NHS FPX 4000 Assessment 1 Applying Ethical Principles Analysis of the case

NHS FPX 4000 Assessment 1 Applying Ethical Principles

Analysis of the case

It is important to identify the relationship between an ethical dilemma and ethical principle. The first aspect is the patient’s autonomy (Jie, 2015). Even though the decision to end life is the patient’s autonomy, but it is taken after knowing that he will live for four to six weeks. He is not cognitively sound and facing emotional distress. This clouds judgment. Thus, the nurse should first establish communication to remove suicidal thoughts as it is her duty to suggest the best possible option to the patient. Snyder Sulmasy & Mueller (2017) argued that even when the patient has complete autonomy, but it is the responsibility of the nurse to implement clinical judgment by limiting cognitive biases. Goligher et al. (2017) supported physician-assisted suicide when a patient is in a vegetative state, but not when a patient can function properly and can live his remaining life. Jie (2015) recommended the nurse take a life-prolonging decision and persuade the patient to communicate with other professionals before making the decision as the ethical clash between beneficence, non-maleficence, and the principle of autonomy should result to benefit the patient.  

The core responsibility of the nurse is to protect the life of Mr. Green as it leads to the beneficence aspect of moral decision-making. The nurse should take positive actions even if at the time it is against the patient’s autonomy. Large et al. (2017) in their study concluded that nurses should identify the patients at risk to commit suicide to prevent it. Discussions with nursing staff and other health care staff help in assessing the situation based on individual and organizational values, policies, morals, and laws (Campo-Engelstein et al., 2015). Further, Awenat et al. (2017) reported that nurses go through psychological issues after assisting suicide, withholding suicide information, or witnessing their patients commit suicide. This indicates negative induced effects on nurses. 

Another aspect is non-maleficence. This ethical principle deals with an obligation to not to harm the patients knowingly or unknowingly. The nurse should take a decision that should harm the patient. For example, suicide attempts might not be successful and it might lead to other complications. The study by Shand et al. (2017) showed that the suicide survivors felt that the decision was instinctive and any outside help would have prevented them from committing the act. Barnfield et al. (2018) also highlighted the need to prevent suicide attempts to reduce potential self-harm. Therefore, violating the patient’s autonomy and informing others to take the right decision is the right choice in this case. However, it is important to explain the benefits and harms of different actions to Mr. Green so that understanding his perspective aid in mitigating the issue (Large et al., 2017). Ignoring the values of beneficence and non-maleficence over autonomy is cannot be justified in this case as even under euthanasia, patients do not have a right to end their life when they want and however they want (Jie, 2015). As a result, the nurse should inform others and persuade the patient not to commit suicide through communication, advocacy, and different therapies. 

Effectiveness of communication approaches

Eliciting and then responding to the suicidal thoughts can help the patient to understand the impact of a recent adverse event on the patient. This can be achieved by establishing paraprofessional or professional-patient interaction to gain trust and understand patient’s perspectives. Further, highlighting the possible adverse outcome of suicide and possibilities of prolonged life by giving examples of previous patients aid in relaxing the suicidal thoughts (McCabe et al., 2016). Instead of group discussion, it is better to establish one-to-one communication first and then discuss the issue with others including family. It is also recommended to interact within the institutional setting or within the community to make the patient feel trusted (Shand et al., 2017). Instead of concentrating on conditions, it is better to focus on suicidal ideations. It is better not to highlight the possibility of health care complexities. Also, it is better to avoid discussing negative family or personal issues (McCabe et al., 2016). 

Ramberg et al. (2016) in their case study highlighted that nurses used education as a means to educate the patients to understand the complications of their actions. The process included establishing a nurse-patient relationship to gain trust and provide emotional support. It is advised to have a positive attitude and implement a persuasive communication strategy. Further, incorporating psychiatric nurses with sufficient training aid in p