Caring is nursing’s primary objective. Consequently, nurses should be knowledgeable about different patient conditions, professional requirements, and bioethical stipulations to ensure care quality and safety. However, nurses endure various ethical dilemmas in their clinical practice, especially when cultural expectations contrast patient rights and other bioethical guidelines. For instance, terminally-ill patients of Asian heritage are not supposed to be informed about their prognosis but still have informed consent and information disclosure rights. Nonetheless, not fully disclosing information to the patient is an ethical breach that may have dire legal consequences. Therefore, nurses can leverage research, collaboration, and evidence-based practice (EBP) to balance patient rights and cultural beliefs.
Nurses can exhibit cultural competency and honor patient rights when handling individuals from the Asian culture. Firstly, information disclosure is a crucial bioethical requirement in nursing as it helps patients participate in vital decision-making processes regarding their treatment, allowing informed consent. As an advanced practice nurse, one should apply their clinical experience and EBP to balance patient rights and their inherent cultural values instead of prioritizing one phenomenon. For example, a clinician may engage the patient’s family members or health surrogate to explain the importance of information disclosure in helping clients understand the cause of their medical conditions and the expected outcome. The process requires one to manifest cultural competency by first acknowledging the beliefs against informing terminally-ill patients about their prognosis. According to Ozdemir et al. (2021), Asian patients rarely get involved in shared decision-making processes in healthcare, making it necessary to engage their kin or mediators to help them understand their right to get vital information on their illness. Involving surrogates and family members facilitates patients’ informed consent, helping determine whether to terminate treatment or embrace palliative care. Hence, nurses should use their cultural competency to establish suitable ways to disclose critical healthcare information to Asian patients.
The choice between balancing a patient’s information disclosure rights and respecting their cultural beliefs may be limited depending on the country where care is delivered. For example, informed consent is a legal requirement in the U.S., UK, and Canada, among other nations. As a result, nurses cannot make personal decisions on whether to choose information disclosure over cultural values without involving their seniors and hospital management. However, patient autonomy may not apply when an ailing person is critically-ill and irresponsive, allowing clinicians to emphasize cultural practices and beliefs when engaging health surrogates or kin (Kaye et al., 2019). Conditions such as terminal cancers can drain patients emotionally, physically, and financially, making it necessary to inform family members about the most suitable clinical choices. Instances involving ethical dilemmas require collaboration and consultation to help attain practical insights from experienced nurses or physicians. Consequently, nurses should understand their practicing country’s legal and ethical guidelines on information disclosure, as patients’ bioethical rights supersede their cultural dispositions. Thus, different countries’ healthcare laws and nursing principles help nurses decide the competencies and rights to prioritize when treating diverse patients.
Overall, nurses should find ways to balance Asian patients’ right to information with respect for cultural practices and values. The feat may be attained by engaging patients’ health surrogates or family members. Emphasizing cultural beliefs over information disclosure would be an ethical breach in several societies, resulting in legal repercussions. Therefore, nursing practitioners should make decisions that enhance patient welfare and observe bioethical guidelines.
References
Kaye, D. K., Chongwe, G., & Sewankambo, N. K. (2019). Ethical tensions in the informed consent process for randomized clinical trials in emergency obstetric and newborn care in low and middle-income countries. BMC Medical Ethics, 20(1), 1-8.
Ozdemir, S., Malhotra, C., Teo, I., Tan, S. N. G., Wong, W. H. M., Joad, A. S. K., … & Finkelstein, E. A. (2021). Patient-reported roles in decision-making among Asian patients with advanced cancer: a multicountry study. MDM Policy & Practice, 6(2), 23814683211061398.
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