Posts Tagged ‘ethical issues’

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Do Patients Have a Right to Choose Providers Based on Race?

October 11, 2010

By mmarcotte51/via Flickr

By Shawn Kennedy, AJN editorial director

We have a wonderful librarian here at AJN who is always on the alert for news about nursing and nurses. Recently she sent me a clipping about a legal case, Chaney v. Plainfield Healthcare Center in Indiana’s Court of Appeals, which has important ramifications for nurses. The court ruled in favor of Brenda Chaney, a certified nursing assistant, and reversed the decision of the lower court that had ruled in favor of the Plainfield Healthcare Center nursing home.

Brenda Chaney brought suit against the nursing home for complying with a resident’s request not to have any black health care workers provide care or enter her room. (She also claimed her firing had been racially motivated. The court agreed that it seemed discriminatory.) The court agreed with Chaney that by acceding to the patient’s wishes, her employer created a hostile workplace and violated her rights. The nursing home claimed it was protecting the patient’s rights and that not doing so “risked violating state and federal laws that grant residents the rights to choose providers, to privacy, and to bodily autonomy.” The court did not agree. The crux of the decision is this:

“In any event, Indiana’s regulations do not require Plainfield to instruct its employees to accede to the racial preferences of its residents. The regulations merely require Plainfield to allow residents access to health-care providers of their choice. 410 IND. ADMIN. CODE 16.2-3.1-3(n)(1). If a racially-biased resident wishes to employ at her own expense a white aide, Indiana law may require Plainfield to allow the resident reasonable access to that aide. But the regulations do not say that a patient’s preference for white aides that Plainfield employs trumps Plainfield’s duty to its employees to abstain from race-based work assignments.”

I can’t believe this has been the only case of such discriminatory patient assignments—and wonder if nurses elsewhere have dealt with similar situations.

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(Editor’s note: For a little more context, here’s a San Francisco Chronicle story that gets at the role the patients’ rights movement may have inadvertently played in determining the nursing home’s approach.-JM)

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Nurses Under the Influence of Pharma—Not Just an NP Problem

July 1, 2010

By Shawn Kennedy, AJN editorial director/interim editor-in-chief

On his blog yesterday, health news watchdog Gary Schwitzer’s note about a conference he attended on whether pharmaceutical companies should fund medical education pointed out that “nurses are not immune from drug industry influence.” He focused, though, just on NPs who prescribe medications. ALL nurses are subject to influence.

When’s the last time you were at a large nursing conference? I go to many—at the major meetings, the exhibit halls are filled with vendors giving away everything from free ice cream and pens (I once collected 32 just to see how many I could get) to mugs and cash. If you filled out surveys, giveaways were worth more—you could be put in a drawing for a laptop or iPhone. 

The danger of an NP succumbing to influence is obvious—she or he may prescribe for reasons (which may be on an unconscious level) other than clinical ones. The issues for nurses who do not prescribe medications are subtle and different. AJN‘s ethics columnist Doug Olsen did a two-part series exploring this last year—in January and February 2009. And AJN‘s editor-in-chief emeritus Diana Mason wrote on this even earlier, in an editorial in December 2000, noting, among other concerns, that “it’s not unusual to see drug company underwriting of speakers at nursing conferences; of course, the topic addressed is almost always related to one of the company’s top drugs.”

Nurses have been proud of our high ranking on Gallup polls as one of the most trusted professions. We need to make sure we continue to earn that ranking.

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