Ethical Dilemma in Nursing

Ethics is usually used to describe moral behavior, social customs, and rules governing practitioners during their duty. A nurse studying to be an advanced nurse practitioner (APN) faces a lot of dilemmas, especially while on duty at the neurology and medical/surgical floor of the hospital. They usually emerge when nurses and patients fail to agree in relation to their decision on care and treatment. The nurse on the advanced practice level faces the practice dilemma where one needs to be honest when there is sensitive information, which needs to be withheld. Such practice issues emerge on the daily basis as performing their duties nurses should base decisions they make on ethical-legal standards that cater to both patients and their needs and priorities as outlined in the ethical code of conduct for nurses.

Case Scenario

The case with the ethical and legal dilemma relates to a middle-aged man with the history of a tumor. During several visits to the hospital, he has been diagnosed with developing an inoperable tumor. From the last visit, the man’s condition has worsened, and he has become a victim of intestinal obstruction, vomiting, and nausea. Doctors and other medical team members have discovered that he has a terminal condition informing the family. The latter have requested to withhold information from the patient. Doctors have agreed, and the man continues to believe that he is suffering from a tumor which can be cured. A practicing nurse working with this particular patient at the neurology and medical/surgical floor has faced a practice dilemma whether to tell the patient the truth or withhold the information from him. It arises when family members are involved in making such requests for important information to be kept away from the client. The nurse needs to decide whether to listen to the family and not to inform the manor just tell the truth to him.

Ethical and Legal Decision-Making Dilemma from the Case Scenario

In the case scenario above, the advanced nurse practitioner faces the ethical dilemma, which requires legal decision making according to the nursing code of ethics. The nurse has to choose between respecting the mutual agreement between the family members and the doctor or apply the following code of ethics, which states that “nursing care is directed toward meeting the comprehensive needs of patients and their families across the continuum of care,” and “promoting, advocating for, and striving to protect the health, safety, and the rights of the patient” according to the American Nurses Association (ANA) (2015, p. 4). This code of conduct will help the nurse make a legal decision. Even if the family members request the one to withhold such information from the patient, the nurse practitioner should follow the code and hospital rules and regulations and inform the man about the true status of his health (Punjani, 2013). The procedure above will help the nurse solve any legal issue that may arise from withholding information from the patient.

Legal Violation

The ANA has developed rules and regulations, with which the nurse must comply in one’s day activities. The fifth provision highlights the “responsibility to preserve integrity and safety, to maintain competence by the nurse” (ANA, 2015, p. 19). It requires the one to be honest in giving information to the patient. Failing to do this, the nurse violates the law and the principle of beneficence, which states that the one should give information since it is beneficial in helping the person plan his life and spend time with his family. When the nurse fails to comply with rules and regulations and it leads to negligence, the one may be charged with a criminal offence (Buppert, 2017). However, in this case under discussion, the nurse will commit a civil act since such actions do not constitute gross misconduct or negligence.

Ethical Principle

Nurse practice demands nurses to follow the ethical principle of autonomy that postulates that the patient has the right to make one’s own decision following his intellectual and developmental abilities and nurses have no right to hide any information from him. By giving the man all information, he can make the right decision on treatment since he is not incapacitated (Punjani, 2013). For the ethical dilemma to be solved, the nurse practitioner should follow the ethical principle of autonomy, beneficence, and justice (Pearson, 2012). As a result, the nurse will deal with the issue in the case.

Decision Portraying Integrity

The nurse is required to look for an alternative favorable treatment method that can help save the patient life. It is done by doing a thorough assessment of the patient according to Anderson & Werner (2018). Any procedure which is done on the patient like a surgery requires one’s consent, and if the one is not capable, the nurse should look for alternative ways. Arrangements should also be made to reach the family members who may help in making a decision whether the patient should proceed for the medical process or not. By doing this, the nurse will not violate the law. Respecting the autonomy of the patient in making his own decision will solve the moral issue arising as a result of not telling him the truth.

Recommendations

The nurse should follow rules and regulations which require the patient to be given full access to his health records and told the truth about his condition. It should be told even if the condition is worse for him to make correct decisions (Medical University of South California, n.d.). In discharging one’s duty, the nurse practitioner should follow the three ethical principles of autonomy, beneficence, and justice (Pearson, 2012). It will assist in solving the ethical dilemma arising at work. The nurse should search for any facts relating to the evaluation of man’s ability to make decisions on any form of treatment that can be conducted on him. Anderson & Werner (2018) recommends the nurse to conduct all assessments to establish the capacity of the patient before telling him the truth. It will help the nurse to deal with moral distress.

Conclusion

The ANP is usually faced with a practice dilemma on the daily basis during work, and telling the truth to the patient about his or her health condition is one’s responsibility. Therefore, the nurse should exercise due intelligence in informing the patient and the family members about the true health status. Finally, the former should provide them with all necessary support required in dealing with the news which may be shocking to them.