The moral agency of institutions: effectively using expert nurses to support patient autonomy

Abstract

Patient autonomy-with an emphasis on informed consent and the right to refuse treatment-is a cornerstone of modern bioethics. Within discussions about patient autonomy, feminist bioethicists have argued for a relational approach to autonomy. Under a relational framework, we must look beyond the individual moment of choice to include the role relationships and specific contexts can play in supporting or undermining autonomy. Given the day-to-day interactions they have with patients, nurses play a significant role in helping patients understand the nature of their illnesses and make truly informed decisions. However, the skills of expert nurses also support patient autonomy in more subtle ways. Specifically, nurses develop skills of attunement that help them to find subtle ways to support patient autonomy. However, in order to effectively do this, nurses need institutions that support their professional autonomy. In this paper, I look at the ways nurses have been inhibited in their professional autonomy both as a profession and as individual practitioners. I argue that turning our attention to institutions and the role they play in supporting or undermining nurses' autonomy can help promote nurses' professional autonomy and thereby enhance patient autonomy.

Desenvolvimento, validação, análise da acessibilidade e certificação internacional de um portal de informações sobre saúde e inclusão

“…Os enfermeiros desempenham um papel significativo em ajudar os pacientes a entender a natureza de suas doenças e tomar decisões realmente informadas, apoiando a autonomia dos mesmos (CHARLES, 2017). Nesse sentido, os portais virtuais têm sido muito utilizados por pesquisadores, profissionais de saúde e pessoas com doenças crônicas ou cuidadores como fonte para obtenção de informações de saúde, por permitirem a colaboração entre usuários, na produção e no consumo das informações (MOICK; TERLUTTER, 2012).…”