Reflection on Ethical Decision-Making and Cultural Care in Nursing

This reflective essay delves into the complexities of ethical decision-making, cultural care, and the influence of personal beliefs in nursing practice, using the case of John, a 20-year-old Aboriginal Torres Strait Islander with end-stage renal disease. The essay explores the ethical principles of autonomy, beneficence, non-maleficence, and justice within the context of John's care, highlighting the challenges posed by cultural differences and the importance of interdisciplinary collaboration. It examines the impact of cultural factors and personal biases on communication and patient care, emphasizing the need for healthcare professionals to be aware of and address these issues. The essay stresses the value of interpersonal communication, cultural sensitivity, and the development of a comprehensive approach to patient care that considers both ethical and cultural dimensions to ensure effective and compassionate healthcare delivery. The essay also reflects on the importance of incorporating the patient's perspective and cultural background in the decision-making process to ensure the patient's autonomy and well-being.

Running Head: REFLECTION
Reflection
Name of the Student
Name of the University
Author note

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The aim of the paper is to provide a reflection in the case if the John and look at the
case from the perspective of ethical decision making in deriving the nature of care and the
consideration that should be made by keeping in concern several factors that are of crucial of
importance in considering the attribute of the ethical factors in effective communication. The
report would indulge in a discussion from the perspective of the collaboration and the
facilitation that it provides in terms of the ethical decision-making. The report also considers
the importance of the cultural aspect is extending effective care to the patients in order ensure
the effectiveness in complying with the ethical attributes of decision-making. The concern of
the report is with the ethical factors and with the implication of the interpersonal interaction
as a strategy in mitigating the effective communication.
As per my observation and understanding, the effective care of the patient is
interwined with certain factors that are primary in ethical consideration in decision making.
Four factors that are crucial in developing an understanding of the ethical decision making
includes the attributes of the autonomy. By the virtue of this factor, it is suggested that the
patient should have a autonomy over deciding the course of their health in future. By valuing
the human dignity, the autonomy is also valued in an effective way (Cerit & Dinç, 2013). The
next attribute is that of the Beneficence, where the suggestion is that duty of the nurse should
be towards acting in the best possible way in order to ensure the effectiveness of the patent
care. Non-malificence in my opinion is a crucial aspect as it allows the integration of the
ideals that no harm should be inflicted to the patients. The function of the factors of justice is
crucial to the understanding of the fact that the justice and the distribution in a fair way
should be done in order to follow the ethical principles (Council, 2013).
The case that has been the concern of the report is that of a 20 year old Aboriginal
belonging to the Strait Islander. The community that he belongs to is a remote indigenous
community and the current situation had placed him 500km away from his home.

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John had been undergoing dialysis under the recommendation of the health care team,
who has supposed that the care would be effective one as well as best for him. He has been
informed by the officials of the medical health care team that he is not expected to survive for
a period more than 3 months while being on the dialysis. The words of the medical
professionals has deprived him of the hope that previously used to invest in his life. The
current situation of helplessness and despair had allowed him to take the decision of putting
an end to his treatment and return to his home town. However, in that case the doctors have
advised him that stopping the treatment would result in him losing the chances of his living to
a certain further extent (Iacobucci rt al., 2013).
Since the case of John is a complex one I would like to share my opinion in favor of
the intervention of an interdisciplinary team in order to ensure the effectiveness in the
decision making in an ethical way. In case of effective communication in an ethical way, te
first step that should be considered in the process should be the one of the identification of
the factors that are inhibiting the effectiveness in extending the patient care. The case of John
is marked by the complexities stemming from the cultural and the racial factors. The
aboriginal community that john belonged to had earned him a lot of prejudices that has
inhibited the effectiveness of the care. As such, in my opinion, the decisions had not been
taken properly regarding how the information was going to be delivered to him regarding the
lesser expectancy about his life. As such, the decision should have been taken collaboratively
in order to provide him with the harsh knowledge. It has been noted in the case of the
effective communication with the patients that the effectiveness of the communication is
enhanced by the intervention of the professional in a interpersonal manner. A little amount of
personal touch in the communication is believed to have enhanced the effectiveness by
manifold.

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The aspect of culture in terms of the effective care of the patient is also very crucial as
it urges that the medical professionals as well as the nurse to keep in concern the importance
of the cultural factors in dealing with it. The reason of john, expressing his willingness to
return to his family in the time of crisis might have stemmed from emotional urge to be close
to his near ones. However, the urge could have been rooted in certain cultural attributes
which might be difficult for the people from different cultures to understand effectively.
As such, I would like to suggest that before communicating the information and its
implication care should have been taken towards enhancing the understanding of the medical
professionals regarding the cultural attributes of the subjects they are effectively dealing with.
In case the patient require individual care, the health care team should have arranged for the
provision of providing the patients with effective care.
Personal belief are the greater source of bias and can affectively inhibit the process of
decision making in an effective way. As such, the care should be taken at eradicating the bias
in terms of interaction with the people. The bias can inhibit the effectiveness as well as
prevent the patients from participate in the communication effectively. The professional
interaction should take into account the aspect of the patient care and the care that should be
taken in order to ensure its effectiveness. The situation of bias is pretty well prevalent in most
of the medical institution based interaction. Thus it requires proper training in my opinion to
mitigate the rigidity of the perception and the bias that exist (SHAPIRA‐LISHCHINSKY,
2014).
Some strategies that can be suggested in this respect should effectively include the
factor of the culture and other related factors in determining the attribute of the
communication. It should also joined by the increased understanding of the members with the
interpersonal attribute in order to extend effective communication towards the patient. A

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personal approach with certain amount of warmth is beneficial in mitigating the effectiveness
of care (Shahriari et al., 2013).
Thus, in conclusion it can be stated that the effectiveness of the ethical decision
making depends upon a multiplicity of factors. The care should be taken while dealing with it
must include the interpersonal interaction and the community and the culture-based
understanding in order to communicate with the patients effectively. As such, the implication
of the patient care can be enhanced if the interdepartmental consensus can be established
regarding the kind of care that should be extended towards the concerned patient.

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References
Cerit, B., & Dinç, L. (2013). Ethical decision-making and professional behaviour among
nurses: a correlational study. Nursing Ethics, 20(2), 200-212.
https://journals.sagepub.com/doi/abs/10.1177/0969733012455562
Council, S. A. N. (2013). Code of ethics for nursing practitioners in South Africa. Pretoria:
South African Nursing Council, 3-5. https://www.sanc.co.za/pdf/Learner%20docs/SANC
%20Code%20of%20Ethics%20for%20Nursing%20in%20South%20Africa.pdf
Iacobucci, T. A., Daly, B. J., Lindell, D., & Griffin, M. Q. (2013). Professional values, self-
esteem, and ethical confidence of baccalaureate nursing students. Nursing
ethics, 20(4), 479-490. https://journals.sagepub.com/doi/abs/10.1177/0969733012458608
Shahriari, M., Mohammadi, E., Abbaszadeh, A., & Bahrami, M. (2013). Nursing ethical
values and definitions: A literature review. Iranian journal of nursing and midwifery
research, 18(1), 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748548/
SHAPIRA‐LISHCHINSKY, O. R. L. Y. (2014). Simulations in nursing practice: toward
authentic leadership. Journal of Nursing Management, 22(1), 60-69.
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2834.2012.01426.x