Integrate One Nursing Ethical Principle In Advanced Practice

Integrate One Nursing Ethical Principle The Advanced Practice Nurse Co

Integrate one nursing ethical principle the advanced practice nurse could use in the decision-making process for a potentially lifesaving procedures of who should be saved first, who lives, and who dies regarding allocation of scarce resources during a pandemic.

During a pandemic, healthcare professionals, especially advanced practice nurses (APNs), are faced with complex decisions regarding the allocation of limited resources such as ventilators, ICU beds, and medications. These scenarios often involve life-and-death decisions, where ethical considerations are paramount. Among various ethical principles, justice stands out as particularly relevant in guiding APNs’ decision-making processes in these critical situations. This paper explores how the nursing ethical principle of justice can be integrated into the decision-making process, ensuring fair and equitable treatment for all patients amid resource scarcity.

Introduction

The COVID-19 pandemic emphasized the importance of ethical principles in healthcare, especially when resources are insufficient to meet the demand. During such crises, healthcare providers must make rapid yet morally sound decisions about who receives potentially lifesaving care. The core nursing principles—beneficence, nonmaleficence, autonomy, and justice—serve as a foundation for ethical decision-making. Among these, justice is particularly integral in managing resource allocation to uphold fairness across diverse patient populations.

The Ethical Principle of Justice in Nursing

Justice, in the context of healthcare ethics, refers to the equitable distribution of resources and treatment, ensuring that no patient group is unfairly disadvantaged (Rooddehghan et al., 2019). It involves impartiality and fairness, where decisions are rooted in clinical needs and potential for benefit rather than extraneous characteristics such as socioeconomic status, race, or age. In pandemic situations, applying justice ensures that all patients are considered based on consistent criteria, promoting fairness in crisis resource management.

Application of Justice in Pandemic Resource Allocation

APNs can leverage the principle of justice in several ways. First, they can participate in developing transparent triage protocols that prioritize care based on objective medical criteria such as severity of illness, likelihood of survival, and overall prognosis (Falcà³ et al., 2021). These guidelines help prevent bias and ensure consistent decision-making, fostering trust among patients and the public.

Furthermore, justice demands that decisions are made without favoritism and that vulnerable populations are protected against discrimination. For example, during COVID-19, elderly patients or those with comorbidities might have been deprioritized based on prognosis, but the process must be ethically justified and transparently communicated. APNs play a vital role in advocating for fairness and in ensuring that resource allocation aligns with ethical standards and societal values (Muñoz-Rubilar et al., 2022).

Challenges and Ethical Tensions

Applying justice can be fraught with ethical tensions, particularly when decisions may conflict with personal beliefs or societal values. For instance, prioritizing patients with better survival chances might seem to neglect the needs of the most vulnerable. APNs, therefore, need to balance justice with other principles such as beneficence—acting in the best interest of the patient—and respect for autonomy (Buckwalter & Peterson, 2020).

In practice, this requires ongoing ethical reflection, transparent communication, and multidisciplinary collaboration. APNs must also consider legal frameworks and institutional policies that guide resource allocation, ensuring that decisions are ethically justifiable and legally compliant (Oguisso et al., 2019).

Conclusion

The COVID-19 pandemic has underscored the critical importance of ethical principles in clinical decision-making during crises. The principle of justice offers a vital ethical framework for advanced practice nurses in allocating scarce resources fairly and equitably. By adhering to justice, APNs can uphold the integrity of nursing practices, promote trust, and ensure that all patients are treated with fairness, regardless of individual circumstances. Integrating justice into decision-making processes not only aligns with professional ethical standards but also fosters a humane and morally responsible response in times of healthcare emergencies.

References

• Buckwalter, W., & Peterson, A. (2020). Public attitudes toward allocating scarce resources in the COVID-19 pandemic. PLOS ONE, 15(11), e0241261.
• Falcà³, P. A., Zuriguel, P. E., Via, C. G., Bosch, A. A., & Bonetti, L. (2021). Ethical conflict during COVID-19 pandemic: The case of Spanish and Italian intensive care units. International Nursing Review, 68(2), 181–188.
• Oguisso, T., Hiromi-Takashi, M., Fernandes de Freitas, G., Barrionuevo-Bonini, B., & Araàºjo da Silva, T. (2019). First international code of ethics for nurses. Texto & Contexto Enfermagem, 28, e20180107.
• Rooddehghan, Z., Nikbakht nasrabadi, A., Parsa Yekta, Z., & Salehiparsa, M. (2019). Patient favoritism as a barrier to justice in health care: A qualitative study. Health, Spirituality & Medical Ethics, 6(4), 29–35.
• Muñoz-Rubilar, C. A., Carrillos, C. P., Mundal, I. P., Cuevas, C. D. L., & Lara-Cabrera, M. L. (2022). The duty to care and nurses’ well-being during a pandemic. Nursing Ethics, 29(3), 527–539.