Nurses are tasked with making ethical decisions every day. In order to make ethical decisions, a nurse must consider the commitment to do the right thing, the consciousness and awareness of acting consistently, and the competency in their nursing skills. Ethical decisions produce and maintain trust; exhibit responsibility and respect; and are persistent with good citizenship .
Using these principles in conjunction with the Four-Topics Method for Analysis of Clinical Ethics Cases, ethical decisions can be made in everyday practice. Often in my practical experience I encounter patients that request antibiotics, sometimes these medications are justified but others they are not. While I am not the prescribing professional, it is still my job to advocate for my patients when I feel that medications are warranted .

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The first topic regarding ethics is Medical Indication. In cases of prescribing antibiotics to cases of viral or no infection, the patient’s medical problem does not call for them so giving them to patients is simply not ethical. The goals of treatment would always be to limit and remove infection, but antibiotics are not the correct way to achieve those goals. The use of antibiotics are not indicated for the chief complaint. Antibiotics will not produce success. The patient will not benefit from the use of antibiotics therefore, they should not be supplied .

The second consideration for ethical nursing and decision making is the Patient. In the case of requested antibiotics, the patient should be informed regarding what antibiotics are used for and fully educated about their condition. Considering the mental capacity of the patient in order to understand this information is important for patient satisfaction when their request for antibiotics is refused .

Quality of life is next consideration when making nursing decisions. Under the circumstances of not prescribing antibiotics to a patient that does not require them will allow the patient to return to a normal healthy lifestyle. Antibiotics will not cure situations in which they are not suited. There will be no change if they are used inappropriately. While some patients might feel that their quality of life will be improved with the use of these drugs, it will in fact make no difference. Withholding antibiotics when they are needed and will make a difference will affect the quality of life for the patient, but the opposite situation will not .

The final piece of the puzzle is justice and fairness. There are no conflicts of interest regarding the treatment with antibiotics. There are no special deals from the manufacturers for the prescribing of the medications. There are no other parties associated with the decision to give antibiotics.  Family members and third parties generally are not affected by these decisions. Patient confidentiality is not an issue. Financial factors do not cause a conflicts of interest as it actually saves the patient and insurance companies money but not prescribing a drug. Not giving this medication also prevents scarcity of health resources. Deny the medication also prevents any religious issues as it is keeping the medication from the patient .

Overall, the only negative aspect of not prescribing antibiotics when they are requested but not warranted is the upset it might cause the patient, but with proper education and explanation of how antibiotics work and the patient’s own medical conditions, this should be overcome easily.

    References
  • Butts, J., & Rich, K. (2016). Nursing Ethics (4th ed.). Burlington, MA: Jones & Bartlett Learning, LLC.
  • University of California San Diego. (2002). Making Ethical Decisions: Process. Retrieved from University of California San Diego: http://blink.ucsd.edu/finance/accountability/ethics/process.html