Upholding Human and Elderly Rights in Nursing

Every patient who walks through a healthcare facility carries with them fundamental rights that must be respected and protected. For nurses, understanding human rights and the specific rights of elderly patients is not just an ethical obligation-it’s a cornerstone of quality care. These rights ensure that all individuals, regardless of age, background, or health status, receive dignified and equitable treatment in healthcare settings.

What are human rights in healthcare? 🔗

Human rights are the basic rights and freedoms that belong to every person simply because they are human. In healthcare, these rights form the foundation for how patients should be treated and what they can expect from their caregivers. The Universal Declaration of Human Rights (UDHR), adopted by the United Nations General Assembly in Paris on 10 December 1948, serves as the primary international document outlining these fundamental rights.

The UDHR was created in response to the atrocities of World War II, with world leaders recognizing the need for a roadmap to guarantee the rights of every individual everywhere. This milestone document consists of 30 articles that detail basic rights and fundamental freedoms, affirming their universal character as inherent, inalienable, and applicable to all human beings. It has since been translated into over 500 languages, making it the most translated document in the world.

Key articles relevant to nursing practice 🔗

Several articles from the UDHR have direct implications for nursing care:

Article 1 (Equality and dignity): All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood. This principle requires nurses to treat every patient with equal respect regardless of their circumstances.

Article 2 (Freedom from discrimination): Everyone is entitled to all rights and freedoms without distinction of any kind-race, colour, sex, language, religion, political opinion, national or social origin, property, birth, or other status. This directly impacts nursing by prohibiting preferential or biased treatment.

Article 3 (Right to life, liberty, and security): This fundamental right means nurses must protect patients’ physical safety and advocate for their well-being at all times.

Article 25 (Right to health and standard of living): This article states that everyone has the right to a standard of living adequate for health and well-being, including medical care and necessary social services. It also specifically mentions the right to security in cases of sickness, disability, widowhood, or old age.

The rights of elderly patients 🔗

As populations age globally, protecting the rights of older adults has become increasingly important in healthcare. The United Nations Principles for Older Persons, adopted by the UN General Assembly on 16 December 1991 through Resolution 46/91, specifically addresses the needs and rights of elderly individuals.

These principles contain 18 guidelines organized under five essential themes: independence, participation, care, self-fulfillment, and dignity. Governments worldwide were encouraged to incorporate these principles into their national programmes to ensure comprehensive protection for older populations.

Independence 🔗

Older persons should have access to adequate food, water, shelter, clothing, and healthcare through income, family support, community support, and self-help initiatives. They should also have opportunities to work or access other income-generating activities and participate in determining when and how they withdraw from the workforce.

For nurses, supporting independence means helping elderly patients maintain their autonomy wherever possible-assisting rather than taking over tasks they can still perform, and involving them in decisions about their daily care routines.

Participation 🔗

According to the UN Principles, older persons should remain integrated in society and participate actively in the formulation of policies affecting their well-being. They should be able to seek opportunities for community service and form associations or movements of older persons.

In nursing practice, this translates to including elderly patients in care planning discussions, seeking their input on treatment preferences, and facilitating their connection with support groups or community resources when appropriate.

Care 🔗

Elderly patients should benefit from family and community care and protection according to each society’s cultural values. They should have access to healthcare that helps them maintain or regain optimal physical, mental, and emotional well-being. Additionally, they should be able to utilize appropriate levels of institutional care providing protection, rehabilitation, and social and mental stimulation in humane and secure environments.

According to nursing ethics principles, nurses have specific obligations to understand and protect patient rights, particularly for vulnerable populations like the elderly who may be at greater risk of having their rights overlooked.

Self-fulfillment 🔗

Older persons should be able to pursue opportunities for the full development of their potential and have access to educational, cultural, spiritual, and recreational resources of society. This principle recognizes that aging does not diminish a person’s desire for growth, learning, and meaningful activities.

Nurses can support this right by facilitating access to recreational activities, respecting patients’ spiritual practices, and recognizing the ongoing capacity of elderly patients to learn and engage.

Dignity 🔗

Perhaps most importantly, older persons should be able to live in dignity and security, free of exploitation and physical or mental abuse. They should be treated fairly regardless of age, gender, racial or ethnic background, disability, or other status, and valued independently of their economic contribution.

This principle is fundamental to nursing care. As the American Nurses Association’s Code of Ethics emphasizes, respect for the inherent dignity, worth, unique attributes, and human rights of all individuals is a fundamental principle underlying all nursing practice.

Why these rights matter in nursing 🔗

The American Nurses Association has established that the protection and promotion of human rights in health and healthcare are fundamental functions of the nursing profession. Nurses navigate ethical and value conflicts daily, and understanding human rights provides a framework for making sound decisions.

Patient autonomy and self-determination: Respect for human dignity requires recognizing specific patient rights, particularly the right to self-determination. Patients have the moral and legal right to determine what will be done with and to their own person, to receive accurate and complete information, and to accept, refuse, or terminate treatment without undue influence or coercion.

Non-discrimination in care: Nurses must recognize that racism, ageism, and other forms of discrimination are harmful assaults that negatively impact care and violate human dignity. Addressing health disparities by providing culturally concordant care and fostering patient-centered communication is essential.

Advocacy role: The International Council of Nursing asserts that human rights are fundamental to nursing and that nurses have an obligation to promote people’s health rights at all times and in all places. This advocacy extends to speaking up when violations occur and working to create environments that support ethical practice.

Applying rights-based care in daily practice 🔗

Understanding these rights is only valuable if nurses can apply them practically. Here are key considerations for daily nursing practice:

Informed consent: Always ensure patients understand their treatment options, potential risks and benefits, and their right to refuse care. For elderly patients, take extra time to explain procedures clearly and verify comprehension.

Privacy and confidentiality: Protect patient information and respect their privacy during examinations and procedures. Article 12 of the UDHR states that no one shall be subjected to arbitrary interference with their privacy.

Respect for cultural and personal values: Patient-centered care requires respecting and valuing patients’ cultural and social characteristics and preferences. Healthcare decision-making in many cultural contexts is a collective process, and nurses should accommodate these differences.

Protection from abuse: Be vigilant for signs of elder abuse, neglect, or exploitation. Elderly patients should be free from physical and mental abuse, and nurses have a responsibility to report and address such situations.

Access to information: Ensure elderly patients and their families have access to information about available services, support systems, and their legal rights within the healthcare setting.

Challenges in upholding rights 🔗

While the principles are clear, nurses often face challenges in upholding patient rights. Time constraints, staffing shortages, institutional policies, and complex family dynamics can all create barriers. Additionally, some patients may have diminished capacity to make decisions, requiring careful navigation between respecting autonomy and ensuring safety.

For elderly patients specifically, ageist attitudes-even unconscious ones-can lead to their voices being dismissed or their preferences ignored. Nurses must actively combat such biases and ensure that age alone does not diminish the quality or respectfulness of care provided.

The broader impact on quality of care 🔗

When nurses consistently uphold human rights and elderly rights in their practice, the benefits extend beyond individual patients. Rights-based care improves patient trust, enhances satisfaction with healthcare services, and contributes to better health outcomes. It also supports nurses’ professional integrity and creates a more ethical working environment.

The UDHR was created with the vision that every individual and every organ of society should strive through teaching and education to promote respect for these rights and freedoms. Nurses, as essential members of the healthcare system, play a vital role in making this vision a reality for patients of all ages.

What do you think? How do you balance respecting a patient’s autonomy with ensuring their safety, particularly when caring for elderly patients who may have varying levels of decision-making capacity? What practices have you found most effective in advocating for your patients’ rights in challenging situations?

References

1. https://www.un.org/en/about-us/universal-declaration-of-human-rights
2. https://en.wikipedia.org/wiki/International_Year_of_Older_Persons
3. https://www.ncbi.nlm.nih.gov/books/NBK526054/
4. https://codeofethics.ana.org/provision-1-1
5. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/
6. https://codeofethics.ana.org/provision-1-4
7. https://pubmed.ncbi.nlm.nih.gov/32552480/
8. https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-022-00833-1