NRNP 6665 Discussion 2-Patient Autonomy-Nursing Paper Examples

Autonomy (Patient Autonomy-Nursing Paper Examples)

Autonomy is an ethical principle that guides nursing practice and patient-centered care. Consequently, autonomy is a fundamental part of human existence, dictating freedom of decision-making. Individuals with sound minds and judgment should exist in moral autonomy, making moral decisions about themselves and also promoting other people’s decisions (Ubel et al., 2019). Patients have an individual capacity to govern themselves and self-express. Therefore, a patient with the ability to defend themselves and make judgments has a right to decide for themselves (Patient Autonomy-Nursing Paper Examples).

Autonomy is both an ethical and legal aspect of nursing practice, becoming one of the dominant principles influencing patient rights. For instance, patients can refuse treatment despite healthcare providers considering it as an act of beneficence. Any coercion by a family member or a provider towards the patient’s decision-making threatens patient autonomy. Therefore, the best healthcare or clinical decision for any patient is considerate of the patient’s values, preferences, attitude, and belief system (Patient Autonomy-Nursing Paper Examples).

Article Review

Ethicists promote patient autonomy as an individual’s right to make decisions without undue influence from other people, including family members or providers. Patient autonomy has ethical and legal consequences that providers should be aware of. It applies differently for adults and children/adolescents, based on the ability to consent and make a sound judgment. According to Ubel et al. (2019), physicians and patients ought to communicate and engage in shared decision-making that remain a requirement to promote patient autonomy. The article perceives the provider’s role in shared decision-making as educational (Patient Autonomy-Nursing Paper Examples).

Physicians should educate the patient about various alternatives, communicating positives and negatives to help the patient make a sound decision. The clinician also helps the patient align their goals with the identified risks and benefits and make decisions that help promote their goals and their autonomous right to make decisions. Shared decision-making also allows the patient to be partly responsible for the final decision, per their preferences, and the clinician to also be responsible for the final decision. Generally, shared decision-making promotes an individual’s relational autonomy and ability to make rational decisions (Patient Autonomy-Nursing Paper Examples). 

Arrieta Valero (2019) explores patient autonomy in line with non-adherence to treatment and the legal and juridical frameworks on which patient autonomy remain founded. Consequently, the article links some aspects of self-governance to the problem of poor treatment adherence in adults with chronic illnesses. Furthermore, according to the article, the current perspective of autonomy is highly influenced by legal and juridical provisions aiming to protect citizens’ right to autonomy under normal circumstances to run their daily operations.

The author argues that the dimensions of autonomy were not developed for disabled or sick people, but instead for healthy individuals. Besides, these legal and juridical constructs have become the standard model of practice in healthcare, leading to many autonomy problems like reduced adherence to treatment (Patient Autonomy-Nursing Paper Examples).

Garanito and Zaher-Rutherford (2019) discuss clinical decision-making among adolescent patients. The article promotes the need to involve adolescents in decision-making about their health. Per the international guidelines, adolescents should be involved in discussions regarding their health, illness, treatment, and consequent decisions. However, the clinician has to assess the decision-making ability of the adolescent and involve a consenting adult in the decision-making process (Patient Autonomy-Nursing Paper Examples).

Conclusively, adolescents ought to be involved in a serious, deliberate, honest, and respectful deliberation process. Parsapoor et al. (2020) also discuss autonomy in children and adolescents and assess the ethical, jurisprudential, and legal considerations. The article posits that children and adolescents can take part in clinical decision-making to some level. Providers should develop the parent-doctor-child/adolescent triangle, but sometimes physicians face ethical and legal dilemmas when these parts are not essentially in agreement, limiting their professional duties.

A nurse’s understanding of patient autonomy and the ethical and legal considerations in care provision for adults and children/adolescents is critical to patient-centered care. Nurses should promote patient autonomy by engaging in shared decision-making, where they assume the educational role, informing patients about the risks and benefits of alternatives, guiding patients to develop their goals, and helping them promote the goals in line with the risks and benefits.

The information provided also indicates that nurses should not only obtain consent from parents when working with children and adolescents but also involve children and adolescents in honest and respectful discussions regarding their health. The patient and the provider should bear responsibility for the final decision (Patient Autonomy-Nursing Paper Examples).  

References

Arrieta Valero I. (2019). Autonomies in Interaction: Dimensions of Patient Autonomy and Non-adherence to Treatment. Frontiers in Psychology, 10, 1857. https://doi.org/10.3389/fpsyg.2019.01857

Garanito, M. P., & Zaher-Rutherford, V. L. (2019). Adolescent patients and the clinical decision about their health. Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo, 37(4), 503–509. https://doi.org/10.1590/1984-0462/;2019;37;4;00011

Parsapoor, A., Parsapoor, M. B., Rezaei, N., & Asghari, F. (2020). Autonomy of children and adolescents in consent to treatment: ethical, jurisprudential and legal considerations. Iranian journal of pediatrics, 24(3), 241–248.

Ubel, P. A., Scherr, K. A., & Fagerlin, A. (2019). Autonomy: What’s Shared Decision-Making Have to Do With It?. The American journal of bioethics : AJOB, 18(2), W11–W12. https://doi.org/10.1080/15265161.2019.1409844