Preventive Ethics with the Elderly

To be effective advocates for the elderly, nurses must understand that the communication of information is essential. Good information permits older persons to make choices that are in line with their own beliefs and values. But it is the nurse's knowledge of the patient that allows appropriate information to be given both to the patient and to others who assist in the advocacy role. Nursing judgment is part of the advocacy role. Thorough data gathering about the patient assists the nurse's clinical judgment by identifying what the patient knows and does not know about his/her condition. As an advocate, the nurse engages in preventive ethics by encouraging patient choice and by anticipating and giving direction for possible future decision-making. For example, when patients predetermine their choices about end-of-life care they are more likely to be spared treatments they do not want. Assistance with understanding the nurse's role in facilitating quality end-of-life care can be found in the ANA's position statements.

Preventive ethics also includes nursing judgments that forecast problems before they arise. For example, when the nurse observes that the patient and his/her family either do not understand information that has been given to them or the implications of following a given course of action, then the nurse engages in preventive ethics by supplying that information. The nurse acts to prevent negative consequences that can potentially arise as a result of poorly understood information. Many problems in health care occur as a result of poor communication or because information has been provided too late for reasoned decision-making.

Preventive ethics also includes social and political activism, in concert with other nurses or professional nursing organizations, in order to effect those changes in the health care environment needed to avert potential hazards for patients.