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Nursing Ethical Analysis: Should they Say No to Treating Ebola Patients?

Summary

Ebola disease has triggered some of the most dreadful fears facing nurses in the 21st century. The viral disease is highly infectious across borders with a high mortality rate. Since its outbreak in West African countries in 2014, more than 50% of the infected patients have succumbed to death. This paper analyzed the serious issues that faced nurses in their line of duty. Both ethical and legal considerations were explored. From a legal point of view, nurses have a duty to take care of an ailing patient while the employer has a responsibility to ensure their lives are not threatened while in the line of duty. The paper also examined the nurses’ code of ethics which outlines their rights along with society and employer’s responsibility. One of the most critical questions facing nurses in the US today day is whether they can refuse to treat patients with infectious disease. In this paper, the researcher explored the nursing ethical guidelines that nurses ought to consider when presented with a situation where they are required to take care of Ebola patients. This analysis was helpful to nurses as it helped them in clarifying their beliefs concerning current ethical crisis where nurses are faced with the choice of providing care services to patients with lethal or highly pandemic diseases like Ebola.

Introduction

Nurses in the US expressed concerns when they were faced with the choice of treating Ebola patients due to the country’s unpreparedness to handle the disease. The American nurses were overwhelmed by the highly infectious disease they had slowly responded to when it first broke out in West African countries (Walter, 2016). When Ebola got detected in the US back in 2014, there was increased over-reaction and blame directed towards the nurses and doctors due to their reluctant and fears in providing care to the infected patients (Narasimhulu, Edwards, Chazotte, Bhatt, Weedon, & Minkoff, 2015). There was excessive quarantining of infected health professionals who were believed to have contracted the deadly virus while treating Ebola in African stricken countries. Such an incidence highlighted the need for public education and improvement of health management systems to enhance the nation’s preparedness to deal with highly infectious diseases. Several articles were published highlighting this contentious issue and defended nurses’ fear and concerns of attending to Ebola patients (Jecker, Dudzinski, Diekema, & Tonelli, 2015).  The nurses’ refusal to provide care for patients infected with Ebola could be justified as they feared to contract the infectious disease which little was known about, but this raised an ethical concern as to whether nurses had a duty to provide care to such patients. Another pertinent concern entailed the nurses’ responsibility to the society and the society’s responsibility to nurses.

Ethical Principles

Ethical principles provide a generalized framework within which certain ethical dilemmas are analyzed. The principles can offer guidance in resolving ethical issues that codes of ethics may not necessarily provide. The definitions of the four ethical principles are as shown below.

Respect for persons/ Autonomy– The principle calls for the acknowledgement of other people’s right to make choices, to hold views, and to take actions on the bases of personal values and benefits.

Justice– This principle requires an equitable treatment to others and fair distribution of benefits or burdens.

Non-maleficence (do no harm) – This is an obligation not to cause harm intentionally.

Beneficence (do good) – The principle ensures that benefits are provided to persons and a contribution made to their welfare.

Pros and cons of nurses’ duty to treat patients with Ebola

Nurses are not allowed by work ethics to choose which patients they care or not care for and ought to provide care to everyone the employer requires them (Hodge, 2015). From the past literature reviews, there are few arguments for or against the nurse’s duty to treat diseases that could endanger their lives. The nursing code of ethics requires nurses and physicians never to abandon sick persons. However, it is the responsibilities of the state to ensure that such nursing professionals are equipped with hazardous protection gear and it would be inconceivable not assure them of their safety such as receiving the best standard or care, should they contract the deadly virus in their line of duty (Evans, 2015). Ebola virus disease tends to be contracted through body fluids such as stool, tears, break milk, and saliva. Nursing professionals handling patients with Ebola ought to have undergone specialized training for their personal safety. As such, the fear to treat Ebola patients is alleviated.

Ebola viral disease tends to cause hypertension and bleeding to the patient and its treatment must entail countering such symptoms (Venkat, Asher, Wolf, Geiderman, & Marco, 2015). It is a disease that severely weakens the patient’s immune system. The survival rate of the patient is dependent upon reinstating a patient’s immune system. The nurses providing care to such patients ought to strengthen their immune system by maintaining a healthy diet. Therefore, a healthy diet could reduce the nurses’ risk of contracting the disease.

However, nurses have a duty to express their concern should they be required to provide care in areas for which they feel incompetent.  In case the nurses have been assigned to provide care to Ebola patient without the requisite competencies, it is recommended that they write a letter protesting the duty but should not abandon the patient as it is an offense to do so under the law (Venkat, Asher, Wolf, Geiderman, & Marco, 2015). However, if the nurses being assigned the duty to care for Ebola patients have the requisite competencies but still refuse such a duty, they are supposed to quit the profession.

Moreover, healthcare professionals are at an increased risk of contracting   Ebola if they attend to a patient with the disease without the requisite training. Since its outbreak five years ago, not much is known concerning the disease pathology. Therefore, nursing professionals taking care of patients with Ebola face the risk of contracting the deadly virus and if not well medicated could lose their lives.  Moreover, the refusal of nursing professionals to care for Ebola can attract tremendous condemnation from the society (Walter, 2016). The society requires nurses to treat patients to the best of their abilities and snubbing this duty is not only morally wrong but goes against the nursing codes of ethics. Nurses are also faced with the challenge of losing their jobs should they refuse to care for the patients with contagious diseases. According to law, the refusal to treat patients with Ebola disease is considered as abandonment. The law regulating nurse-patient relationships tend to differ from one state to another in the US. For instance, refusing to accept the duty to treat as assigned by the employer equates to patient abandonment in some states while it is not the case in others.

Conclusion

From the above analysis, the duty of nurses to treat Ebola patients raises three themes including ethical, associated risk-factor, and social contract obligations (Venkat, Asher, Wolf, Geiderman, & Marco, 2015). The nursing code of ethics requires the nurses to treat patients without discrimination. Concerning the social contract obligation, nursing professionals have the responsibility to treat patients provided that they have the requisite competencies provided that the employer provides them with the necessary protective gear to undertake the duty and assures them of a high standard of care should they get infected in the cause of discharging their duties.

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