ketoacidosis that could lead to health disorders or even death. Unfortunately, the clients preferred not to take the medication, and this is a choice that, according to my perspective, could cause harm to the patient.

At this point, I did not understand why the patient made such choices, and the only perspective was maybe the patient did not realize her decision could lead to severe conditions. I also realized that despite that, the patient had been well informed about the purpose and the side effect associated with the medical treatment; it was not indicated that withholding this particular treatment may contribute to the severity of the condition. I felt that omitting this information may have been a contributing factor to the patient’s decision. Additionally, I had to take a step further and evaluate whether other ethical concerns such as cultural, religious, and personal interest may have influenced the patient’s decision (Toh et al. 2018). After a close interaction with the patient, I realized that as a Muslim, she believes that her illness was a punishment from God. The patient also outlined that she felt without religious support, such as prayers from her family and friends, she would not recover regardless of the type of medication administered to her. With this perspective, therefore, I identified that her faith might have been one of the contributing factors to her withdrawal from medical treatment.

It is also worth identifying that during the various treatment such as insulin therapy, the probability of successful results can be influenced by the amount of dosage in which a higher dosage of insulin can increase the risk of low blood pressure. There is also a possibility of failure to reduce blood sugar level to normal as intended for some patients, and in such a case, the next move includes adjusting the infusion rate of insulin to a doubled dose. Despite that convectional infusion of the treatment may be insufficient for the patient condition to adjust to normoglycaemia, most patients usually recover after a higher infusion rate. This implies that there is a higher possibility of having a successful result from this treatment.

Considering that this treatment can help the patient to recover and cause no harm when adequate precaution is observed, this client can receive psychological treatment to help her deal with her emotional issues concerning her religious belief. To ensure that harm is avoided as a result of the poor decision, the patient should also be advised more about her condition and the importance of her medication. By considering the fact that as a nurse I must comply to both nonmaleficence and beneficence principle, I have learned it is crucial to include the patient preference in the decision making process for the care provided as well as when selecting the choice of treatment.

Reference

Jahn, W. T. (2011). The 4 basic ethical principles that apply to forensic activities are respect for autonomy, beneficence, nonmaleficence, and justice. Journal of chiropractic medicine, 10(3), 225.

Toh, H. J., Low, J. A., Lim, Z. Y., Lim, Y., Siddiqui, S., & Tan, L. (2018). Jonsen’s Four Topics Approach as a Framework for Clinical Ethics Consultation. Asian Bioethics Review, 10(1), 37-51.