Ethical dilemma from your nursing practice

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.

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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.

Sample Answer

       

Ethical Dilemma: Patient Autonomy vs. Beneficence

  A classic ethical dilemma in nursing involves a conflict between patient autonomy (the right of a patient to make their own decisions about their care) and beneficence (the ethical principle of acting in the best interest of the patient). A common scenario is when a patient with a life-threatening illness refuses a treatment that is medically proven to be effective and could save their life. For example, an elderly patient with a treatable form of cancer may refuse chemotherapy, stating they have lived a full life and do not wish to endure the side effects of the treatment. The healthcare team, guided by the principle of beneficence, believes the treatment is the best course of action and has a high chance of success. The nurse, who has built a trusting relationship with the patient, is caught between advocating for the patient's right to refuse treatment and the professional duty to provide care that promotes well-being.