We frequently talk about an RN’s abilities in terms of their clinical knowledge and competence. Still, it’s also crucial that they be able to recognize and handle many types of ethical dilemmas in nursing that may arise. In addition to safeguarding your patient, your mental health depends on your ability to handle difficult situations and speak out when necessary. Here is a brief introduction to nursing ethics and some real-life scenarios in which nurses face ethical challenges.
What is ethical dilemma in nursing?
An example of an ethical dilemma in nursing is a circumstance in which a nurse must choose opposing ideals while being aware that there will be repercussions for their decision no matter which path they choose. Confronting an ethical problem might cause a nurse’s principles or the nursing profession’s code of ethics to conflict.
Ethical Considerations for Nurses
In surveys of American workers, nurses routinely score best for honesty and ethical standards. For the seventeenth year running, in 2018, they were rated highest by Gallup’s survey, with physicians coming in as a distant second.
Because of their one-on-one interactions with patients, nurses have a special place in healthcare ethics. According to a recent article published in Johns Hopkins Magazine, nurses may have unique insight into their patients’ and their families’ emotions and concerns. If they spend much time with patients, they may be better able to advocate for them than other healthcare professionals.
Nurses need to respect the public’s confidence in them. The American Nurses Association has developed a Code of Ethics for Nurses that all RNs should be acquainted with to provide a framework for making ethical decisions in their practice.
Can You Define an ethical dilemma in nursing practice?
Despite the ANA’s recommendations, nurses will inevitably face a circumstance where they must decide between two or more solutions, which may not be entirely ethical. If a nurse faces a moral problem, they must choose between two or more options, each of which would violate some portion of the profession’s ethical code. Also, a nurse’s convictions may conflict with the Nurse’s Code of Ethics when faced with an ethical problem.
Caring for patients raises ethical dilemmas in nursing research for nurses. Nurses encounter ethical difficulties for many reasons, but some of the most prevalent are as follows:
- Patients who refuse therapy even though they may die without it
- Projects that go against their morals,
- Important to have parents’ permission before treating kids,
- Decision-making by minors,
- Values held by nurses and patients are different,
- The confrontation between the need for privacy and the need to abide by other ethical standards.
Ethical dilemma in nursing essay
The following are essays on ethical dilemmas in nursing case study examples;
1. DNR ethical dilemma in nursing
Due to a lack of comprehension of what a DNR indicates, the healthcare provider, in this instance, refuses to administer treatment, which creates an ethical problem. Again, I want to emphasize that “do not treat” is not what “DNR” stands for. Regardless of whether or not a patient is in a code state, many operations may and should be done.
2. Ethical dilemma in nursing informatics
The following is a list of only some of the ethical dilemma scenarios in nursing
challenges that are now influencing the direction of the health informatics profession:
- The safeguarding of confidential patient information
- Protection of the patient
- Risk assessment.
- Design of reports and presentation of data.
- The installation of the system
- Curriculum development.
- The morality of research.
3. Ethical dilemma in mental health nursing
Research in psychiatry raises a unique set of crucial ethical concerns distinct from those raised in other areas of medicine. These problems are associated with things like informed consent, confidentiality, conflicts of interest, therapeutic misconceptions, placebo-related problems, vulnerability, exploitation, and operational hurdles, amongst other things.
Ethical dilemma topics in nursing
The following are some topics you can use to base your ethical dilemma in the nursing essay;
- Consent that is informed.
- Maintaining the Confidentiality and Privacy of Our Patients
- Participation of the Patient in Decision-Making.
- Taking into account Preparation for Advanced Care.
- Insufficient human resources and available resources.
Example of ethical dilemma in nursing
Most nurses may face some ethical difficulties throughout their employment, and the causes mentioned above, together with the nine requirements of the Nurse’s Code of Ethics, provide some instances.
Ethical dilemma in nursing examples and solutions
We will examine some examples of ethical dilemmas in nursing, typical ethical dilemmas in which tension between the patient’s rights and the nurse’s duties may lead to difficult situations for the patient. In addition, we will cover some ethical nursing concepts to assist nurses in making decisions that are in their patients’ best interests.
Abortion ethical dilemma in nursing
The dispute between pro-life and pro-choice advocates is one of the most contentious ethical issues in the United States today. Roe v. Wade, the historic U.S. Supreme Court decision that ruled a woman’s right to choose whether or not to have an abortion is guaranteed by the Constitution, is set to be overturned soon, most likely in May 2022. Strong convictions and reasons may be found on both sides as to why legal protection should be granted to one course of action.
However, in nursing, the difficulty emerges when the patient requires one thing but the law or a medical condition represents something different. Patient A is pregnant and has a family history of congenital cardiac abnormalities; this presents a common ethical problem. Patient A’s condition is likely to deteriorate throughout pregnancy. The baby may also be born with a heart defect, which may make delivery even more challenging. However, based on their religious views, patient A is reluctant to get an abortion.
When questioned about it, should the nurse counsel the patient to continue with the therapy required to preserve their life, or should they respect their personal choice? That’s the problem of pro-choice vs. pro-life arguments.
Evidence-based knowledge versus spiritual beliefs
We must respect the beliefs and rituals of others. When a patient’s religious convictions conflict with the care they need to be well, how do you as a nurse make a decision? One of the most typical circumstances where the ethical issue of empirical knowledge vs. religious belief emerges is when nurses treat patients who are Jehovah’s Witnesses. Their religious views do not enable such patients to undergo a blood transfusion
But what if the patient needs a transfusion? Once again, should you, as a nurse, follow what you have been taught to do and ensure the patient is safe and healthy, or respect their wish? That, of course, is the core problem.
If the patient is aware of the risks associated with rejecting the transfusion and yet chooses to do so, you will likely not be able to do much to change their mind. Ensure you give them a full medical explanation of their illness and preserve careful records of their decision to decline treatment.
Independence vs. Helpfulness
Among other ethical dilemma cases in nursing is where a nurse needs to consider whether they should continue with a required therapy that the patient is opposed to is examined in the autonomy vs. beneficence nursing ethical problem.
Consider the following ethical dilemma in a nursing scenario. Imagine that one of your patients has been told that nothing more can be done for them since they have stage IV cancer. At that point, all that can be done is to prescribe painkillers and send the patient home to recover from their ordeal. To spend their last days with their loved ones, the patient does not want to be sedated and weak; hence they refuse to take the prescribed medicine. The patient’s loved ones are pleading with you, the nurse, to give the patient pain medicine without their awareness. Can you give me any advice?
Although it may be distressing for family members to see their loved ones suffer, nurses must follow patients’ desires if they are competent to make such decisions.
Children not being immunized due to parental refusal
Even though vaccination is a proven method of illness prevention, many individuals in the United States and throughout the globe are unwilling to get vaccinated. Nurses face a far more difficult problem when parents refuse to allow their children to be vaccinated than when they must deal with adults making choices that might hurt themselves.
If a parent objects to anything being done to their kid, the nurse has no choice but to comply. You can only do what you can to provide parents with as much information as possible so they can make an informed choice that will benefit their kids. If it is not mandated by law that a kid gets a particular vaccination, you must get the parents to sign a statement declaring their position.
Truthfulness against concealment
Honesty goes a long way toward establishing credibility between patients and their doctors. From a young age, we are drilled, to tell the truth, but what if you worry that doing so would result in more trouble than it’s worth? For example, suppose that Patient B is not doing well in their treatment for a certain health concern, and you are faced with the ethical dilemma of whether or not to tell them this. The more you explain the seriousness of their situation as a nurse, the more worried and anxious they will get, which might hurt their mental health.
Yet, it would help if you told patient B the whole truth and not hide anything from them unless there is hard evidence showing that doing so will have a catastrophic effect on their health. You are in a situation where you must, despite the difficulty, choose the “honesty” side in a conflict like this.
The balancing act: health care demands vs. Available resources
Nurses are expected to provide the same level of care to each patient regardless of their perceived level of need. In other circumstances, they will be forced to decide which of the two is more deserving of care or has more medical urgency. Example ethical dilemmas in nursing involving patients’ healthcare requirements against available resources arise when supplies that would allow the nurse to treat each patient fairly are in limited supply.
Picture yourself as a nurse responsible for a dozen patients’ care and medicine administration. However, you have been notified that critical medication is now scarce. So then what?
If a safe alternative drug could be used instead, that would be ideal. But even if that were the case, you’d still have to prioritize which patients need the correct prescription immediately.
Limitations, both personal and professional
Both professional limitations can bring about another example of an ethical dilemma in nursing. Keeping work and life apart is easier said than done. Because of your positive impact on your patients’ lives, they may want to become friends with you or reach out to you for support.
Today, when it’s so simple to discover people online and develop connections, it’s not uncommon to have a patient, ex-patient, or even a patient’s family follow you on social media. It’s hard to imagine any evil coming from this. However, as a nurse, do you have the liberty to develop relationships with your patients that go beyond the traditional nurse-patient dynamic? To put it simply, the answer is negative.
It is appropriate to return a patient’s greeting, inquire about their health, and respond in like. However, having a professional connection with someone is quite different from being friends.
Decision-making at the end of life
Patients with terminal illnesses or injuries that leave them with little time to live may choose to forego life-sustaining procedures if given the option. As difficult as it may be, a nurse must honor a patient’s request that they cease life support.
When a patient’s heart stops beating normally, the difficulty of making end-of-life decisions becomes acute. As a healthcare provider, you must decide whether to follow your instincts, attempt resuscitation, maintain life-sustaining therapy, or honor the patient’s wishes and allow them to die. Patients in this situation often sign do not resuscitate orders, stating that medical personnel should not do CPR if it is medically indicated. The DNR is in the patient’s medical record and must be followed.
Science vs. religion
Different from one another, yet mutually beneficial, are the spiritual and scientific perspectives on life; even in medicine, where the spiritual practice has been shown to have a beneficial effect on outcomes, the two complement one another. That is not always the case, however. Patients who are too committed to their religious or ideological convictions may be resistant to rational explanations.
As a nurse, you may face moral difficulties when confronted with conflicting beliefs between the spiritual and scientific worldviews held by patients, family members, and friends. What should you do if patient X’s loved ones, knowing their loved one has a negligible chance of survival during surgery, refuse to accept the danger out of a spiritual conviction that everything would be all right?
The Nurse’s Code of Ethics mandates sensitivity to patients’ cultural and religious norms. Thus, you must back their choice even though you disagree with it and are upset when they disregard your cautions and explanations of the possible risk.
Conclusion
Nursing and ethical problems go hand in hand; therefore, whether you are an aspiring nurse reading about obstacles you might face in the future or a licensed nurse wondering if they are the only ones dealing with such problems, know that you are not alone in dealing with such problems. You are not required to shoulder all of the responsibility. Seek help and guidance to make difficult navigating ethical dilemma in nursing scenarios easier for yourself.
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