In this study of nursing ethics the case of the frequent flyer 32-year old Asian female will be explored. In this case the patient states that her husband beats her and that she is fearful he will find out. Further he is a prominent individual and is well-known for helping the less fortunate, and a board member of the hospital. According to Durborow, Lizdas, O’Flaherty et al. (2011), it is important to note that many states have enacted mandatory reporting laws requiring reporting of specific injuries and wounds and suspected abuse of domestic violence among individuals being treated by healthcare professionals (p.1). This is regardless of who that individual is.
These laws are separate from elder abuse and abuse against children or other population. Injuries caused by weapons may have separate rulers compared to cases where violence and injury results from non-accidental means. Many patients withhold information and avoid seeking help because they fear law enforcement reports made by healthcare providers will place them at risk; removing reporting requirements can allow domestic violence victims to be more candidate and to receive follow-up care, allowing with allowing advocates to work with victims to address their needs (Durborow, Lizdas, O’Flaherty et al. 2011). These may include acquiring restraining orders, help with finances, safety planning and emergency shelter among other needs.
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"Nursing Ethics and Culture".
Ethically a nurse or other healthcare provider has a duty to provide access to services geared toward meeting the patient’s unique needs, which may include addressing the patient’s fears, and allowing the patient information that includes safety planning, and access to emotional and spiritual support.
Many batterers and other perpetrators will use a variety of tactics to assert their control, causing a victim to feel powerless with regard to their life (Durborow, Lizdas, and O’Flaherty et al. 2011). If the victim is forced to report this can cause further limitations and limit the control that a victim feels they have over their life. This would be the case in the instance of the 32-year old patient, who already feels powerless, and who may feel even more powerless if she is forced to report or file a report when her husband is a member of the hospital board. Removing this requirement will allow the patient to gain more control while still understanding what her healthcare options are.
Justice refers to the fairness of treatment provided to the patient. In the case of the patient presenting with a healthcare problem resulting from domestic violence, the patient has a right to treatment and must be treated equitably in the healthcare system. Healthcare has to be delivered on a one-to-one or an individual basis, thus this patient should not be seen in terms of “frequent flying” but rather for each specific incident. It is possible that the history of abuse or violence has resulted in the patients need to frequently arrive at the emergency room, and thus the healthcare provider may be an asset and help in determining what the root cause of the problem is, and help the patient seek safe methods of alleviating the concern, the health risk and helping the patient find safe resources for planning and for acquiring safe resources and counseling or other assistance following treatment.
Fidelity refers to how loyal the healthcare relationship is and the ability of healthcare providers to keep their promises and be true to what they offer patients (Beauchamp & Childress, 2001). In this case, the healthcare provider must be true to their word that they will keep information that they can regarding the patient’s healthcare status confidential, and make a commitment that they will work to commit to the best outcome for the patient. This can be challenging in the healthcare setting. Fidelity may also mean working with the patient to find appropriate choices, and resources given their situation. For example, if the patient is exploring resources, then it may be necessary for the healthcare provider to work with the patient to determine the best course of action based on positive and negative consequences.
Veracity refers to informed consent, and is the foundation for autonomy, allowing patients to exercise individual decisions. Deception in certain instances may be legitimate and legal; the healthcare provider may feel that it is appropriate to withhold information that may be detrimental to the patient; for example in this instance it may be beneficial to withhold information about the patient’s fears for harm from the husband if the husband is the perpetrator or may punish the patient for seeking healthcare assistance (Griffin & Koss, 2002).
In this case it is vital that the healthcare provider provide adequate treatment for the patient. It is also vital the healthcare provider address the client’s claims of domestic violence. This may require intervention by a case worker (Beauchamp & Childress, 2001) or other representative. The case worker can work with the client confidentially to provide resources to the patient that can help them in developing a short and long-term plan for ongoing healthcare and support given their situation. The patient has a right to protect her confidential healthcare needs, but the healthcare worker also has an ethical duty to assure the patient is protected and is receiving the resources that she needs to feel safe, and get protection and to gain the emotional, physical and spiritual support she may need prior to discharge.
