Ethical Issues in Nursing (Professional Ethics) by Geoffrey Hunt

By Geoffrey Hunt

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Of two patients who thought they may have had a prostatectomy, one had signed his consent form for a bladder neck incision and the other for a TURP and orchidectomy. One patient stated that he had had a prostatectomy but had signed for a TURP. Operation described by women: D & C and hysteroscopy 5; did not know or did not remember 5; did not read the form 1; D & C, hysteroscopy and laparoscopy 1; D & C 4; D & C and clipped tubes 1; D & C, IUCD removal and sterilisation 1. Comparing the women’s consent forms with their statements we find that, of the seven women who gave the correct description, one who had signed for a D & C and hysteroscopy mentioned the D & C but not the hysteroscopy she had undergone; the consent form gave only D & C as the operation and the hysteroscopy was not mentioned.

However, there are occasions when one must question whether particular research or quality assurance activities are justified, in view of the intrusions into patients’ privacy which they involve. This has been true for some time in the area of research, and in particular the research content of the curricula of many nursing courses. 15 Quality assurance is a more recent phenomenon, having come to prominence with the introduction of general management in the 1980s. However, there is some evidence that the increase in quality assurance initiatives has not been without its problems, and one has to ask whether the consequent intrusion of privacy experienced by patients in INTIMATE ASPECTS OF CARE 43 areas subjected to various kinds of audit can be justified.

Sherlock makes a case for a rethinking of consent as conceived in American law and medical practice. 13 This non-defensive understanding of consent is much more in keeping with the goals and ideals of nursing. NOTES 1 I am presently (1992–3) undertaking a larger and more detailed study of the same kind in several London hospitals. , Napier, A. ’, British Medical Journal, 1988, vol. 296, pp. 839–40. : Department of Health, 1990. On consent and the law also see Ann Young’s chapter in this volume.

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