Heath care is a dynamic environment and one in which consumerism is expanding. Patients and families are more educated and involved in their care than ever before. The movement toward health consumerism has spawned additional ethical conundrums. The American Heart Association, American Association of Critical-Care Nurses, Emergency Nurses Association, and other health care entities have all addressed the topic of family presence during resuscitation and/or invasive procedures. Clinicians and researchers have cited a multitude of ethical principles when supporting arguments for or against family presence during resuscitation. On one hand family presence may be unhealthy for the family and cause untoward provider stress during an already tense situation. However, on the other hand do families have the right to attend these events and might it be beneficial for closure and education. Members of the health care team must evaluate both sides of the question.
Nurses serve as vital members of hospital resuscitation teams and as such family presence during the process directly impacts nursing. Nurses account for the largest group of health care professionals in the nation (IOM, ***). Therefore, it should not be unexpected that they are thought of as the face of health care. Nurses provide not only direct patient care and education, but also frequently interact with the families of their patients. In a resuscitation situation nurses are called to serve in vital roles. Families are likely to look to a familiar and comforting figure for direction and information during this stressful and critical time. The nursing staff will need to facilitate caring for the patient as well as the family which could result in role strain and complicate care. Nursing is often the member of the team that works closely with the family when the patient is unable to be resuscitated successfully. It is during this time that having family present may aid in facilitating closure and assurance everything possible was done. In my clinical practice I have worked in mostly environments in which family was not precluded from attending the resuscitation. However, the practice was not necessarily encouraged and policies regarding the matter were nonexistent.
Autonomy, justice, beneficence, and nonmaleficence are some of the ethical principles cited by those in support of family presence during resuscitation. In relation to medical ethics, autonomy is defined as respecting the ability of others to make their own decisions without outside influence (Butts & Rich, 2011). Supporter argue that...