In health care settings nurses are continuously dealing with various ethical problems and dilemmas. Ethical dilemma arises when there are equal moral obligations for or against two or more possible courses of action (College of Nurses of Ontario, 2008). Very often, there are not only simple ethical problems but rather complex issues involved many participants and multiple decisions. According to Wilson-Barnett (1986), nurses are more aware of its participation in decision making involving ethical issues. In ethical decision making, the nurse must be able to have the knowledge and skills about the entire scenario of a patient before making any possible interventions. Parker (2007) emphasized that the patients and their families along with other
Using relational ethics proposed by Bergum (1999) which includes principles of engaged interaction, mutual respect, embodiment and positive environment where freedom and choice are flourishing, and by considering patient’s vulnerability, a reasonable decision has to be made. Engaged interaction is when all participants are encouraged to share its thoughts and question on the impending decision. Mutual respect includes positive collaborative relationship, active listening and non-verbal behavior, confidentiality, prompt feedback and clear communication (Kaplan, Mestel & Feldman, 2010). Mutual respect is important not only for Adeline who can offer help in clarifying possible outcomes and providing emotional support but also for family members. Marcellus (2005) states that nurse must work towards respect of the others by trying to understand their circumstances. Difficult questions often arise when dealing with such a dilemma. How are the rights of Mr. Parma balanced with those of his children? Are nurse‘s moral values and believes allow her to suggest the course of action for this family? A reasonable decision cannot be reached if one key participant is not heard. All key participants here are vulnerable especially when faced with a hard decision, it is either they will stand firm or just move with the flow. At this point, the most vulnerable is Mr. Parma, not only physically but also emotionally. To entice the patient to express his doubts and concerns might help the nurse. In every ethical decision, everyone has a choice. This choice will either help the patient or not. A possible option for the patient, nurse, and family members is to meet on a common
During week 4, we became familiar with the application of ethics in the nursing practice settings. We learned about ethical theories and principles, which are crucial when practicing in any clinical settings during ethical decision-making and while facing one or multiple ethical dilemmas. Also, we were introduced to the MORAL model used in ethical decision – making progress. The MORAL model is the easiest model to use in the everyday clinical practice, for instance at bedside nursing. This model can be applyed in any clinical settings and its acronyms assist
Every nurse will be faced with a decision making dilemma at some point in his or her career. Being familiar with the nursing code of ethics, what is ethically and morally expected in society and how to approach the situations can help make dilemmas less of a nightmare. “The purpose of nursing ethics is to inspire questions and examine what would be the ethically right action in health care situations demanding a choice between at least two undesirable alternatives” (Toren & Wagner, 2010, p. 394). There are many different ways one can approach a situation to reach a resolution, finding a method that works best with the situation at hand is ideal.
In the medical profession, doctors and nurses run into ethical dilemmas every day whether it be a mother who wants to abort her baby or a patient who has decided they want to stop cancer treatment. It is important for the nurse to know where they stand with their own moral code, but to make sure they are not being biased when educating the patient. Nurses are patient advocates, it is in the job description, so although the nurse may not agree with the patient on their decisions, the nurse to needs to advocate for the patient regardless.
Ethics has been a popular topic in nursing for a long time. Nurses are expected to demonstrate ethical decision-making as well as professionalism. I believe that in order to accomplish this, they need to use the ANA Code of Ethics as framework for their decision-making. It is also imperative for nurses to have a strong understanding of ethics, because they will be faced with many difficult ethical decisions that do not always have a straightforward solution.
The frameworks are (a) utilitarian, (b) rights-based reasoning, (c) duty-based reasoning, and (d) intuitionist. The utilitarian framework infers that decisions should be for the greater good. In other words, the decision made should take into consideration the needs of a group versus that of an individual. Conversely, rights-based reasoning is more concerned with one person's rights. Duty-based reasoning focuses on the rights of the people and a caregiver’s duty to maintain these rights. Lastly, the intuitionist framework is based on the decision maker's feelings and instincts about a situation. It is the individual’s intuition that drives the decision. In addition to frameworks, there are ethical principles. The nursing profession is based on a group of ethical principles. As nurses, we strive to promote good (beneficence) and to do no harm (non-maleficence). Nurses support patient autonomy and self-determination. Society expects that nurses will be trustworthy, respectful and act with integrity (fidelity and veracity). Nurses have an obligation to tell the truth and treat patients fairly and equally; and, deal with them with respect and dignity (justice). These ethical principles, in addition to the ethical frameworks, help us, as leaders, to make the right decisions at the right time in all situations. The situations may be patient or staff-centered; ultimately, all healthcare
Nurses are face with numerous ethical dilemmas each day and if theses ethical situation are not handled in a professional and ethical manner there can be severe consequences for both the nurse and the patient. When nurses are face with theses ethical dilemmas, they have a decision to make. Therefore, what does the nurse do when decision-making involves ethical dilemmas? So, has a nursing student, I have chosen to put myself in the role of a health care provider such as a nurse. It was my first day of clinical rotation and the client that I was assigned to, was due for a bath. I was not comfortable giving the patient a bath a lone, so I ask for assistance from one of my colleagues. The client was a male who was shy and soft spoken. While undressing the client, I overheard a patient and her family arguing. She wants to refuses life support and the family says they want everything done. She is competent individual, who as cancer breast and had gone through many round of chemotherapy and radiation therapy and yet the cancer is still spreading. She is experiencing side effect from the treatment, like vomiting, loss of appetite, weakness and fatigue. The nurse who was in the room with the client and her family, just said he will give them some time to converse the situation, then come back later to see what they had agreed on.
...ay arise between health care professionals, nurses, and the patient and family. Most often, when an ethical dilemma occurs, nurses most make a choice between the two equally unfavorable alternatives.
This paper will focus on two BNUR leaner outcomes (University of Calgary, 2013) relevant to my learned understanding of nurses as ethical decision makers. I will outline the ways that I have seen ethics used and not used in practice, what I learned about ethics and its use in my theory courses and throughout my practicums, and I will reflect on how this understanding will translate into my professional practice moving forward.
An advanced practice nurse (APN), will be faced with different types of ethical-legal dilemmas that in most cases will require the APN to make urgent decisions that will include both moral and ethical attention. Ethical dilemmas are conditions that have to scenarios course of actions to take that will contradict each other (Westrick, 2014, pp 258-265). The APN will have to choose between the two urgent decisions because each of these choices is deemed to be equally right and urgent. This is the reason that makes dealing with ethical-dilemmas very stressful for the APN and other experienced caregivers involved. It is very noteworthy that an APN has many medical responsibilities to provide care, and are also in the position to make urgent medical decisions that is independent because of being the person in authority at that time. Many of the existing ethical dilemmas will fall in with a variety of treatment withdrawal vs maintenance, the quality of life vs the quantity of life, euthanasia vs non-euthanasia, and pro-choice vs pro-life (Westrick, 2014b, pp.77-83).
Since ethical dilemmas are not always easily answered through the use of The Code of Ethics, ethical decision-making models are effective tools that can assist nurses in dealing with ethical issues. Ethical decision-making models provide a framework for working through difficult choices. They seek to define the limits of what is morally acceptable and help clarify the guidelines for making those difficult decisions. Ethical decision making models assist nurses in analyzing situations by focusing on understanding the patient needs, need for responsiveness to circumstantial considerations, and recognizing the uniqueness of each situation.
Nurses everywhere face problems and challenges in practice. Most of the challenges occur due to a struggle with the use of ethical principles in patient care. Ethical principles are “basic and obvious moral truths that guide deliberation and action,” (Burkhardt, Nathaniel, 2014). Ethical principles that are used in nursing practice include autonomy, beneficence, non-maleficence, veracity, confidentiality, justice, and fidelity. These challenges not only affect them, but the quality of care they provide as well. According to the article, some of the most frequently occurring and most stressful ethical issues were protecting patient rights, autonomy and informed consent to treatment, staffing problems, advanced care planning, and surrogate decision making (Ulrich et. al, 2013). The ethical issue of inadequate staffing conflicts with the principle of non-maleficence.
An ethical dilemma is defined as a mental state when the nurse has to make a choice between the options and choices that he or she has at her disposal. The choice is a crucial task as the opting of the step will subsequently determine the health status of the concerned patient, hence it requires a great deal of wisdom along with proper medical and health training before any such step is opted as it is a matter of life and death. Strong emphasis should therefore be on the acquisition of proper knowledge and skills so that nurses do posses the autonomy to interact with patients regarding ethical issues involved in health care affairs and address them efficiently. It is normally argued that nurses are not provided sufficient authority to consult and address their patients on a more communicative or interactive level as a result of which they are often trapped in predicaments where their treatments of action and their personal beliefs create a conflict with the health interests of the patient. (Timby, 2008)
The first part of this is respect for human dignity which is the need for and right to health care is universal, transcending all differences (Code, 2015). The second part of the first provision is about relationships with patients. Nurses set up relationships of trust and provide nursing services according to need, setting aside any bias or prejudice (Code, 2015). When a patient choices are risky, nurses have to discuss the behavior and offer opportunities to change the behavior to eradicate the risk (Code, 2015). The third part of the first provision is about the nature of health. Nurses should respect the dignity and rights of all human beings regardless of the factors contributing to the person’s health status (Code, 2015). The fourth part of the first provision is the right to self-determination. Patients have the moral and legal right to decide what will happen with and to their own person (Code, 2015). The fifth and last part of the first provision is the relationship with colleagues and others. This part is about respect for persons extends to all people with whom the nurse interacts (Codes,
In conclusion, there are numerous legal and ethical issues apparent in the nursing practice. Nurses should study and be as informed as they can with ethics and legality within their field in order to ensure no mistakes occur. Ethical issues vary based on patient’s views, religion, and environment. Nurses are influenced by these same views, but most of the time they are not the same as the patients. As a nurse we must learn to put the care of our patients and their beliefs, rights, and wishes before our own personal
In every nurse's career, he or she will face with legal and ethical dilemmas. One of the professional competencies for nursing states that nurses should "integrate knowledge of ethical and legal aspects of health care and professional values into nursing practice". It is important to know what types of dilemmas nurses may face