Question

What are examples ethical dilemma that are encountered in a nursing practice? How would they be handled.

Answer 1

Ans) Common Nursing Ethics Dilemmas:
1. Informed consent

- Concerns that patients and their families have not been fully informed about their treatments or clinical prognosis is a common ethical concern of nurses, Ulrich reported.

“It can create great concern for nurses,” Ulrich said. “Patients feel more comfortable asking the nurse to decipher what was said [by the doctor]. But it’s an ethical issue about how much they should convey.”

This is especially true about end-of-life decision making, she said. But nurses may not be prepared to have this discussion. She suggested building stronger interdisciplinary teams.

2. Disclosing medical conditions:

- Another example of an ethical dilemma is telling the truth to a patient vs. being deceptive, Altman said.

- Sometimes families request that patients not be told about their medical condition or diagnosis. “The nurse must consider the patient's right to know.

- The nurse has an obligation to the patient and the ethical principles of nonmaleficence and fidelity—the obligation to prevent harm and the obligation to be faithful to your colleague.“The nurse’s own value of truth telling must also be considered.”

3. Incompetence among peers:

- Another dilemma involving nursing ethics is when a nurse notes incompetence in a fellow health care team member and struggles with speaking up or staying silent, said Sarah Delgado, RN, MSN, ACNP, clinical practice specialist with AACN.
- They may feel the behavior should be reported because of the threat to patient safety but hesitate to do so because it would worsen inadequate staffing. Some staff dilemmas can be framed as competing obligations, such as protecting the patient on one hand and protecting the staff on the other. The principles to consider are nonmaleficence and fidelity.

- Resolving what appear to be competing obligations often requires thinking creatively.

- Solutions often become apparent when we stop and consider all the possible actions available to us. Beyond report or don’t report, there may be an option to talk to the individual in question, assess his or her awareness of the incompetence, and encourage further training, education or practice.”

4. Broader ethical issues:

Top three nursing ethics issues as:

Creating and maintaining an ethical work environment
Nursing’s role in social justice, such as opposing capital punishment
Moral distress and moral resilience.
“The Code of Ethics for Nurses with Interpretive Statements is clear that nurses are bound in their duty to protect human health. As the guiding voice for nursing ethics in the United States, the ANA feels that it is important to take a strong position on issues affecting human dignity and societal health.”