advocating women’s rights to determine the direction of
their own pregnancy and childbirth experience.
Nurses and midwives as advocates must realise they do
not make ethical decisions for their patients; instead, they
facilitate patients’ decision making. They:
•
Interpret findings for their patients
•
Inform them of various aspects to be considered
•
Help them verbalise and organise their feelings
•
Call in those people who should be involved in the
decision making (e.g. family, primary nurse, physician
or spiritual adviser)
•
Help patients assess all of their options in relation to
their beliefs.
In this way, nurses and midwives advocate for the right of
patients to make their own decisions concerning their health.
However, not all individuals want to make their own treat-
ment decisions, and you should not violate the spirit of
autonomy
(self-determination) by forcing it on anyone.
Nurses and midwives sometimes advocate for patients by
helping them to delegate decisions to a preferred decision
maker whom they trust. In addition, when claiming to be a
patient advocate, they must be careful to clarify exactly
Unit II Foundations of nursing and midwifery practice
210
what it is they mean by advocacy because, in most
instances, this is not simply supporting patients in all of their
preferences. For example, if a woman in the early stages of
Alzheimer’s disease, with the support of her partner, asks a
nurse for help in terminating her life, the nurse would have
strong ethical grounds for refusing to advocate for this par-
ticular request.
Being politically active
No discussion of advocacy would be complete without
noting nursing and midwifery’s continuing voice in the
political arena on behalf of those least well served by the
existing healthcare system, including homeless people,
minorities, women and children. As governments become
more involved in the delivery and funding of healthcare
services, and as those designing rationing plans speak seri-
ously of age and other variables as criteria for limiting care,
nurses and midwives must continue to advocate for the
healthcare needs of those least empowered to do so for
themselves. Nurses and midwives are a powerful block of
voters whose potential for influencing healthcare legislation
is able to be tapped.
Developing critical thinking skills
1.
Students choose nursing as a career because of different
values. A desire to help others, a love of money, wanting
a career that allows you to work anywhere at any time,
a commitment to provide for your children’s well-being,
a love of science and technology, and respect for your
parents’ wishes are all values that may lead to choosing
nursing as a career. What were yours?
2.
Interview your classmates and identify the values that
brought everyone to nursing. When a classmate lists
more than one value, ask him or her to rank these in
order of their importance. Compare your lists.
3.
Discuss which values, if any, provide the best motivation
for professional nursing. Are there certain values that are
incompatible with professional nursing and that ought to
be grounds for rejecting candidates for the profession?
4.
Make a judgement about how well your personal values
equip you for professional nursing. Are any modifica-
tions needed?
5.
Make a list of all the values that might positively or neg-
atively influence someone’s ability to lose weight.
Think about how you could use this knowledge when
counselling obese patients.
6.
Another student tells you: ‘Who I am outside of school
is no-one’s business and has no effect on my nursing.’
Do you agree? Why or why not?
7.
Take any current ethical issue (assisted suicide, human
cloning, how to allocate scarce organs for transplanta-
tion, everyone’s right to healthcare) and poll your class
Developing knowledge skills
In this chapter you have been learning about values, ethics
and advocacy and their influence on nursing and midwifery
practice. Once you have had the opportunity to put this
theory into practice you will become more confident in car-
rying out the identified skills.
What have you learnt?
•
The importance of developing a thorough understanding
of the role of ethics in nursing and midwifery practice
•
How the nurse and midwife’s own values affect care
delivery
•
How to develop skills in clarifying the values of patients
•
To define ethics and the broad categories of ethical theories
•
How to describe the formal study of nursing and
midwifery ethics
•
An understanding of ethical conduct, ethical/moral
agency and the importance of professional ethical
development
•
Knowledge of the codes of ethics that guide professional
practice
•
An understanding of patients’ rights
•
How to use a decision-making process when an ethical
problem is encountered
•
Understanding of the role of nurses and midwives in
advocating for patients.
To enhance your learning and facilitate further
understanding of this chapter, refer to thePoint
and LNPS online resources.
