Week 7 Discussion

The ethical principles in modern medicine are derived to ensure human dignity and rights are upheld during research and evidence-based practice implementation (Igai, 2020). These ethical principles include patient autonomy, beneficence, nonmaleficence, justice, patient-provider fiduciary relationship, and sanctity and dignity of human life. The ethical issues in relation to sanctity and dignity of human life requires a morally acceptable decision-making based on how the core ethical principles interact. One of the most ignored ethical issues relating to human dignity is the randomization of patients or participants into treatment and no treatment groups. The ethical issues relating to this practice in evidence-based practice is that the ethical principles of beneficence and nonmaleficence are being flouted. This is because assigning patients to the no treatment or intervention group amounts to directly denying known benefits of an intervention to one group (Winter & Winter, 2017). The issue of randomization of the participants into intervention and no intervention group degrades the human sanctity and dignity.

According to Leadbeater et al. (2018), the randomization of participants into intervention and no intervention group is unethical especially when the intervention being implemented has already demonstrated positive benefits in other projects. Relatively, when the intervention being offered has not been ascertained to produce positive results, it is unethical to implement it because it violates the ethical principle of dignity and sanctity of human life (Winter & Winter, 2017). This means that before the implementation of an intervention, the state of current knowledge regarding the intervention must be clearly explained to ensure that human dignity and sanctity is upheld (Leadbeater et al., 2018). Relatively, an implementation design that involves no intervention group is unnecessary and unethical in situations where the positive impacts of the intervention have already been established. Altogether, the EBP implementation should consider alternative designs such as standard training to avoid the ethical issue of human dignity and sanctity (Igai, 2020).

References

Igai, Y. (2020). Concept analysis of dignity‐centered care for people with chronic progressive disease. Japan Journal of Nursing Science, 17(6), 1-10. https://doi.org/10.1111/jjns.12302 (Links to an external site.)
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Leadbeater, B., Dishion, T., Sandler, I., Bradshaw, C., Dodge, K., & Gottfredson, D. et al. (2018). Ethical challenges in promoting the implementation of preventive interventions: Report of the SPR Task Force. Prevention Science, 19(7), 853-865. https://doi.org/10.1007/s11121-018-0912-7 (Links to an external site.)
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Winter, S., & Winter, S. (2017). Human Dignity as Leading Principle in Public Health Ethics: A multi-case analysis of 21st century German health policy decisions. International Journal of Health Policy & Management, 7(3), 210-224. https://doi.org/10.15171/ijhpm.2017.67

Week 7: Discussion Board Posting

            Patients are now better informed and aware of their rights and options, especially that of refusing treatment. The informed consent process has evolved to emphasize patient autonomy and choice, and to provide protective procedures for patients who are not completely autonomous, including unborn fetuses (Artal & Rubenfeld, 2017). An evidence-based practice (EBP) implementation goal is not to generalize a process or its findings.  It is instead the goal of a clinician to initiate and sustain meaningful change in their practice, both for themselves as well as their specific patients or clients (O’Mathuna, 2019). A controversy surrounds the issue of ethical implementation of EBP and how it compares and contrasts with clinical research. Regardless of how a project or study is categorized, several ethical issues must be addressed.

            An example of ethical challenge of human dignity and/or human rights related to the implementation of evidence-based practice is the attempt to improve the quality of care for some patients that may inadvertently harm others, an example is, if people or resources are diverted away from them (O’Mathuna, 2019). This would violate the ethical principle of equality, justice, and equity, which promotes efficient use of resources in an equitable and timely manner. Having a commitment to treat everyone equitably is crucial. All people deserve consideration and care. Keeping people on different paths does not imply giving them equal treatment. It means that any decisions to differentiate between them must be ethically and legally justified (Fritz et al., 2020). As advanced practice nurse keeping and maintaining a clear mindset when it comes to ethical ground is crucial. Protecting and promoting the well-being of everyone involved in a project or a study, including how their personal data are protected should be utmost importance.

References

Artal, R., & Rubenfeld, S. (2017). Ethical issues in research. Best Practice & Research: Clinical Obstetrics & Gynaecology , 43, 107–114. https://doi.org/10.1016/j.bpobgyn.2016.12.006 (Links to an external site.)

Fritz, Z., Huppert, J. L., Liddell, K., Holton, R., & Fuld, J. P. (2020). Ethical principles and a practical approach to support policy making through the next phases of the COVID-19 pandemic and beyond. Clinical Medicine, 21(2), e122–e125. https://doi.org/10.7861/clinmed.2020-0843

O’Mathuna, D. P. (2019). Ethical Considerations for Evidence Implementation and Evidence Generation . In Melnyk, B. M., & Fineout-Overholt, E. (Eds.), Evidence-based practice in Nursing & Healthcare: A guide to best practice (4th ed., pp. 681–699. Wolters Kluwer.