Nursing research methods and applications

Nursing Theory

The Ethical Implications of Improving the Kidney Donor Pool

Stemming from economic problems, industry shortcomings and educational stagnation, the healthcare industry is due for serious reformation. One of its greatest points of failure is in its concurrence with meaningful ethical standards for nurse practitioners. While there are clearly defined standards for legal treatment and patient's rights, quite often under the duress of the daunting hospital workload, ethical concerns may be relegated behind expedience, convenience or outright misappropriate of practice. Especially in the emergency room where pressure is at its highest, an often shorthanded nursing staff will be forced to overcome myriad physical and emotional limitations. Thus, it is extremely important for a medical facility to retain a lucid and clearly defined code of ethics, behavior and penalties to which nurses can refer in pressurized situations.

Exploring the bioethical theories endorsed by both the American Nursing Association and by the World Health Organization, as well as the applicable effects of ethical practitioner conditions in the emergency room, it is clear that various medical and bioethical deficiencies in a nursing staff will be interrelated. This is to argue that the ethical disposition of the emergency room staff will be directly correlated to the competence of said staff. In most medical settings, this distinction can have a determinant impact on the ability of the staff to preserve life and diminish pain and suffering. However, this is an issue which takes on added dimensions when discussion organ donation and transplant, which require a sensitivity to the needs of both the donor and the patient. By extension, both parties will also typically come with support networks of families, friends and personal physicians, all of which may be impacted by or may impact the demands placed upon a medical staff. For the nursing staff, then, there is a direct ethical imperative to prepare for the specific humanitarian implications of conducting such a transplant.

As this study will be dedicated to finding ways to increase the number of kidney donors entered into the donor pool, it will be important to remain abreast of all due ethical considerations in doing so appropriately. The International Review Board will play a direct part in this process, providing a set of reference points for determining ethical compliance before proceeding with certain campaign methods. In attempting to increase the pool of available donors, it will be necessary to ensure that the modes of achieving this increase are restrained by acknowledgement of bioethical parameters and legal issues specific to organ donation.

This will also be guided by the principles of humanitarian medical attention accorded by our chosen theoretical framework. In such theories as Margaret Newman's "Health as Expanding Consciousness" model, it is clear that the decisions which a nurse must make regarding which information to apply and which to disregard will be founded on the intercession between a complete understanding of the bases for such theories and the particulars of a patient in question. Conjecturing that a nurse will provide a specific emotional connection and psychic closeness to "people facing the uncertainty, debilitation, loss and eventual death associated with chronic illness," Newman's model illustrates that in such cases of intractable affliction, the theoretical approach taken by the nurse will bear as instrumental an impact as will the proficiency of medical attention offered. (Newman, 1) Here, it can be evidenced that the empathy accorded by the theoretical framework will provide an ideological umbrella for how best to address one's condition while simultaneously abiding the regulatory medical requirements common to most forms of modern treatment.

This means possessing a degree of pertinent information where nursing theory is concerned that will allow for such pragmatism and a firm understanding of the practices pertinent to kidney donation as denoted in the annotated bibliography provided here below.

Cohen, E. & Pifer-Bixler, J. (2009). Surgeons Remove Health Kidney Through Donor's Vagina. CNN. Online at http://www.cnn.com/2009/HEALTH/02/03/kidney.vagina.surgery/index.html

The article here described a first-ever successful procedure in which a healthy kidney was removed through a donor's vagina rather than through traditionally employed and far more invasive surgical procedures. This is useful to our discussion because it reduces the strain and cosmetic impact of making a kidney donation. The article cites the possibility that this new procedure could help to encourage potential donors.

Griffin, D. & Fitzpatrick, D. (2009). Donor Says He Got Thousands For His Kidney. CNN. Online at http://www.cnn.com/2009/WORLD/meast/09/01/blackmarket.organs/index.html

This article describes figures and exchanges on the organ black market. The piece identifies black market kidney sales and purchases as violated specific U.S. laws but also of occurring with some degree of regularity. This demonstrates both the serious need for available kidneys in the legitimate medical context that justifies the research project and simultaneously highlights the serious ethical dilemmas that enter into asking live, healthy donors to part with a kidney.