Instructions: The reply to each peer should be a minimum of two paragraphs. Use APA 7th ed. format.
Peer 1 : Teleological theory defined is an outcome that produces the greatest good for the greatest number. “According to Bentham’s theory, actions are right when they increase happiness and diminish misery, and wrong when they have the opposite effect.” (Burkhardt 2020). Utilitarianism is a type of teleological theory stating that an action is either good or bad based off of the end result.
An example of teleological theory that may be justified as a nursing action could be a religious faith in which Jehovah’s Witnesses do no believe in blood transfusions as accepting someone else’s blood is not allowed. A nurse could give the patient blood without their consent and without the patient knowing if let’s say the patient would die without receiving blood. Although this is ethically wrong, this produces the greatest good and ultimately increases happiness. The end result would be that the patient is alive and well instead of the alternative due to the patient dying without receiving the blood transfusion.
Deontological theory however, is the duty regardless of the consequences. It means to treat those how you would want to be treated because that is their duty. “It recognizes the dignity and autonomy of individuals and allows all people equal consideration.” (Burkhardt 2020). Patients have the right to make their own decisions when it comes to healthcare and it is our duty to honor it.
An example of deontological theory are things that nurses do everyday on the job. Such as being honest with the patient and advocating for their rights, even when they can’t do so on their own. Helping the patient get better by practicing within their scope and asking for help when needed. A more specific example could be a nurse not knowing how to do a skill such as inserting a Foley catheter. Instead of the nurse attempting to do something that could cause trauma or injury to the patient, it is the duty of the nurse to ask for help from a colleague and also to read the policies and procedures when it comes to that skill.
Burkhardt, m. & Nathaniel, A. (2020). Ethics & Issues in Contemporary nursing (1st ed.). St.Louis, MO; Elsevier
Peer 2 : Teleological theory is an ethical theory that focuses on the rightness or wrongness of an act based on its end result. The name of the theory comes from the Greek word “Telos”, meaning “end”, and the theory holds that the best ethical choice in a particular situation is the act that results in the greatest good for the greatest amount of people (Burkhardt & Nathaniel, 2020, p. 23). Teleological theory is used routinely in healthcare as providers, nurses, and caregivers make difficult decisions on the distribution of care and resources. Consider a day shift charge nurse creating the assignment for night shift on a busy medical-surgical unit with 20 occupied beds. Two nursing techs were scheduled for the shift, but the hospital’s Patient Flow team has pulled one of the techs to sit with a suicide risk patient on another unit. The medical-surgical unit currently houses an 87-year-old patient experiencing confusion following surgery to correct a hip fracture, who continuously tries to get out of bed and often becomes agitated and physically aggressive with staff attempting to redirect him. The patient has a doctor’s order for a one-on-one sitter, but the only staff available was the second tech on the medical-surgical unit, and the Patient Flow team considered the suicide risk patient to be a higher priority. The charge nurse now faces the decision of whether to place the only remaining nursing tech with the confused patient or to assign the tech to assist with the personal needs of all 20 patients on the unit.
Based on teleological theory, the charge nurse decided to assign the tech to assist with the needs of all 20 patients on the unit. The decision was made based on the idea that patients’ basic needs for toileting, comfort, and cleanliness would be more easily met with an extra staff member, and the nurses would feel less overwhelmed trying to attend to these needs on top of their other duties. Other measures would be employed to maintain the safety of the confused patient, including hourly rounds, bed alarms, and placement nearer to the nurse’s station where he would be visible to the night shift charge nurse who did not have any assigned patients. Better meeting the needs of 20 patients and four nurses is a greater good for more people than ensuring one-on-one observation for one patient for which other safety measures could be implemented.
Deontological theory, whose name comes from the Greek for “duty”, differs from teleological theory in that it judges the rightness or wrongness of an action based on the act itself, regardless of its consequences or end result (Burkhardt & Nathaniel, 2020, p. 26). Nurses are required to adhere to the standards, principles, and protocols that are outlined by the board of nursing in the state in which they live, as well as by the healthcare institution and unit in which they are employed. Consider a patient with a history of stable angina who is admitted to an unmonitored surgical unit following an uncomplicated laparoscopic cholecystectomy. The patient begins to experience chest pain that resembles his usual pattern of stable angina. He expresses to the nurse that he is having chest pain, and following unit protocol, the nurse calls a rapid response and obtains an order for a STAT EKG. The patient is outraged, stating all he needed was his sublingual nitroglycerin, and if he was at home, the pain would have already been resolved without the hassle of tests, bloodwork, and a larger hospital bill. He demands to put in a complaint with the unit’s charge nurse and nurse manager.
According to deontological theory, the charge nurse and nurse manager support the nurse’s decision to call a rapid response, as the unit is unmonitored and the hospital upholds that every complaint of chest pain be taken seriously. Hospital policy requires that a rapid response be initiated on unmonitored units in order to protect heart muscle in the event of a true cardiac event. The patient is frustrated by the personal and financial consequences of the rapid response, but the charge nurse and nurse manager advise him that the nurse acted according to her duty. In line with deontological thinking, this nurse made the best ethical decision.
References
Burkhardt, M. A. & Nathaniel, A. K. (2020). Ethics & issues in contemporary nursing: Nursing ethics for the 21st century. Elsevier, Inc.
