Four decisions for a middle-aged man.

Snelling, Paul ORCID: https://orcid.org/0000-0002-9781-0784 (2019) Four decisions for a middle-aged man. In: 20th International Nursing Ethics Conference and the 5th International Care Ethics Conference, 24-25 July 2019, University of Surrey. (Unpublished)

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Abstract

Advancing years brings questions about my prostrate, my cholesterol and my lifestyle choice and a surgical procedure into sharp focus, as well as the methods nurses use to educate patients to support decision making
The most regulated information giving is for operative procedures. A recent English legal case recognised the availability of information on the Internet and found that the test of adequate knowledge is no longer what the professional judges, but what a particular patient would want to know. A minority opinion suggested that the information given – in relation to vaginal delivery – was partly driven by a view that normal delivery was morally preferable, but that the woman was entitled to take her own values into account. This is consistent with guidance from the National Institute of Health and Clinical Excellence which sets out ways of giving information which are most easily understood, including using absolute rather than relative risk, frequency instead of percentages, and both negative and positive framing.
This presentation assesses the information given to me to make decisions on operative risk, prostrate screening, whether to take a statin and whether to reduce alcohol intake. For the first three, there is a genuine attempt to present information in a format that can best be understood. However, in relation to alcohol consumption, both for the patient and within educational resources for nurses, information is not presented following the NICE guidance. It is difficult to escape the conclusion that this is because it is driven by value judgements and not by a desire to assist individuals make informed decisions. This may be in line with policies seeking to reduce behaviours, but does not value individual autonomy, or respect persons, both of which are claimed to be fundamental tents of the nursing profession.

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