Full Answer Section

Key Stakeholders

The key stakeholders in this ethical dilemma are:

• The Patient: The individual making the decision about their care.
• The Nurse: The primary caregiver who must balance patient advocacy with professional responsibilities.
• The Physician/Healthcare Team: The professionals who have a duty to provide beneficial medical treatment.
• The Patient’s Family: Individuals who may be emotionally invested and have their own opinions about the patient’s care.
• The Hospital/Healthcare System: The institution that provides the care and has policies regarding patient rights and medical treatment.

Impact on Key Stakeholders

• The Patient: The patient’s decision to refuse treatment could lead to a decline in their health and potentially death. They may also feel pressure from family and healthcare providers to change their mind, which could diminish their sense of autonomy and well-being.
• The Nurse: The nurse experiences significant moral distress. They may feel a sense of failure if the patient’s condition worsens. They must navigate the difficult task of supporting the patient’s decision while also dealing with their own professional and personal beliefs about what is “right.” This can lead to burnout and emotional exhaustion.
• The Physician/Healthcare Team: The team may feel frustrated by the patient’s refusal of treatment, as they believe they are not being allowed to do their job effectively. They may also face legal or ethical scrutiny if the patient’s decision is not clearly documented as an informed refusal.
• The Patient’s Family: Family members may be devastated by the patient’s decision and may disagree with it. This can cause significant conflict within the family and with the healthcare team. They may also feel helpless and unable to influence the outcome.
• The Hospital/Healthcare System: The hospital must ensure that the patient’s rights are respected and that all ethical and legal procedures are followed. This includes confirming the patient’s capacity to make the decision and documenting informed refusal properly. Failing to do so could result in legal challenges.