Nurse’s Ethical Duty in Wound Care

Performing an evaluation, assessment, or management of any type of wound is an ethical endeavor and may present ethical challenges at times. The specific concepts of paternalism, autonomy, beneficence, nonmaleficence, fidelity, role fidelity, veracity, therapeutic privilege, conflict of interest, confidentiality, and justice will be addressed.

The nurse might wonder why consideration of morals is of any importance when what he or she is doing is providing clinical services for some type of wound. The practice of wound care is fraught with areas in which the morals or society’s determination of right and good conduct of the health-care professional may be seriously tested. Understanding the concepts of morals, moral duty, and moral obligation are critical in providing wound care.

Specific obligations and duties for the privilege of professional access to patients, including the following:

• First, the patient’s interests are placed above the personal interest of the nurse. If this duty is overlooked or forgotten, the contract (standard of practice) among the health-care provider, the health-care organization, and the patient is broken. — Example: The health-care provider conducts a seminar and needs wound photographs to supplement the written and verbal components of the presentation. The provider takes photographs of the patient’s wounds solely for the purpose of using them in the seminar. The only reason for taking these photographs is for the convenience of the health-care provider, and therefore the activity is actually for the nurse’s personal interest and not for the patient’s best interest. The patient would need to grant the nurse informed consent to use the photographs to avoid any consideration that the photographs are for personal interest. The nurse would need to assure the patient that any refusals on the patient’s part would have no effect on the nurse-patient relationship or the patient’s treatment.
• The patient’s privacy is protected from another individual’s or society’s desire to know details of the patient’s treatment. It is the health-care provider’s responsibility to have a complete understanding of the legal rights of all involved. It is ultimately the responsibility of the nurse to know the legal rights of the patient, family, and health-care provider. However, in many areas of the world, the general public does not have any legal right to knowledge concerning the patient’s care, progress, or prognosis. The health-care provider must identify if the health-care organization has a policy or procedure concerning this challenge.
• Does the health-care provider have a duty to treat the patient who has a wound(s)?

It is important to remember that this information concerns the ethical decision making only and is not to be construed as presenting a legal argument for or against treatment. Failure to treat may have potential legal consequences.