HOW POSSIBLE IS ETHICAL NURSING CARE IN THE PRESENCE OF VIP PATIENTS?

Öz

ABSTRACT VIP patient means a very important person or a very influential patient from the perspective of health professionals. Among all health professionals, nurses are more exposed to ethical problems in nursing care of VIP patients. The number of studies examining the nursing care of VIP patients from an ethical perspective is very limited. The aim of this review is to critically analyze the ethical issues of VIP patients in nursing care according to ethical principles. When ethical principles are analyzed, VIP patients are disadvantaged compared to other patients in terms of the principle of privacy, but they are very advantageous in terms of the principles of autonomy, equality, nonmaleficence, beneficence and justice, and this situation may harm other patients. Nurses are under great moral distress due to the endless demands and compulsions from VIP patients and their relatives, managers, superiors and other health professionals. In this situation, nurses may allocate their resources and time to VIP patients unethically and to the detriment of other patients. In conclusion, VIP nursing care is inconsistent with nursing ethics, values and philosophy. Ethical nursing care of VIP patients is not possible except to treat a serious illness of an important public figure without guaranteeing the public interest or the benefit of other patients. Keywords: Nursing Care, Nursing Ethics, Principle Based Ethics, Recommended Patient, VIP Patients

Anahtar Kelimeler

• Nursing Care
• Nursing Ethics
• Principle Based Ethics
• Recommended Patient
• VIP Patients

VIP HASTALARIN VARLIĞINDA ETİK HEMŞİRELİK BAKIMI NE KADAR MÜMKÜN?

Öz

ÖZET VIP hasta, sağlık profesyonellerinin bakış açısından çok önemli bir kişi veya çok etkili bir hasta anlamına gelir. Tüm sağlık profesyonelleri arasında hemşireler, VIP hastaların hemşirelik bakımında etik sorunlara daha fazla maruz kalmaktadır. VIP hastaların hemşirelik bakımını etik açıdan inceleyen çalışma sayısı oldukça sınırlıdır. Bu derlemenin amacı, VIP hastaların hemşirelik bakımında etik sorunları etik ilkelere göre eleştirel olarak analiz etmektir. Etik ilkeler incelendiğinde VIP hastalar mahremiyet ilkesi açısından diğer hastalara göre dezavantajlı ancak özerklik, eşitlik, zarar vermeme, yararlılık ve adalet ilkeleri açısından oldukça avantajlı durumdadırlar ve bu durum diğer hastaların zarar görmesine neden olmaktadır. Hemşireler, VIP hasta ve yakınlarından, yöneticilerden, üstlerinden ve diğer sağlık çalışanlarından gelen bitmek bilmeyen talep ve zorlamalar nedeniyle büyük bir ahlaki sıkıntı da yaşamaktadırlar. Bu durumda hemşireler kaynaklarını ve zamanlarını VIP hastalara etik olmayan bir şekilde ve diğer hastaların zararına olacak şekilde ayırabilirler. Sonuç olarak, VIP hemşirelik bakımı hemşirelik etiği, değerleri ve felsefesi ile uyuşmamaktadır. VIP hastaların etik hemşirelik bakımı, ancak önemli bir kamusal figürün ciddi bir hastalığını kamu yararına veya diğer hastaların yararını garanti altına almadan tedavi etmek dışında mümkün değildir. Anahtar Kelimeler: Etik İlkeler, Hemşirelik Bakımı, Hemşirelik Etiği, Önerilen Hasta, VIP Hastalar

Anahtar Kelimeler

• : Etik İlkeler
• Hemşirelik Bakımı
• Hemşirelik Etiği
• Önerilen Hasta
• VIP Hastalar

Kaynakça

1. Alfandre, D., Clever, S., Farber, N. J. et al. (2016). Caring for ‘very important patients’—ethical dilemmas and suggestions for practical management. The American Journal of Medicine, 129(2), 143-147. https://doi.org/10.1016/j.amjmed.2015.09.019
2. Alkhawaldeh, I. M., Jaradat, J. H., Amro, R. et al. (2024).The recommended patient syndrome: Charting new frontiers. Qatar Medical Journal, 2024(4), 68. 1-7. https://doi.org/10.5339/qmj.2024.68
3. American Nurses Association. (2015). Code of ethics for nurses with interpretative statements. Silver Spring, MD. www.Nursesbooks.org
4. Bani Issa, W., Al Akour, I., Ibrahim, A. et al. (2020). Privacy,confidentiality, security and patient safety concerns about electronic health records. International nursing review, 67(2), 218-230.https://doi.org/10.1111/inr.12585
5. Barnett, P., and Bagshaw, P. (2020). Neoliberalism: what it is, how it affects health and what to do about it. The New Zealand Medical Journal (Online), 133(1512), 76- 84.
6. Baru, R. V., & Mohan, M. (2018). Globalisation and neoliberalism as structural drivers of health inequities. Health research policy and systems, 16(Suppl 1), 1-29. https://doi.org/10.1186/s12961-018-0365-2
7. Beauchamp, T. L., Childress, J.F. (2013). Principles of biomedical ethics. 7th ed. New York: Oxford University Press.
8. Boluktas, R. P., Ozer, Z., and Yildirim, D. (2018). Investigation of the International Nursing Oath in terms of Professional Values. Istanbul Sabahattin Zaim University Journal of Social Sciences, 6(13), 83-98. Campbell, S. M., Ulrich, C. M., Grady, C. et al. (2018). A broader understanding of moral distress. In Moral distress in the health professions. The American Journal of Bioethics, 16(12), 2–9. https://doi.org/10.1080/15265161.2016.12397 82

9. Caruso Brown, A. E., Arthur, J. D., Mutrie, L. H. et al. (2019). Seeking a second opinion on social media. Pediatrics, 144(5). 1-4. https://doi.org/10.1542/peds.2019-0817
10. Cheraghi, R., Valizadeh, L., Zamanzadeh, V. et al. (2023). Clarification of ethical principle of the beneficence in nursing care: an integrative review. BMC nursing, 22(1), 1-9. https://doi.org/10.1186/s12912-023-01246-4
11. Conlon, D., Raeburn, T., and Wand, T. (2024). Nurses’ understanding of their duty of confidentiality to patients in mental health care: A qualitative exploratory study. Collegian, 31(3), 144-153. https://doi.org/10.1016/j.colegn.2024. 02.002
12. Evrenol Ocal S, Simsek Cetinkaya S, Yucel C. et al. (2020).Gene Replacement in the Prevention of Hereditary Mitochondrial Diseases: Three Parent Babies and Ethics. Arc Health Sci Res, 7(2): 201-206. https://doi.org/10.5152/ArcHealthSciRes.2020.58939
13. Geiderman, J. M., Malik, S., McCarthy, J. J. et al. (2018). The care of VIPs in the emergency department: triage, treatment and ethics. The American Journal of Emergency Medicine, 36(10), 1881-1885. https://doi.org/10.1016/j.ajem.2018.07.009
14. Georges, E. M., Anzia, J. M., and Dinwiddie, S. H. (2012). General effect of VIP patients on delivery of care. Psychiatric Annals, 42(1), 15-19. https://doi.org/10.3928/00485713-20111229-04
15. Gershengoren, L. (2016). Our duty to the “VIP Patient”. Journal of Graduate Medical Education, 8(5), 784-784. http://dx.doi.org/10.4300/JGME-D-16-00468.1
16. Guzman, J. A., Sasidhar, M., and Stoller, J. K. (2011). Caring for VIPs: nine principles. Cleve Clin J Med, 78(2), 90-94.https://doi.org/10.3949/ccjm.78a.1011
17. Hedman, M., Haggstrom, E., Mamhidir, A. G. et al. (2019). Caring in nursing homes to promote autonomy and participation. Nursing ethics, 26(1), 280-292. https://doi.org/10.1177/0969733017703698
18. ICN. (2021). The ICN Code of Ethics for Nurses: Revised 2021. In International Council of Nurses. International Council of Nurses.https://www.icn.ch/sites/default/files/inline-files/201 2_ICN_Codeofethicsfornurses_ eng.pdf
19. Kaya, A., Boz, İ. (2019). The development of the professional values model in nursing. Nursing ethics, 26(3), 914-923. https://doi.org/10.1177/0969733017730685
20. Keskin, A. Y. (2020). Ethical Approaches in Nursing. The Concept of Ethics, Historical Process, Types of Ethics, Ethical Theories, Ethical Codes and Ethical Principles for Nurses (pp.1-12), Ankara: Akademisyen Publishing.
21. Labonté, R., Stuckler, D. (2016). The rise of neoliberalism: how bad economics imperils health and what to do about it. J Epidemiol Community Health, 70(3), 312- 318. https://doi.org/10.1136/jech-2015-206295
22. Marcangelo, M. (2012). Consultation-liaison psychiatry for the VIP patient. Psychiatric Annals, 42(1), 20-24. https://doi.org/10.3928/00485713-20111229-05
23. McIntosh, J. T. (2020). VIP care: ethical dilemmas and recommendations for nurses. Nursing ethics, 27(3), 809-820. https://doi.org/10.1177/0969733019878833
24. Morley, G., Ives, J., Bradbury-Jones, C. et al. (2019). What is ‘moral distress’? A narrative synthesis of the literature. Nursing ethics, 26(3), 646-662. https://doi.org/10.1177/0969733017724354
25. Pourmand, A., LeSaux, M., Pines, J. M. et al. (2017). Caring for VIPs in the emergency department: Are they VIPs or patients? The American journal of emergency medicine, 36(5), 895-896. https://doi.org/10.1016/j.ajem.2017.09.037
26. Rooddehghan, Z., Yekta, Z. P., and Nasrabadi, A. N. (2018). Ethics of rationing of nursing care. Nursing ethics, 25(5), 591-600. https://doi.org/10.1177/0969733016664973
27. Sakellariou, D., and Rotarou, E. S. (2017). The effects of neoliberal policies on access to healthcare for people with disabilities. International journal for equity in health, 16, 1-8. https://doi.org/10.1186/s12939-017-
28. Kaya & Süha / TFSD, 2025, 6(2), 62-69690699-3 Schenkenberg, T., Kochenour, N. K., and Botkin, J. R. (2007). Ethical considerations in clinical care of the “VIP”. The Journal of Clinical Ethics, 18(1), 56-63. https://doi.org/10.1086/J CE200718109
29. Simsek, H., Kilic, B. (2012). Basic concepts related to inequalities in health. Turkish Journal of Public Health, 10(2), 116-127. https://doi.org/10.20518/tjph.173070
30. Sonmez, S., and Cevik, C. (2021). Elderly and Inequalities in Health. Humanistic Perspective, 3(2), 496-511. https://doi.org/10.47793/hp.943515
31. Tekingunduz, S., Kurtuldu, A., and Isik Erer, T. (2016). Inequality and ethics in health services. 8(4), 32-43. Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28. https://doi.org/10.1159/000509119
32. Vincent, J. L., Mariano, E. C., and McLeod, J. A. (2007). Emergency care for the VIP patient. In Intensive Care Medicine: 2007 Annual Update (pp. 969-975). Springer Berlin Heidelberg. https://doi.org/10.1007/978-3- 540-49433-1_88
33. Watson, J. (2009). Assessing and measuring caring in nursing and health sciences. New York: Springer. Watson, J., (2012). Human Caring Science: A Theory of Nursing, 2nd ed. Jones & Bartlett Learning, Sudbury, MA. Zhou, J., Qin, Q., Chen, S. et al. (2024). Moral Dilemmas Regarding Physical Restraints in Intensive Care Units: Understanding Autonomy, Beneficence, Non- Maleficence and Justice in the Use of Physical Restraints. Journal of Multidisciplinary Healthcare, 1619-1627. https://doi.org/10.2147/JMDH.S455910