Patient Autonomy
Submitted by Hanna Leedom
Tags: healthcare ethics Informed consent Nurse-patient communication Patient autonomy Patient-centered care
The medical field is vast and ever changing. People are faced with new challenges to their health daily. Each decision a person makes regarding their health will result in an outcome, either positive or negative. In health care, we as healthcare providers have extensive knowledge about the body, diseases, medication, procedures, etc. The average lay-person usually does not have the appropriate knowledge needed to make informed decisions regarding health without some information provided by a healthcare professional. With that being said whatever information is presented to a patient, it is ultimately the decision of the patient to make involving their health. It is our duty as healthcare providers to ensure accurate, timely and appropriate information is given to patients in order for an informed decision to be made. Although we know what might be best in a scenario, it is not our opinion that matters. This is a heavy responsibility of healthcare providers because we are giving patients the information necessary to make some weighty decisions. We have to be conscious that despite what our choice would be in any given situation that we provide unbiased, objective information for patients. It is our professional obligation to give each patient this information, while still allowing them to have autonomy in the process.
Nurses specifically have a duty to patients to provide accurate information with every encounter. There are numerous touch points in a single interaction between a nurse and patient to inform and allow a patient to exercise their autonomy. In the setting of a medication pass in the hospital a nurse would verify the patient, scan medications and possibly have a conversation about the new medications the patient has been ordered. This scenario provides the nurse with the opportunity to teach the patient why this new medication has been prescribed, the intended purpose, any side effects and adverse reactions. Only once the patient has received this information can they appropriately decide whether it is something they are going to accept. In the same way nurses have opportunities like this, other 'teaching moments' throughout their day. Patients must be given the ability to choose for themselves because it is their body, their health. Although we as the expert know what might be best in a given situation, our job is to provide all the information and let each patient make their own decision. Sometimes it can cause an ethical or moral dilemma to the provider. It is the duty of the provider to not only inform the patient of the intended outcomes, but also of outcomes expected without intervention. When a patient makes a decision to forgo intervention that could potentially be beneficial, life saving even, it can be difficult for a provider to step away from the situation and not feel as though more could have been done.
Regardless of the choice made by a patient, the provider must be confident in the information presented to the patient and how they react to their decision. Providers must remain professional and continue to provide medically appropriate care based on the treatment route the patient decides upon. As medical professionals we know more information than the average person in this area. We must be diligent to remain unbiased in our presentation and take care to thoroughly inform each patient. We are obligated to respect each decision by patients and continue to provide patient-centered care. Supporting a patient's autonomy is important to their healing as well and to gain confidence in their decisions. There is a balancing act all medical professionals must continue to juggle in order to maintain professional obligations and promote the autonomy of patients.