The Pros And Cons Of Patient Abuse Reporting

The first major ethical challenge discussed in the study involves the dilemma of removing the patient from harm but still obtaining their consent. With mandatory elder abuse reporting, nurses may be more keenly focused on the issue and are obligated to report it. The challenge involves the ethical principle of beneficence, defined as to “do good” (Butts & Rich, 2013, p. 446) for the patient. Health care professionals want to provide adequate care and reporting suspected abuse can help remove the patient from harm and stop the abuse from occurring. However, nurses may be hesitant to report abuse, especially if the patient is not willing to report it themselves. If a health care professional reports a suspected case “in good faith, [they are] protected from
criminal or civil penalty for reporting suspected abuse if that does not turn out to be the case” (Stanford School of Medicine, 2014). So, it is better for a nurse to report any type of suspicious abuse. Nurses have always been taught to respect a patient’s autonomy, defined as “the ability to make independent decisions for oneself and to have those decisions respected by others” (Butts & Rich, 2013, p.
446). If a nurse is mandated to report suspected abuse, then she may believe that the patient’s ability to make independent decisions is not being respected or acknowledged. Many older adults are afraid to report abuse and refuse interventions and services because of “fear of reprisals by the abusing relative, fear of criminal action against the relative, or guilt for causing family tensions” (Gilbert, 1986, p. 55). It becomes difficult for health care professionals to remove individuals from harm by reporting the incident while still respecting the autonomy of the patient. One way health professionals can respect one’s autonomy is “to assess the capacity of older adults for self-determination in addition to assessing the likelihood that they have been abused” (Gilbert, 1986, p. 60). If an adult has the ability to make his or her own decisions, then he or she is the one, not the nurse, who should decide if they are being abused and if they want to report it. Nurses can use persuasion as a way to influence a
patient. Using “rational persuasion to convince a person of something proposed by another…[can] facilitate autonomous decision-making” (Dunbar, 2003, p. 41). Patients will be encouraged to make these reports on their own. Nurses need to be able to obtain consent from competent adults while trying to remove the patient from dangerous situations.