Ethical Dilemmas in Nursing

A comprehensive look into ethical dilemmas in nursing

What Is An Ethical Dilemma In Nursing?

An ethical dilemma in nursing is a circumstance in which a nurse must choose between opposing ideals while being aware that the decision will have implications. Ethical quandaries may contradict the nurse’s personal convictions or the Code of Ethics for Nurses.

Top 5 causes of ethical dilemmas in nursing that nurses must deal with every day

When providing care for patients, nurses frequently encounter moral challenges. A number of factors can combine to create a sticky moral situation. The five most common sources of ethical challenges in nursing are discussed here.

  1. To begin, patients or their loved ones must choose between life and death.
  2.  The patient opposes treatment.
  3. Cultural and religious values may be at odds with nursing tasks.
  4. Incompetence among nursing colleagues
  5.  Insufficient nurses

Also, read the Top 5 Issues Nurses face in their Careers. This is also related to Ethical Issues in Nursing

Examples of ethical dilemmas in nursing

Here are some examples of ethical dilemmas that nurses and other healthcare professionals may encounter:

  1. Confidentiality: A patient discloses confidential information to a healthcare professional, but the healthcare professional believes that the information could potentially harm the patient or others. The healthcare professional must weigh the duty to respect the patient’s confidentiality against the potential risk of harm and decide whether to breach confidentiality or not.
  2. Informed Consent: A patient refuses treatment that healthcare professionals believe is necessary to save their life. The healthcare professionals must respect the patient’s autonomy and right to refuse treatment while balancing the duty to promote the patient’s well-being.
  3. End-of-life care: A patient’s family disagrees on the course of treatment for a terminally ill patient. The healthcare professionals must consider the patient’s wishes, the family’s concerns, and the legal ethical principles involved in end-of-life care to make a decision that aligns with the patient’s best interests.
  4. Resource Allocation: A hospital has limited resources, and two patients require a life-saving treatment. The healthcare professionals must decide which patient to prioritize based on their clinical needs, the availability of resources, and the ethical principles involved.
  5. Cultural and Religious Beliefs: A patient’s cultural or religious beliefs conflict with the healthcare professionals’ recommended treatment plan. The healthcare professionals must respect the patient’s beliefs and work collaboratively with them to identify an alternative plan that aligns with the patient’s values while promoting their health.

In summary, ethical dilemmas arise in healthcare when there is a conflict between the patient’s values, the healthcare professional’s obligations, and the ethical principles involved. Nurses and other healthcare professionals must carefully consider the situation, identify the ethical principles involved, and make a decision that upholds the principles of patient autonomy, beneficence, non-maleficence, justice, fidelity, and veracity.

Ethics and decision making in nursing

Ethics and decision making are crucial components of nursing practice. Nurses often face ethical dilemmas that require them to make decisions that are in the best interest of their patients while respecting their autonomy and values. Here are some key considerations for ethical decision making in nursing:

  1. Assess the Situation: Nurses must first assess the situation to identify the ethical issue or dilemma. They need to consider all the available information, including the patient’s medical history, cultural background, and preferences, as well as any legal or institutional requirements.
  2. Identify the Ethical Principles Involved: Nurses must identify the ethical principles involved in the situation, such as autonomy, beneficence, non-maleficence, justice, fidelity, and veracity.
  3. Explore Options: Nurses must explore different options and consider the potential consequences of each option. They need to weigh the risks and benefits of each option and identify which option aligns best with the ethical principles involved.
  4. Make a Decision: Nurses must make a decision based on the information gathered, the ethical principles involved, and the potential consequences of each option. They must consider the patient’s autonomy and values, while also promoting their well-being.
  5. Take Action: Once a decision is made, nurses must take action and implement the plan. They need to communicate the decision to the patient and other members of the healthcare team and monitor the situation to ensure that the plan is effective.
  6. Reflect on the Decision: Nurses must reflect on their decision-making process and the outcome of the situation. They need to identify what worked well and what could be improved for future ethical dilemmas.

In summary, ethical decision-making is a critical component of nursing practice. Nurses must assess the situation, identify the ethical principles involved, explore options, make a decision, take action, and reflect on the decision. By following these steps, nurses can promote ethical and effective patient care while respecting patient autonomy and values.

Examples of ethical dilemmas case studies

Case Study 1: Informed Consent

A patient with a history of mental illness has been admitted to the hospital with severe depression. The patient is refusing to take medication and undergo any medical interventions. The healthcare team is concerned about the patient’s well-being and is considering involuntary commitment to ensure the patient receives treatment. However, this would mean going against the patient’s autonomy and informed consent.

Ethical Principles Involved: Autonomy, Informed Consent, Beneficence, Non-maleficence

Possible Solutions: The healthcare team could attempt to work with the patient to explore their concerns and reasons for refusing treatment. They could also involve the patient’s family and other support systems to help convince the patient to receive treatment. However, if the patient’s condition worsens and they become a danger to themselves or others, involuntary commitment may be necessary to prevent harm.

Case Study 2: End-of-Life Care

A patient with advanced cancer is terminally ill and has expressed a desire for physician-assisted suicide. The healthcare team is conflicted about whether to honor the patient’s request as it goes against their values and beliefs.

Ethical Principles Involved: Autonomy, Beneficence, Non-maleficence, Justice

Possible Solutions: The healthcare team could explore alternative options such as hospice care or palliative care to provide comfort and pain management to the patient. They could also involve the patient’s family and other support systems to help provide emotional support. However, if the patient’s suffering is unbearable, the healthcare team may need to respect the patient’s autonomy and provide physician-assisted suicide as an option.

Case Study 3: Confidentiality

A patient has tested positive for a sexually transmitted infection but has asked the healthcare provider to keep the information confidential. The healthcare provider is concerned that the patient’s partner may also be at risk.

Ethical Principles Involved: Autonomy, Confidentiality, Beneficence, Non-maleficence

Possible Solutions: The healthcare provider could attempt to educate the patient about the risks of not disclosing the information to their partner and encourage them to do so. They could also offer to notify the patient’s partner anonymously or offer counseling and support to both the patient and their partner. However, if the patient continues to refuse to disclose the information, the healthcare provider may need to weigh the risks of harm to the patient and their partner and consider breaking confidentiality.

6 Ethical principles used in decision-making

There are several ethical principles that are commonly used to guide decision-making in ethical dilemmas. These include:

  1. Autonomy: This principle recognizes that individuals have the right to make their own decisions and to have their choices respected. In healthcare, this means that patients have the right to be informed about their treatment options and to make decisions about their care.
  2. Beneficence: This principle requires healthcare providers to act in the best interests of their patients and to promote their well-being. It also requires them to prevent harm and to balance the risks and benefits of any intervention.
  3. Non-maleficence: This principle requires healthcare providers to avoid causing harm to their patients. It also recognizes that some interventions may have unintended negative consequences and that healthcare providers must balance the risks and benefits of any intervention.
  4. Justice: This principle requires that healthcare resources be distributed fairly and that similar cases be treated similarly. It also recognizes the importance of treating people with equal dignity and respect.
  5. Fidelity: This principle recognizes the importance of keeping promises and being trustworthy. In healthcare, this means that healthcare providers should be honest with their patients and should keep their commitments.
  6. Veracity: This principle requires healthcare providers to be truthful and honest in their interactions with patients. This includes being transparent about risks and benefits, as well as disclosing any conflicts of interest.

Also read: Applying The Four Ethical Principles Essay

When faced with an ethical dilemma, it is important to consider these principles and to weigh the competing values, principles, or obligations involved. Ultimately, the decision should be based on what is in the best interests of the patient, while also respecting their autonomy and dignity.

More about ethical dilemmas in nursing:

Ethical Legal Dilemma Advanced Practice Nursing

One common ethical legal dilemma faced by advanced practice nurses is maintaining patient confidentiality while also ensuring that patient care is optimized. Advanced practice nurses are often privy to sensitive information about their patients, and they are bound by ethical and legal obligations to maintain patient confidentiality.

However, there are situations where a nurse may be compelled to disclose confidential information, such as when the patient poses a danger to themselves or others. In such cases, the nurse may be faced with the dilemma of whether to disclose confidential information or risk harm to the patient or others.

Another ethical legal dilemma faced by advanced practice nurses is the issue of informed consent. Nurses are responsible for ensuring that patients are fully informed about their treatment options and the potential risks and benefits associated with each option. However, there may be situations where patients may be unable to give informed consent, such as in emergency situations or in cases where the patient lacks capacity.

In such cases, the nurse may need to make decisions on behalf of the patient, such as providing life-sustaining treatment. This can be a challenging ethical legal dilemma as the nurse needs to balance the patient’s autonomy and right to self-determination with their duty to act in the patient’s best interests.

Other ethical legal dilemmas faced by advanced practice nurses include issues related to end-of-life care, conflicts of interest, and cultural competency. It is important for advanced practice nurses to be aware of these dilemmas and to have a clear understanding of their ethical and legal obligations to ensure that patient care is optimized while maintaining patient confidentiality and autonomy.

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