Ethical Nursing Dilemmas and Decisions
ANSWER
Discuss these moral problems and offer suggestions for how to solve them.
Respecting a suffering client’s desire for a respectful death:
One of the most important ethical guidelines in healthcare is to respect a patient’s desire to pass away in peace. Advance directives, do-not-resuscitate (DNR) orders, and palliative care are frequently brought up in these conversations. To make sure that the patient’s preferences are known and respected, nurses should stand up for the patient’s autonomy and collaborate closely with the patient’s family and the medical staff. The patient’s values and preferences should be taken into account, along with the applicable legal and ethical frameworks, while making the choice.
Honoring the health surrogate’s decision to stop providing life support:
Respecting the surrogate’s wishes entails being aware of and sensitive to the patient’s values and preferences as expressed by the surrogate, much like in the first problem. This could be a difficult situation, especially if the patient’s wishes and those of the surrogate don’t match up or if it’s unclear what the patient would have preferred. In these situations, nurses may need to have difficult discussions, confer with ethical committees, and make sure the choice is made with the patient’s best interests in mind while still honoring the surrogate’s role.
Seeing another nurse use more medication (oxycodone) raises concerns for patient safety, professional ethics, and possibly even unlawful behavior. Any unethical or unlawful behavior that nurses see among their coworkers must be reported. A patient injury might result from taking recommended medication, which is against ethical principles and trust. In order to protect patient safety and uphold the integrity of the medical profession, such instances must be reported.
Regarding a particular moral problem:
An example is when a patient’s family member asks a nurse for information on the patient’s condition but requests explicitly that the nurse not tell the patient who is there in the room specific crucial data. The family member thinks the patient is emotionally fragile and won’t be able to handle the reality.
Making a decision: In this situation, the nurse must choose between upholding the patient’s autonomy, which includes the right to knowledge about their condition, and upholding the request of the patient’s family member to withhold information. In order to comprehend the patient’s and the family member’s concerns, the nurse should speak with them separately. If necessary, the nurse should also speak with the medical staff and an ethics committee. In the end, the choice should put the patient’s right to information first while sensitively addressing the family’s worries; this may involve having a carefully phrased conversation with the patient to determine whether they are ready to receive information.
Moral anguish is a feeling that a nurse could have when they are pulled between opposing ethical values. Making the optimal choice for the patient’s well-being can be emotionally challenging, which is why seeking ethical advice, consulting with colleagues, and receiving support from them are essential.
QUESTION
Today’s health care environment gives nurses many reasons to be conflicted. Genetic testing, abortion, and end of life care are just some of the areas in which nurses may face ethical dilemmas. Consider how you feel about the following issues:
- Respecting the wishes of a suffering client that he is permitted to die with dignity,
- Respecting the health surrogate’s wishes regarding termination of life support,
- Or even observing another nurse take two tablets of oxycodone as ordered but keeping one for herself.
Then give an example of an ethical dilemma you may have confronted in your own clinical experience or workplace. How did you come to the decision you made? What feelings did you experience while coming to that choice? (If you have not yet faced an ethical dilemma, research one and comment on it, answering the same questions.)
