How can “good” people in traditionally honor-bound professions become complicit in some of the worst violations of humanity in history?

A HISTORY OF NURSING ETHICS
The Nuremberg trials at the close of WWII offered disturbing questions. How can “good” people in traditionally honor-bound professions become complicit in some of the worst violations of humanity in history? What happens when individual professionals are not held to account by their peers, professions, and society as a whole? The trials showed how moral individuals within organizations can engage in morally “wrong” functions. “I was just following orders,” complicit healthcare providers, doctors, and nurses claimed.
Morality refers to principles that help determine what is “right” and what is “wrong.” Ethics is the related field that puts these principles to work to:
apply moral principles to choose “right” actions,
conduct relationships in an ethical manner, and
manage situations where a “right” action is clear but for some reason not possible.
Read the ethical dilemma below and explain your response and actions:
Nurse Is Instructed to Have Patient with Low Literacy Level to Sign Consent for Treatment
Scenario: Nurse Gloria is instructed by the attending physician to have Mr. Isaacs sign a consent form before a scheduled colonoscopy. As Nurse Gloria goes over the form with the patient, she notices he seems confused and is unsure where or how to sign the paperwork.
Ethical Dilemma: It is common for nurses to be the ones to get signatures on consent forms, especially for procedures like the one described in this scenario. When faced with a situation like the one here when the nurse is not sure that the patient understands what he is being told or if he can read, the decision of whether to delay a busy schedule to have the doctor come back and talk to the patient or explain to the best of her knowledge and get the patient’s signature may seem difficult to make.
ANSWER
**Response and Actions**
In this ethical dilemma, Nurse Gloria should **delay the procedure and have the doctor come back to talk to Mr. Isaacs**. This is the most ethical course of action because it ensures that Mr. Isaacs fully understands the risks and benefits of the colonoscopy and is able to give informed consent.
Here are some specific actions that Nurse Gloria can take:
1. **Explain the situation to the doctor and request that he come back to speak with Mr. Isaacs.** Nurse Gloria should explain that Mr. Isaacs seems confused and unsure of what he is signing. She should also explain that she is concerned that Mr. Isaacs may not be able to read the consent form.
2. **Accompany the doctor when he speaks to Mr. Isaacs.** This will allow Nurse Gloria to provide support and answer any questions that Mr. Isaacs may have.
3. **Make sure that Mr. Isaacs has time to read and understand the consent form before he signs it.** Nurse Gloria should also make sure that Mr. Isaacs has the opportunity to ask questions and get clarification from the doctor.
It is important to note that it is never acceptable to pressure a patient into signing a consent form. If Mr. Isaacs is not comfortable signing the form, Nurse Gloria should respect his decision.
**Rationale**
There are several reasons why it is important for Mr. Isaacs to fully understand the risks and benefits of the colonoscopy before he gives consent. First, the colonoscopy is a medical procedure that carries some risks, such as bleeding, infection, and perforation of the colon. Mr. Isaacs needs to be aware of these risks so that he can make an informed decision about whether or not to have the procedure.
Second, Mr. Isaacs needs to understand the benefits of the colonoscopy so that he can weigh the risks and benefits and make the best decision for his health. The colonoscopy can help to detect colon cancer and other serious conditions early, when they are most treatable.
Finally, it is important for Mr. Isaacs to be able to ask questions and get clarification from the doctor before he signs the consent form. This ensures that he fully understands what he is signing and that he is comfortable with the decision.
By delaying the procedure and having the doctor come back to talk to Mr. Isaacs, Nurse Gloria is ensuring that he has all of the information he needs to make an informed decision about his care.