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I found another ethical article. Do you think this one is better. What ethical principle apply here (justice, trust, beneficence?) and how the nurse solved the ethical dilemma. Thanks The Case of Ms. Haddad Ms. Haddad was a 36-year-old Muslim woman who was being admitted for extensive gastrointestinal testing. The patient was accompanied by her sister, who explained to the admitting nurse that her sister spoke primarily Arabic and had only limited English skills. She said she would remain with Ms. Haddad and interpret as needed. Who Should Be the Interpreter? Amy, the admitting nurse, excused herself and went to confer with her manager. Amy told her manager she was concerned about the ethics of confidentiality if the sister acted as an interpreter. The manager suggested that Amy ask Achmed, the unit’s social worker who was certified as an Arabic interpreter, to assist. However, accompanying Amy back to Ms. Haddad’s room, Achmed explained that most Arabic women are uncomfortable with having nonrelated males in their room and prefer female family members to serve as interpreters. Achmed’s prediction proved to be correct. When Achmed explained to Ms. Haddad and her sister that he was the Arabic interpreter, the patient indicated she would prefer her sister interpret for her. Achmed documented that he had offered interpreter services (as required by the Office of Civil Right’s [2000] interpretation of the 1965 Civil Rights Act for persons with limited English proficiency skills) but that Ms. Haddad requested her sister serve as her interpreter. Amy conducted the admission interview, with Ms. Haddad ‘s sister serving as the interpreter. Amy found the sister very helpful. She answered questions when the patient did not understand and always translated for her sister when necessary. As her rapport with the patient and her sister increased, Amy felt comfortable asking more about the Muslim culture that would be important for healthcare providers to know. Questions About Diet Amy asked about preferred diet and discovered that Ms. Haddad followed a Muslim halaal diet. The institution did not prepare halaal diets; however, they did have arrangements with an outside provider for kosher meals, which are prepared in the same way as halaal foods. This was acceptable to the patient, and Amy completed the necessary request forms. Respecting Clothing and Culture Issues After completing the admission interview, Amy 356 Home Healthcare Nurse http://www.homehealthcarenurseonline.com Mrs. Haddad is a Muslim; please observe the following at all times: ■ Assign female caregivers (nurses or aides) to this patient. Assign female housekeepers, meal servers, and transporters when possible. (If not possible, make sure that another woman is in the room with a male provider.) ■ Respect her modesty and privacy. Conservative Muslim women dress to show no more than their faces and hands to anyone other than very close relatives. Provide long-sleeved gowns or a robe with long sleeves. Allow her to wear her own hair covering (hijab/headscarf). Always knock before entering room. ■ When possible, do examinations over a gown. Ask permission before examining any covered body part, and allow her to pull clothing aside as necessary. ■ Always make sure another woman (family or staff) is in the room when examining the patient. This is especially important if the examiner is a man. ■ Take time to explain all procedures and treatments. Use family members as interpreters or contact Social Services for an Arabic interpreter. ■ Ensure that the diet is kosher. (Contact Meal Services with any questions.) ■ Ask patient or family member when in question about care. ■ Allow family to be with patient for support. Figure 1. Amy’s instruction for the care of a female Muslim patient. gave the patient a hospital gown and asked the patient to put on the gown and get into bed. When Amy returned to the patient’s room, she found both the patient and her sister holding the hospital gown and looking very apprehensive. When she asked if something was wrong, the patient’s sister explained how important modesty was for Muslim women and that bare arms were unacceptable to her sister. Being unable to locate a long-sleeved patient gown in the institution, the nurse helped her patient into a lightweight robe that had long sleeves and was more concealing than the gown. This made both women smile. Amy, aware of the import of modesty, completed her physical assessment without exposing the patient in any way that would embarrass her. Leading Staff to Be Culturally Sensitive After completing the admission process, Amy conferred once again with her manager, and with her permission she posted a note on Ms. Haddad’s chart outlining some of the most important aspects of providing culturally sensitive care to their new patient (see Figure 1). Amy also sent a copy of her note to other departments that would be involved with Ms. Haddad ‘s care. There were many comments about Amy’s note. Several people questioned why one patient was receiving “special” attention, and several people questioned the idea of female-only caregivers: “Was this patient biased against male nurses?” Amy tried to explain the Muslim concept of modesty was not a bias but a cultural norm for this patient. She further argued that being culturally sensitive was an ethical responsibility and a nursing responsibility. When the objections persisted, she took the problem to the Institutional Ethics Committee. Ethics Committee Deliberations The Institutional Ethics Committee met to consider the ethics of the question about changing certain institutional practices in deference to individuals of differing cultures. The committee addressed several ethical principles related to this dilemma: justice, beneficence, non-maleficence, and trust. Some questioned the justice of purchasing a supply of long-sleeved gowns for a small group of patients, the extra cost involved with obtaining special meals, and the necessity to rearrange assignments to accommodate the need for female caregivers. The response to this was that justice does not mean that all should receive the exact same benefits; rather, justice could be understood as the distribution of benefits without which the care recipient could be harmed (e.g., the additional stress would pose a concern about maleficence). Another member argued that anything with the potential to improve the welfare of patients should be our legitimate goal. Another member suggested that not only would meeting the cultural needs of patients be an act of beneficence for individual patients but could also be seen as beneficence for the Muslim community. Some committee members also felt that by providing culturally sensitive care, they would be respecting the autonomy of individual patients (e.g., supporting their personal decisions about cultural aspects of their care as well as building trust, which would help all reach the desired outcomes). The Committee’s Decision The Ethics Committee overwhelmingly supported the ethical arguments for culturally sensitive care. They also made recommendations that were forwarded to all levels of Administration. • To form an action committee that would develop an institution-wide program of cultural sensitivity education that would include a review of the National Standards for Culturally and Linguistically Appropriate Services (CLAS Standards) released in 2000 by the United States Department of Health and Human Services (DHHS) Office of Minority Health (OMH, 2004). • That each department examine its standards of practice for specific changes that could be revised to encompass the needs of a culturally diverse patient population. Conclusion Although many professional education programs have traditionally included some classes in cultural diversity, the healthcare industry and healthcare institutions or agencies were somewhat slow to recognize the need for culturally sensitive healthcare environments. In 1985, the United States Department of Health and Human Services developed the Office of Minority Health to study the problem of healthcare for minorities and ethics groups and to develop programs that promoted cultural sensitivity in healthcare.

is it good ethical dilemmas to write? please give me some ideas about the 2 articles here. http://news.nurse.com/article/20090525/NATIONAL01/90520001 http://news.nurse.com/apps/pbcs.dll/article?AID=2005503140357

Thanks systoly!! I need to find an ethical dilemma that can use a book, articles, a movie or a real patient scenario. The ethical dilemma must be health care related, and must have to have a patient, a nurse and an ethical dilemma. That's all the information I need to have for my 5-6 pages long essay.

Thanks systoly!! I need to find an ethical dilemma that can use a book, articles, a movie or a real patient scenario. The ethical dilemma must be health care related, and must have to have a patient, a nurse and an ethical dilemma. That's all the information I need to have for my 5-6 pages long essay.

Thanks to all of you guys for posting!!

Hi, I am doing a nursing ethical dilemma essay recently and I couldn't find any good articles about it. Does anyone have any good nursing ethical dilemma articles to share. Thank you

Thanks Faybyrd!!

i am new to the concept map thing. i don't know what to do. please help me. thanks so much!!! the question ask: describe impact at the cellular level involving vascular impact of kidney, brain, lungs, tissue perfusion to vital organs if the shock is not reversed.