In December 2019, New York State Governor Andrew Cuomo signed a bill to expand the rights of patients in all health care facilities across New York State (Uddin, 2020) . According to the Governor and state health secretary, the bill would strengthen patients' rights and enhance transparency in all health care facilities. The bill took effect on January 13, 2020, and it requires all health care facilities to develop new policies and change the current practices to accommodate the new changes in the law. The new law states that all patients in a health care facility have the right to be informed of all aspects of care provided. Thus, the health care providers at the nursing home have to fully inform the patients or their representatives their medical condition, the proposed treatment or medication and the patients or representative have to consent for they have the right to refuse. In the event, the patient refuses treatment. The health care facility has to inform the patient of the consequences of refusal. Thus, through the new law, the health care facilities have good faith immunity from patients' refusal to treatment as the patients choose their own care services.
State Recommendation
The new law recommends that all patients in a health care facility have the right to be informed of all aspects of care provided, and they have the right to choose the treatment option.
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Overview of the Problem
Nursing is a very noble profession, and the ethical principles of veracity, autonomy, fidelity, accountability, nonmaleficence, beneficence, and justice must be upheld (Nibbelink and Brewer, 2018). However, there lies a thin line between the boundaries of the principle of beneficence and autonomy. According to the principle of beneficence, a nurse is supposed to offer the best care for the patient to attain better health outcomes. However, the principle of autonomy encourages the nurse to allow patients to make decisions concerning the care options provided. Because of the thin line between the two principles, nurses have had to make decisions for patients overriding the patients' right to autonomy. The new law expands the patients' right to autonomy. Through the law, patients will be fully involved in the care, and the nurse will not be liable in the event patients reject the best treatment options to the patients.
Review of Relevant Research
Many studies have been done to establish the scope of autonomy to patients. According to Nibbelink and Brewer (2018), patients' autonomy is limited in instances where it may lead to harm. Thus, in the event, a patient rejects a treatment a nurse may take the decision to administer the treatment to avoid patients harm. In another study by Houska and Loučka (2019), patients’ autonomy can be overridden when it causes harm to others. In the case, a patient rejects treatment hence exposes the physician or healthcare team to harm, then the right to autonomy is disregarded. A study by Kilbride and Joffe (2018) noted that the issue of autonomy requires appropriate communication, moral reasoning and the respect of empathy.
Application of Research Results
The results of the above research on the application of autonomy indicate that it is one of the ethical principles that need to be cautiously applied. Nurses and physicians need to critically analyze the situation at hand before they allow the patients to make their own decision. This is so as to ensure there no negative consequences to the patient and the physicians.
Policy Implications
The new policy signed into law by Andrew Cuomo, the Governor of New York expanded the rights of patients' autonomy in all healthcare facilities in New York. However, its implementation started on January 13, 2020, a time when the globe had been hit by a deadly infectious disease – the Corona Virus. The Corona Virus disease is very infectious and can lead to death if not managed (Uddin, 2020) . With the danger of the virus in New York, the application of the new law would delay the disease management hence lead to harm to the patient. Secondly, in the event, a patient would refuse the treatment option to disease; it would cause harm to the nurses and health care providers and other people exposed to the patients. The implication of the policy to nurses and healthcare professionals was complicating the coronavirus management process, and in the event, patients would refuse care options then the patient would expose the nurses, healthcare professionals and other people near the patients to harm.
Conclusion
In conclusion, the concept of patients' autonomy still poses an ethical dilemma and creation of strict laws that expand patients' rights and deprive the healthcare professional control of the care poses a threat to harm to the patients, healthcare professionals and other people. It would be prudent that healthcare professionals are empowered to control the levels of autonomy to patients so as to ensure there is no harm to any party out of patient’s decisions.
References
Houska, A., & Loučka, M. (2019). Patients' autonomy at the end of life: A critical review. Journal of Pain and Symptom Management , 57 (4), 835-845.
Kilbride, M. K., & Joffe, S. (2018). The new age of patient autonomy: implications for the patient-physician relationship. Jama , 320 (19), 1973-1974.
Nibbelink, C. W., & Brewer, B. B. (2018). Decision‐making in nursing practises an integrative literature review. Journal of clinical nursing , 27 (5-6), 917-928.
Uddin, K. N. (2020). Corona controversies. BIRDEM Medical Journal , 10 (3), 141-144.
