AN EVALUATION OF THE PROFESSIONAL ETHICS AND ETHICAL CHALLENGES RELATED TO NURSES AND PATIENTS IN CAMEROON

CHAPTER ONE

INTRODUCTION

Background of the Study

One vital component of the medical team is the nurse. Nonetheless, it has long been recognised that doctors and nurses must provide patients with treatments that maximise benefits while minimising danger. Both the Florence Nightingale Oath for Nurses and the Hippocratic Oath, which physicians take upon completing their training, make this very plain (Miracle, 2019). Healthcare professionals (HCPs) who possess sufficient ethical knowledge may be able to provide patients with higher-quality care and be better equipped to handle ethical challenges that come up in normal consultations. 

A healthy society requires ethics, and because of its beneficial effects on individuals, organisations, and society as a whole, researchers, educators, and managers of associations and organisations are always driven to maintain and raise the bar on ethics (Ghorbanizadeh & Kariman, 2019). Dehghani, Mosalanejad & Dehghan-Nayeri (2018) state that the mission of nursing is to provide essential healthcare, nursing, medical, and rehabilitative services at the highest standard to ensure, preserve, and promote community health. They also state that adherence to ethics is an intrinsic part of nursing professionalism. Innovations in the area have an impact on nursing ethics, a subset of medical ethics (Horton et al., 2019). Furthermore, nurses do not need to become experts in ethics; they only need to be aware of the fundamentals of ethics and familiar with related topics. 

Nursing ethics, according to Adib-Hajbaghery & Aminoroayaei (2020), addresses issues including autonomy, beneficence, respect for human life, non-maleficence, honesty, and secrecy. Positive outcomes, including enhanced healthcare quality and patient satisfaction, decreased negative factors in teamwork, increased job satisfaction, and positive relationships among colleagues, increased organisational commitment and emotional attachment, increased spirituality in the work environment, increased citizenship behaviours, and decreased deviant behaviours in the workplace, can result from adhering to ethical principles and standards in the workplace, especially in nursing (Valentine, 2019; Niazazari et al., 2020; Niazazari et al., 2020). Furthermore, Pennino (2019) categorize influential factors on nursing ethics into three aspects: individual, organizational, and environmental. 

Professional functioning has become an essential component of today's healthcare systems due to developments in healthcare systems. According to Tiruneh, M.A. and B.T. Ayele (2019), "professional functioning" is a word that is frequently used in nursing education and is a crucial component of nursing practice and ethics. Baille and associates, however, think that nursing should put caregiving ethics ahead of medical reasons.Nursing ethics standards state that a nurse's main duty is to put the needs of their patients first and foster an atmosphere that upholds people's rights, values, and dignity (Kangasniemi, Pakkanen & Korhonen, 2019). The biggest problem is their capacity to apply ethical components in clinical settings, even though the majority of nurses and nursing students are aware of the ethical features of their job and their importance. However, the reason ethics are important to study is that laws, policies, and other processes won't work well if ethical principles aren't internalised by a society and its institutions. Thus, this study seeks to evaluate the professional ethics and ethical challenges related to nurses and patients in Cameroon.

Statement of the Problem

Nurses in industrialised nations attest that biomedical ethics training has improved their attitudes and behaviours about ethical matters (Johnston and Haughton, 2018). However, it has frequently been noted that HCPs' knowledge of bioethical concepts and their application of the code of ethics are inadequate in the global south, especially in settings with limited resources (Monsudi et al., 2018; Tiruneh & Ayele, 2018). There are not enough research on healthcare ethics among medical practitioners in several low- and middle-income countries.

In Cameroon, medical schools that train doctors, together with some institutions that train nurses and other healthcare professionals, such as laboratory scientists, are the main recipients of ethics education. Numerous organisations, including the national ethics committee, CAMBIN (Cameroon Bioethics Initiative), and research ethics committees located in the health sciences faculties of all public universities, contribute to the nation's efforts to promote ethics education. Even though many doctors and nurses receive ethics education as part of their training, there have been instances in the past of unethical behaviour on the part of some medical professionals who engaged in unethical behaviour when advising or interacting with patients in various hospitals across the nation (Essomba et al., 2019; Benjamin and Bayemi, 2020). 

Furhermore, the lack of proper funding for Cameroon's healthcare system frequently results in staffing shortages, restricted access to cutting-edge medical technologies, and shortages of necessary medical supplies (Ajei, 2022). Because of these shortcomings, nurses are forced to make morally challenging choices, like allocating patients' treatment priorities according to the severity of their diseases. Additionally, The fact that doctors and other higher-ranking healthcare professionals frequently have the power to direct nurses can create ethical dilemmas, especially when the nurses' professional judgement is ignored or disregarded (Ngoh, 2020). The autonomy principle may be compromised by this dynamic, which affects patients whose treatment may be impacted by hierarchical decision-making rather than needs-based care, as well as nurses in the performance of their professional obligations. Hence, it is in the light of these challenges, the study seeks to evaluate the professional ethics and ethical challenges related to nurses and patients in Cameroon.

 1.3  Objectives of the Study

The main purpose of this study is to evaluate the professional ethics and ethical challenges related to nurses and patients in Cameroon. Specifically, the study will;

Assess the level of adherence to professional ethics among nurses in Cameroon.

Identify the common ethical challenges faced by nurses in their interactions with patients in Cameroon.

Evaluate the impact of ethical challenges on the quality of patient care provided by nurses in Cameroonian healthcare facilities.

Investigate the strategies employed by nurses to manage ethical dilemmas in their daily interactions with patients.

1.4  Research Questions

The following questions have been prepared for the study:

What is the level of adherence to professional ethics among nurses in Cameroon?

What are the common ethical challenges faced by nurses in their interactions with patients in Cameroon?

How do ethical challenges impact the quality of patient care provided by nurses in Cameroonian healthcare facilities?

What strategies do nurses employ to manage ethical dilemmas in their daily interactions with patients?

1.5 Research Hypotheses

H0: There is no significant relationship between professional ethics and the quality of patient care in Cameroon.

Ha: There is a significant relationship between professional ethics and the quality of patient care in Cameroon.

1.6 Significance of the Study

For nurses and other healthcare professionals, the study will serve as a crucial tool for understanding the ethical dilemmas they face daily and how to navigate these challenges while upholding the highest standards of patient care.Furthermore, subsequent researchers will use it as a literature review. This means that other students who may decide to conduct studies in this area will have the opportunity to use this study as available literature that can be subjected to critical review. Invariably, the result of the study contributes immensely to the body of academic knowledge with regard to the professional ethics and ethical challenges related to nurses and patients in Cameroon.

1.7 Scope of the study   

The scope of this study is boarded on the professional ethics and ethical challenges related to nurses and patients in Cameroon. Empirically, the study will assess the level of adherence to professional ethics among nurses, identify the common ethical challenges faced by nurses in their interactions with patients, evaluate the impact of ethical challenges on the quality of patient care provided by nurses in healthcare facilities and investigate the strategies employed by nurses to manage ethical dilemmas in their daily interactions with patients.

Geographically, the study will be delimited to nurses in Cameroon.

1.8 Limitation of the study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed. More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other schools, local governments, states, and other countries in the world.

 1.9 Definition of Terms

Nursing: profession and practice of providing care to individuals, families, and communities to maintain or improve their health and quality of life.

Ethics: set of principles and standards that guide moral conduct and decision-making.

Ethical challenges: Ethical challenges refer to situations or dilemmas where individuals or organizations must make difficult decisions that involve conflicting moral principles, values, or standards. These challenges often require choosing between actions that may have significant moral, legal, or societal implications.

Patients: Patients are individuals who receive medical care, treatment, or consultation from healthcare professionals, typically due to illness, injury, or other health-related concerns.

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