Ethics Question

1. 0 Hi there,
   
   I am doing a paper about a ethical dilemma where the patient who requires a 2 person is refusing to have a bath.
   
   A plan to resolve the dilemma is to explain to the patient the consequences of not having a bath and making sure they are informed and then letting them make the decision. Client choice over client well being.
   
   How does that sound?
   
   Thanks in advance!

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2. 10 Comments

   Comment
3. 
   #1 1

   Oct 12, '12 by gwapo

   Quote from studentnurse1992

   Hi there,
   
   I am doing a paper about a ethical dilemma where the patient who requires a 2 person is refusing to have a bath.
   
   A plan to resolve the dilemma is to explain to the patient the consequences of not having a bath and making sure they are informed and then letting them make the decision. Client choice over client well being.
   
   How does that sound?
   
   Thanks in advance!

   there is indeed some dilemma, but i don't think it is ethical. You are not resolving your dilemma by informing them of consequences.
4. 
   #2 0

   Oct 12, '12 by studentnurse1992

   Any suggestions on how to resolve it?
   
   We were given this scenario and were to explain what makes it a ethical dilemma.
5. 
   #3 0

   Oct 12, '12 by gwapo

   Quote from studentnurse1992

   Any suggestions on how to resolve it?
   
   We were given this scenario and were to explain what makes it a ethical dilemma.

   Realistically, when a patient says no, there is nothing much you can do unless that intervention will risk his life. Even then, you still cant enforce anything without his consent. You cannot force him to have a bath as that may come out as assault. Hope somebody can help you and see an ethical dilemma from that situation. Good luck.
6. 
   #4 0

   Oct 12, '12 by Okami_RN, ADN, RN

   You could explain to the patient that proper hygiene will prevent degradation of skin integrity by removing dirt, debris, and bodily fluids that would otherwise cause skin breakdown. Explain the importance of a proper skin assessment to flag any possibly reddened areas that within 2 hours of lying still would begin the skin breakdown process. Afterwards I guess you could once again ask them if they would like a bath at this time. If they refuse once more then there isnt much you can do; as another poster said it could be taken as assault if a bath is done without a patient consenting.
7. 
   #5 1

   Oct 12, '12 by twinkerrs

   The ethical issue is whether to try to "force" the patient to bathe or just take their no as a no. You need to assess whether it is a cultural issue or something along those lines. Their normal bathing habits etc
8. 
   #6 0

   Oct 12, '12 by studentnurse1992

   Thanks for the help. Respecting their choice is really the only way to go in this situation but I have to also look at the other side of it in regards to the paper.
9. 
   #7 0

   Oct 12, '12 by studentnurse1992

   Thanks! That helps me a lot.
10. 
    #8 0

    Oct 12, '12 by studentnurse1992

    Great point. Thank you
11. 
    #9 0

    Oct 12, '12 by gwapo

    Quote from twinkerrs

    The ethical issue is whether to try to "force" the patient to bathe or just take their no as a no. You need to assess whether it is a cultural issue or something along those lines. Their normal bathing habits etc

    Great! I helps not to think too much
12. 
    #10 0

    Oct 13, '12 by Esme12, ASN, BSN, RN Senior Moderator

    Welcome to AN! THe laregest online nursing community!
    
    The patient requires a 2 person......what, bath?
    

    the patient who requires a 2 person is refusing to have a bath.

    I am not so sure how this is an ethical dilemma unless it is very clear that the patient has ignored all personal hygene yet still chooses to refuse a bath....but is refusing a bath imposing on your obligation as a nurse and as a personal belief and personal hygene. Some Examples of ethical dilemmas
    
    
    

    1. Pro-choice versus pro-life. This issue affects nurses personally. Many of the positions nurses assume in this dilemma are influenced by their own beliefs and values. How does a nurse care for a patientwho has had an abortion, when the nurse considers abortion murder? Can that nurse with very opposing values support that patient’s right to choose, her autonomy? A woman that has gone through IVF/fertility is having a selective reduction of half of the embryos.....you are strictly pro-life.
    2. Freedom versus control. Does a patient have the right to make choices for one’s self that may result in harm, or should the nurse prevent this choice? For example, a patient wants to stop eating, but the nurse knows the consequences will harm the patient. Does the nurse have the “right” to force the patient to eat? You cannot "force" a patient with anorexia to eat yet they are starving to death.
    3. Truth telling versus deception. This is another issue that nurses may have to deal with, especially when families want to deny telling the patient the truth about the medical condition. What should a nurse do when a family insists telling the patient the prognosis will cause harm? How can a nurse know if this is true? Does the patient have the right to know? The family hiding that the forgetfullness of Mom is actually alzheimers.........or that that the cancer diagnosis is actually that the patient has been given a life expectancy of a few months and the family insists that the patient not "know" for it will disturb their "will to live"
    4. Another dilemma involves the distribution of resources. Who should get the limited resources? For example, nurses working with patients that are in a vegetative state; should these patients be left on life support? Look at the cost of maintaining these patients. These patients are consuming resources that could be used for patients in whom such costly interventions, if available, could save their lives. What is the role of the nurse when a family wants to continue life support for a medically futile family member? The parents of a child that has been in a persistent vegetative state for 20 years want to stop feeding/hydration.
    5. Empirical knowledge versus personal belief. In these dilemmas, research based knowledge in nursing is contrasted to beliefs gained from such things as religious beliefs. For example, what should a nurse do when a patient is admitted to the hospital that desperately needs a transfusion to live but has the belief that transfusions are unacceptable? The nurse knows this patient will die without the transfusion. How does that nurse deal with the patient’s family who supports the family member’s choice and still be supportive of the patient’s and family’s right to this decision? This occurs frequently with Jehovah witnesses and the refusal of blood transfusion.....What if it was a child involved in a bike accident with a splenic rupture and needs surgery and blood transfusions.The parents are refusing blood and maybe the surgery itself.

    Last edit by Esme12 on Oct 13, '12

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