To Disclose or to Not Disclose: Nursing and the Ethics of Nondisclosure in the Dying Patient Essay

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To Disclose or To Not Disclose:
Nursing and the Ethics of Nondisclosure in the Dying Patient
Kally L. Price
Samuel Merritt University

In nursing, the practice of nondisclosure is an ethical issue that calls into question the founding principles of trust, integrity, and autonomy in the nurse-patient relationship. Although the decision of nondisclosure to the terminal patient is the physician's, the nurse must follow and support this decision. The right of the patient to have control over their own healthcare information, and their right to know their diagnosis and prognosis and make treatment decisions are supported by the American Hospital Association, The Patient Self Determination Act, which requires education on
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Patients must be able to make informed decisions in regards to their medical treatment. The practices of informed consent and education on advanced directives (as required by The Patient Self-Determination Act) reinforce the rights of the patient to stay informed and to play a central role in the decision making process in their end of life medical care (Cochella & Pederson, 2003). In order to get the terminal patients on board for a risky treatment modality, the gravity of their illness must be put into the balance in order for the patient to make an informed decision (Krisman-Scott, 2000). iii. Analysis It is central to the role of nursing to recognize the patient's autonomy, their ability to participate in their own healthcare regimen and power to move themselves to independence and better health (Black & Chitty, 2011). The American Hospital Association acknowledges the patient's right to their healthcare diagnosis and treatment options (Black & Chitty, 2011). California's 2008 Terminal Patients’ Right to Know End-of-Life Options Act requires physicians, upon request, to fully disclose all end-of-life care options including: voluntary stopping of eating and drinking, refusal or withdrawal of life extending measures, and hospice, palliative care and sedation (Morrow, 2008). The Code of Ethics for Nurses (Provision 3) requires that nurses