Ethical dilemmas are situations in which two or more ethical principles conflict. Nurses face ethical dilemmas on a regular basis, and they need to be prepared to address them in a thoughtful and ethical way.
There are many different ethical dilemmas that nurses can face. Some of the most common include:
- Patient autonomy vs. beneficence: This dilemma arises when a patient’s wishes conflict with what the nurse believes is in their best interest. For example, a patient may refuse to take a medication that is essential to their health.
- Patient confidentiality: Nurses have a legal and ethical obligation to keep patient information confidential. However, there are some situations where confidentiality may need to be broken, such as when there is a risk of harm to the patient or others.
- End-of-life care: Nurses play a vital role in end-of-life care. However, there can be ethical dilemmas associated with end-of-life care, such as deciding when to stop life-sustaining treatment or how to manage a patient’s pain.
Patient Autonomy vs. Beneficence
Autonomy is the right of a person to make their own decisions about their care. Beneficence is the principle of doing what is good for the patient.
Ethical dilemmas can arise when patient autonomy and beneficence conflict. For example, a patient may refuse to take a medication that is essential to their health. The nurse may believe that it is in the patient’s best interest to take the medication, but they also need to respect the patient’s right to make their own decisions.
Here are some strategies for resolving ethical dilemmas involving patient autonomy and beneficence:
- Educate the patient: The nurse should provide the patient with all of the information they need to make an informed decision about their care. This includes the risks and benefits of different treatment options, as well as the consequences of refusing treatment.
- Respect the patient’s decision: Once the patient has made a decision, the nurse should respect it, even if they disagree with it.
- Document the patient’s decision: The nurse should document the patient’s decision in their medical record. This will help to protect the nurse and the patient if there are any questions about the decision later on.
Patient Confidentiality
Patient confidentiality is the right of a patient to have their personal information kept private. Nurses have a legal and ethical obligation to keep patient information confidential.
However, there are some situations where confidentiality may need to be broken. For example, if a patient is a threat to themselves or others, the nurse may need to break confidentiality in order to protect them or others.
Here are some examples of situations where a nurse may need to break confidentiality:
- If a patient tells the nurse that they are planning to harm themselves or others
- If a patient has a contagious disease that poses a risk to others
- If a patient is a child and is being abused or neglected
If a nurse is considering breaking confidentiality, they should consult with their supervisor or another healthcare professional to get their advice.
End-of-Life Care
Nurses play a vital role in end-of-life care. They provide physical and emotional support to patients and their families during this difficult time.
However, there can be ethical dilemmas associated with end-of-life care. For example, nurses may need to decide when to stop life-sustaining treatment or how to manage a patient’s pain.
Here are some strategies for resolving ethical dilemmas involving end-of-life care:
- Follow the patient’s wishes: If the patient has expressed their wishes about end-of-life care, the nurse should respect those wishes.
- Communicate with the patient and their family: The nurse should communicate with the patient and their family to understand their wishes and concerns.
- Use an ethical framework: There are a number of ethical frameworks that can be used to help make decisions about end-of-life care. These frameworks can help nurses to weigh the different ethical principles involved and make a decision that is in the best interests of the patient.
