Ethics
1. The part that had the biggest impact is that they lured oblivious men, into a study that they knew absolutely nothing about. They were lied to, with a promise of treatment from a painful disease and medical care. When in actuality, those leading the research had no intentions of treating them at all. Reading about the study is hurtful, but what hurts more is that those men look just like me. They could very well be a relative of mine.
The Belmont Report says in order for there to be a “Respect for persons”, there must be informed consent. Likewise, the participants must understand exactly what they are signing up for or agreeing to. The Tuskegee Study was done without informed consent. The participants blindly agreed to treatment and medical benefits. Although they did receive healthcare, some free food, and burial insurance, the promise of treatment for syphilis was never seen…intentionally. The CDC reports that there is no indication that the men were ever informed of the study, and that they were actually deceived the entire time (2020). In addition, the Belmont Report explains that “Respect for Person” also entails that the person make an autonomous choice. The Belmont Report states being autonomous allows the person to think about the clear and concise information presented to them and decide based off of that information (U.S. Department of Health and Human Service, 2017). If the researchers had talked with those men and thoroughly explained what the study truly entailed, they probably would not have willingly consented to it. I believe the researchers knew that.
2.
We are presented the Tuskegee Syphilis Study and how it affected their human subjects as well as the Belmont Report that discusses the ethical principles with research. The Tuskegee Syphilis Study’s goal was to examine the effects of syphilis. They recruited poor African American men to study the effects however they failed to tell the men the actual purpose of the study. The part of the study that was most impactful to me was the fact that this study was conducted over a span of 40 years and there were deliberate efforts made to make the actual purpose of the study unknown to the human subjects.
Per the Belmont report, the respect to persons was violated. This ethical principle serves to allow a patient or subject autonomy which is the giving the individual the information that would allow them the ability and freedom to make decisions on their behalf. Because the study did not get informed consent from the participants, the patients did not have ability to make decisions about their treatment. Throughout the 40-year period, the study continuously either withheld proper treatment or implemented treatment that caused more harm than good without once notifying the participants.
QUALITY IMPROVEMENT
1. This is a situation that many nurses have likely been in, maybe not with the same outcome but having to prioritize your patients is a part of nursing. At the time she only had one patient in crisis and therefore prioritized that one. A systems-based solution that I think could have really helped in this situation is a nursing back-up system. By this I mean in addition to each nurse’s assigned patient load it is decided that they will back each other up. When nurses take their breaks, this is already something that is implemented but it could always be utilized to ensure that proper patient care is always provided. On every unit, I have seen the nurses have some sort of pager or phone for calls but also for alerts on their patients. The alerts should be sent to the backup as well, so every patient is being looked after, it would be used as a fail-safe. This quality improvement would allow for an improved system, productivity, and provide quality outcomes by ensuring a backup plan is already built into the day-to-day running of the unit (Shirey et al., 2011). If this nurse had an assigned backup for her other patient then maybe this scenario would have played out differently, the care she was providing was not wrong but the system of monitoring other patients within this unit is what was flawed in this situation.
2. The integration of nursing informatics system would have been useful in preventing the event. This is because the employment of computerized intelligence is applied to enable the nurses to be aware of patient status. In addition, the system allows nurses to monitor changes in patient vitals identifying emergency on a patient’s status. Care planning, as well as care evaluation enabled through the informatics system, increases efficiency in patient care through assessment and timely monitoring of patients (Masic et al., 2010). The response obtained from system information articulates the needs that patients have. Additionally, the information can be shared with other nurses on shift leading to timely responses as the system supports information dissemination to authorized personnel. Also, the system would have enabled workload assessment, limiting such events associated with nurses missing second patient crises. Provision of patient records enables the nurses to evaluate changing needs by the patient for quality assurance (Masic et al., 2010). This is useful in quality support in patient care.
