Competent patients' refusal of nursing care

Denise M. Dudzinski, Sarah Shannon

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Competent patients' refusals of nursing care do not yet have the legal or ethical standing of refusals of life-sustaining medical therapies such as mechanical ventilation or blood products. The case of a woman who refused turning and incontinence management owing to pain prompted us to examine these situations. We noted several special features: lack of paradigm cases, social taboo around unmanaged incontinence, the distinction between ordinary versus extraordinary care, and the moral distress experienced by nurses. We examined this case on the merits and limitations of five well-known ethical positions: pure autonomy, conscientious objection, paternalism, communitarianism, and feminism. We found each lacking and argue for a 'negotiated reliance' response where nurses and others tread as lightly as possible on the patient's autonomy while negotiating a compromise, but are obligated to match the patient's sacrifice by extending themselves beyond their usual professional practice.

Original languageEnglish (US)
Pages (from-to)608-621
Number of pages14
JournalNursing Ethics
Volume13
Issue number6
DOIs
StatePublished - Nov 2006
Externally publishedYes

Fingerprint

Nursing Care
Nurses
Paternalism
Feminism
Taboo
Professional Practice
Social Responsibility
Negotiating
Artificial Respiration
Pain
Therapeutics

Keywords

  • End-of-life care
  • Ethics
  • Nursing
  • Obesity

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Competent patients' refusal of nursing care. / Dudzinski, Denise M.; Shannon, Sarah.

In: Nursing Ethics, Vol. 13, No. 6, 11.2006, p. 608-621.

Research output: Contribution to journalArticle

Dudzinski, DM & Shannon, S 2006, 'Competent patients' refusal of nursing care', Nursing Ethics, vol. 13, no. 6, pp. 608-621. https://doi.org/10.1177/0969733006069696
Dudzinski, Denise M. ; Shannon, Sarah. / Competent patients' refusal of nursing care. In: Nursing Ethics. 2006 ; Vol. 13, No. 6. pp. 608-621.
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