By Helen Caulfield
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The debate then takes place about how best to define need, for example, emergency treatment to save life, or planned treatment to improve the quality of another person’s life. Is it right to give expensive emergency treatment to a motorcyclist who crashed when he was travelling at 80 miles an hour because his needs are more urgent than those being provided through the chiropody services for older people? Need in this case may be defined as life-saving need, in which case those waiting for treatment that would improve the quality of care in their life but who are not in urgent need of treatment would wait until there were resources available to them.
4: NMC competence case in fitness to practice Sunita is an overseas nurse who was admitted to the NMC register after completing an adaptation course in a nursing home. She now works for an NHS Trust in intensive care. The nursing staff are very concerned about her language skills, particularly with the family members of patients. She appears to be abrupt and defensive with them. Also, she does not appear to understand the pressure of the environment and takes a longer time than the other nurses to complete her tasks.
Some nurses will seek to persuade the patient to their way of thinking without realising that this compromises the fundamental right of autonomy. Other patients may agree with the logic of the course of action but just refuse for their own reasons to go ahead and have that treatment. This is where paternalism can conflict with autonomy. Balancing the autonomy of the patient with the professional paternalism to provide the best health outcome is a complex aspect of ethics in nursing practice. Summary • • Ignoring the individual autonomy of the patient is paternalism.