Critical thinking stop point 12.2

Possible answer to: Is your practice as a nurse ethical? 

Thinking about the above section on the patient perspective, would you describe your practice as a nurse as ethical? If so, think of some examples where you have put this into practice. If not, think about what some of the hindrances to proper ethical practice have been. 

The chapter recounts some of the experiences of Diana Rose during a hospital admission in 1999 at the ‘sharp end’ of psychiatry. These experiences included control and restraint, forced injections, ECT, close observations and seclusion. It is also noted that nurses are particularly involved in these coercive aspects of inpatient care. The extent to which such interventions are deemed to be ethical depends upon how legitimate psychiatric interventions are accepted to be. If our ethics are about not doing harm, then clearly there is a problem because all of these forms of coercion are known to cause harm. If our ethics are more pragmatic, and some harm is seen to be justified for a more generally positive outcome of prevention of worse harms, then there may be an ethical defence for coercion. Of course, none of this is certain, and the conclusions drawn may depend on other considerations, such as social and political views. The fact that coercive practices exist under a neo-liberal polity that severely restricts resources also impacts upon nurses’ capacities to act ethically, not least in terms of limiting the availability of non-medical alternatives such as the psychotherapies that many patients prefer.