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Written by: Darby Faubion BSN, RN
If you're a nurse, you've probably been in situations where you've had to make decisions based on your beliefs about whether something is right or wrong, safe or not. This type of decision is based on a system of ethical behavior. It is critical that all nurses develop and implement ethical values in nursing practice. If this sounds familiar, you may be wondering, "What are the most common examples of ethical dilemmas in nursing?" There are many things that could be considered an ethical dilemma in nursing, and it is important that nurses know how to deal with them when they occur. In this article, I will present the 20 most common examples of ethical dilemmas in nursing and provide information on how to address them.
What is an ethical dilemma in nursing?
An ethical dilemma in nursing is a situation in which a nurse must choose between competing values and know that any choice she makes will have consequences. Ethical dilemmas may conflict or conflict with the personal values of the caregiverCode of Ethics for Nurses.
Top 5 Reasons Nurses Face Ethical Dilemmas in Nursing
Nurses often face ethical dilemmas when caring for patients. Ethical dilemmas present themselves in a variety of ways and for a variety of reasons. Below are five main reasons why nurses face ethical dilemmas in nursing.
1. Patients or their loved ones must make decisions about life or death
2. The patient refuses treatment
3. Nursing assignments may conflict with cultural or religious beliefs
4. Nursing colleagues show incompetence
5. Inadequate staff
How to recognize ethical dilemmas in nursing?
Nurses of all disciplines face ethical challenges from time to time. The best way to describe and identify an ethical dilemma in nursing is to consider how a situation makes you think and feel. Ethical dilemmas create a conflict between two courses of action that are correct but represent different principles or values. When something good and bad is done at the same time in a situation, and one of these actions negatively affects the other action, a dilemma arises.
WHAT ARE THE MOST COMMON EXAMPLES OF ETHICAL DILEMMAS IN NURSING?
(Here are the 20 most common examples of nursing ethical dilemmas and tips on how to deal with each one.)
Example 1:Pro-life vs. pro choice
Screenplay:
Samantha is a 28-year-old college student who is 18 weeks pregnant. She has a history of heart disease made worse by her pregnancy. Samantha's doctor is concerned that continuing the pregnancy could lead to a worsening of her heart condition and a life-threatening emergency. She recommended an abortion within the next two weeks. Samantha resists and explains that although she doesn't attend church, she was raised believing that abortion is wrong and she believes that God will heal her. She wants to know what the nurse would do in her place. Nurse Jennifer does not believe in abortion under any circumstances.
Ethical dilemma:
Patients often turn to nurses for advice on their health, wellness, and care decisions. In some cases, such as the scenario presented here, the medical necessity of treatment or intervention is at odds with the patient's personal moral and/or religious beliefs. It is not uncommon for patients to want someone to tell them what the best decision is. In these situations, an ethical dilemma in nursing can arise, especially when the nurse has different opinions from the patient or the doctor.
How to deal with this ethical dilemma:
according to thatAmerican Nurses Association Position Statement on Reproductive Health,“Health care clients have a right to privacy and the right to make informed health decisions without coercion. In addition, nurses have the right to refuse participation in a given case for ethical reasons. However, when a patient's life is in danger, caregivers have a duty to ensure patient safety and prevent abandonment."
Although Nurse Jennifer does not believe in abortion, she should not express her personal beliefs or opinions to the patient. In her place, the caregiver should encourage the patient to talk to and seek advice from her partner (if appropriate), her family, her spiritual adviser, or anyone else she can trust. The nurse should schedule a follow-up appointment with the physician prior to the two-week period in which the physician intends to perform the procedure to discuss options and decisions.
Example #2:Protection of the right to privacy of young people
Screenplay:
Michael is a 16-year-old boy who has been diagnosed with a sexually transmitted infection (STI). Although the doctor examined Michael and privately told him of his diagnosis, Michael's mother is in the waiting room and wants to know what the doctor said. Michael told the doctor and nurse that he didn't want anyone to find out about the STI, not even his mother.
Ethical dilemma:
Perhaps one of the most common examples of ethical dilemmas in nursing occurs when nurses must decide whether it is appropriate to discuss a patient's medical information with a parent or guardian. For years, parents and guardians have had access to the medical records of all patients under the age of 18. Today all states have laws that allowMinors must agree to careunder certain conditions, without parental knowledge, consent, or access to their medical records.
How to deal with this ethical dilemma:
In most states, when a youth is old enough to consent to medical care, information about that care is generally considered confidential. A breach of patient confidentiality can have serious consequences, including the loss of a job or license. Therefore, it is necessary for nurses to be aware of the laws in their state and to work closely with those laws and supervisors to comply with their organization's policies. It is always appropriate to follow your facility's policies or seek managerial intervention or guidance if you are unsure.
Example #3:empirical knowledge vs. Religious beliefs
Screenplay:
Mr. Elliott is a fifty-eight-year-old man who goes to the emergency room after a car accident. He has multiple injuries and has been diagnosed with internal bleeding. The emergency physician requested surgical consultation. Although Mr. Elliott agrees to surgery if necessary. However, he refuses to accept a blood transfusion, even if his life depends on it. His reason for refusing a blood transfusion is that Mr. Elliott is a Jehovah's Witness and receiving a blood transfusion is against his religious beliefs.
Ethical dilemma:
It can be difficult to remain objective with patients, especially in life-threatening situations. An ethical dilemma in nursing can arise when a patient's wishes conflict with what is medically necessary to promote health or sustain life.
How to deal with this ethical dilemma:
When a patient is alert, informed, and understands the consequences of accepting or refusing medical care or treatment, they may refuse that care. While it is normal to want to promote life-saving interventions, nurses must learn to walk the line between providing accurate information and imposing their own opinions or beliefs. The nurse must document all explanations provided and the patient's response, including the reason for her refusal of treatment. Proper documentation protects the nurse and the health center from legal action if the client or her family believes that the treatment should have been given.
Example #4:Parents refuse to vaccinate children
Screenplay:
Mr. Black is the father and sole guardian of five-year-old twins who are preparing to go to kindergarten. Mr. Black has never vaccinated his children and claims that forcing him to vaccinate his children is a violation of his and his children's rights.
Ethical dilemma:
In order to protect the health of the population and the community, the health sector advocates vaccination against preventable diseases. Caregivers may feel caught between their proactive stance on vaccinations and the patient's or caregiver's right to choose which treatment to accept.
How to deal with this ethical dilemma:
Vaccination laws are generally based on CDC recommendations. Every state requires up-to-date immunization records for children entering elementary, secondary, or post-secondary schools and day care centers. WeatherSome states allow vaccination exemptionsThe caregiver's role may not be to force the administration or withholding of a vaccine. Rather, the nurse's job is to educate parents enough so that they can make an informed decision about the safety of vaccines and any potential risks. If a parent refuses to immunize her child, the nurse must have the parent sign a refusal form and document the education provided to the parent.
Example #5:Personal and professional limits related to social networks
Screenplay:
Nurse Madison works in a busy children's ward and loves her job. Recently, the mother of one of her patients sent her a friend request on social media and posted a comment on Nurse Madison's public wall asking about a patient who was in the room next to her son's. . The post read: "Hi Maddie! How's Gavin? We haven't seen him since Austin got fired."
Ethical dilemma:
Our world is full of technology available to us. When used correctly, nothing speaks against the use of technologies like social media platforms. It is important that nurses understand where theBoundary between personal and professional relationships.or acquaintances lie, taking care not to blur or cross these limits.
How to deal with this ethical dilemma:
Protecting patient privacy and confidentiality is the responsibility of all caregivers. This responsibility does not end when a patient is discharged from care. In that case, Nurse Madison had better NOT accept the friend request from the mother of her former patient. As Sister Madison and the mother develop a friendship that extends beyond caring for their son and connect on social media, Sister Madison must be accountable for things that are posted on her public wall or shared with others. She should also be proactive in removing all public communication and express to the friend that she must always maintain the patient's confidentiality.
Example #6:The nurse is instructed to ask patients with low literacy levels to sign consent for treatment.
Screenplay:
The attending physician instructs Nurse Gloria to have Mr. Isaacs sign a consent form before a scheduled colonoscopy. As Nurse Gloria reviews the form with the patient, she notices that he seems confused and isn't sure where or how to sign the paperwork.
Ethical dilemma:
It is common for nurses to collect signatures on informed consent forms, especially in procedures like the one described in this scenario. Faced with a situation like this, in which the nurse is not sure if the patient understands what is being said or knows how to read, the decision to postpone a busy schedule so that the doctor can return and talk to the patient or explain as best Knowing it and getting the patient's signature may seem difficult.
How to deal with this ethical dilemma:
The language used in medical care and health documents is complicated for most patients. It can be even more difficult for patients with poor literacy skills. However, all patients have the right to be fully informed and understand treatment options and procedures before they are provided. It is ALWAYS right to err on the side of the patient's vulnerability. The nurse must provide information in a format that the patient can understand, ask questions, and allow or refuse treatment. If the patient does not fully understand what the nurse is saying, the nurse should notify the doctor and ask him or her to explain the procedure again, including the expected results and risks.
Example #7:decision making at the end of life
Screenplay:
Ms. Douglas has metastatic lung cancer. Her doctor advised her on treatment options that could extend her life by six months to a year. However, to the chagrin of her family, Mrs. Douglas chose only comfort measures. Ms. Douglas prepared an enhanced directive, including signing a DNR (Do Not Resuscitate).
Ethical dilemma:
End-of-life care decisions are one of many examples of ethical dilemmas in care. Nurses can easily become overwhelmed trying to comfort loved ones while accommodating with patients' wishes.
How to deal with this ethical dilemma:
Nurses are invaluable resources in helping patients and their families through end-of-life transitions. If Ms. Douglas is of her right mind and clearly understands her prognosis with and without treatment, she has the right to decide what treatment she wants or not. Although the situation may be difficult, the nurse's primary responsibility is to her patient. Nurses must defend the autonomy and rights of the patient. In this scenario, because the patient has an advance directive, it may be easier to follow her wishes.
Example #8:Insufficient resources to care
Screenplay:
Nurse Judy is the wound care nurse at a home health center. She stopped by the office to get extra wound care supplies for her weekend visits. However, the head nurse informed her that the shipment of wound care supplies had not arrived. As a result, there are not enough supplies for Sister Judy's planned visits.
Ethical dilemma:
Nurses may be faced with situations where they need to determine which patient needs more need or treatment than another. While this isn't an ideal situation, it happens more often than most people would like to admit.
How to deal with this ethical dilemma:
This situation requires the nurse to use her triage skills and determine which patients, if any, could safely change or supplement their prescriptions. The nurse should review the nurses' notes and obtain a report from the person who last saw the clients for whom she will be providing care over the weekend. If a patient has a wound that has healed or is improving, she should report these changes to the nurse, GP or doctor on call to see if instructions can be changed. This allows the nurse to have enough supplies to care for patients needing wound care services until the supplies are delivered.
Example #9:Former patients: updated or not updated?
Screenplay:
Wesley is a patient at the local clinic where Nurse Sabrina works. After almost a year at the clinic, Wesley told Sabrina that he thought she was very pretty and invited her to dinner.
Ethical dilemma:
Patients trust nurses with some of their most confidential information. While this trust is good and places caregivers in unique positions to help patients, an ethical dilemma of care can arise if the caregiver does not maintain professional relationships.
How to deal with this ethical dilemma:
Professional boundaries protect nurses and patients. It is important for caregivers to recognize the warning signs that can lead to crossing these boundaries before things get out of hand. Nurses should avoid after-hours phone calls with the patient of a personal nature, giving and receiving gifts, flirting, keeping secrets, or excessively interfering with the patient's business or personal affairs.
Example #10:acceptance letter
Screenplay:
Mr. Thomas is a 68-year-old man with a history of diabetes and peripheral hypertension. Due to the vascular changes and uncontrolled blood glucose, Mr. Thomas developed an ulceration on his right heel. Treatment of the wounds was unsuccessful and Mr. Thomas suggests amputation as the next step. Mr. Thomas agrees with the doctor, but his wife doesn't. Mrs. Thomas expresses her concern to the nurse that her husband is being tricked into having his foot amputated because the doctor is tired of treating her injuries.
Ethical dilemma:
The concept of informed consent is a common ethical dilemma in nursing. Informed consent for treatment is the process by which a patient or their designated representative gives permission to healthcare professionals to administer treatment or perform procedures. Informed consent requires healthcare professionals to educate patients about the potential risks and benefits of proposed treatments and inform them of alternative treatment options.
How to deal with this ethical dilemma:
It is common for patients or their loved ones to confide their concerns or ask caregivers questions before speaking with doctors, especially when they are worried or stressed. In this scenario, Ms. Thomas seems more comfortable talking to the nurse. It is vital that the nurse try to understand Mrs. Thomas and try to comfort her. In addition, it is important that the nurse inform the responsible nurse and the doctor about the situation of Mrs. Tomás. Although the decision to seek treatment rests with Mr. Thomas, his wife's concerns should not be ignored.
Example #11:inadequate staff
Screenplay:
Nurse Cathy works the night shift in the medical-surgical ward. The hospital has established protocols that include a nurse to patient ratio not to exceed six patients per nurse. There are twenty-three patients on the Med Surg floor. A nurse called and left three nurses to care for the patients.
Ethical dilemma:
Nurses have a duty to promote patient safety. An ethical dilemma in nursing arises when nurses have more patients than they can safely care for, putting both patients and staff at risk.
How to deal with this ethical dilemma:
There are times when staff shortages are unexpected or unavoidable. It is the responsibility of the charge nurse or care manager to strive to maintain the nurse to patient ratio within institutional guidelines. However, nurses should never leave their jobs due to the disproportionate number of patients they see. When caregivers are faced with personnel issues, it is necessary to raise the concerns immediately with the caregiver. The nurse must then prioritize care based on the patient's needs or condition.
Example #12:Spirituality x Science
Screenplay:
Mr. Jenkins has been in intensive care for ten days. He was initially admitted to the emergency department with a high fever of unknown cause and suspected sepsis. After diagnostic testing, it was determined that Mr. Jenkins had a perforated intestine that resulted in whole body sepsis. He has had two strokes in the last 12 hours, is unresponsive and has no living will. The Jenkins children say they "hold on to the belief that God will help them." Despite the doctor's efforts to explain the seriousness of the situation and try to prepare the children for the worst, they insist that all possible measures be taken to save lives.
Ethical dilemma:
Health and care is results-oriented and science-based. The science behind patient care may conflict with personal or religious beliefs. Nurses can be frustrated that the science they know is not enough to save their patients. When families struggle to come to terms with a poor prognosis for their loved one and instead cling to religious beliefs, caregivers can feel powerless.
How to deal with this ethical dilemma:
The American Nurses Association Code of Ethics states that nurses should recognize and abide by this"Unique differences of patients, including lifestyle, value systems, and religious beliefs."However, the code also requires that the patient's beliefs be respected."does not mean that the nurse endorses these beliefs or practices on a personal level."Many patients experience less stress when they trust their faith in times of medical challenges. Nurses must be aware of the spiritual and religious needs of the patient. In this scenario, although the nurse accepts the science behind the patient's diagnosis and the expected outcome, it is her role to respect and support the family's decisions.
Example #13:Patient dependent on prescribed analgesics
Screenplay:
Jones is a 34-year-old man who was taken to the emergency room after a car accident. He is well known to the ER staff, as he has been admitted more than once for complications of substance abuse. As he awaits X-rays of his left leg, which appears to be broken, Mr. Jones complains of "extreme pain" and asks for painkillers. Paramedics will not issue a prescription for painkillers stating that Mr. Jones is "a painkiller addict."
Ethical dilemma:
Nurses are often faced with the dilemma of following physician orders wholeheartedly or seeking intervention from supervisors or administrators. Moving up the chain of command can expose nurses to the risk of professional retaliation and allegations of disobedience. On the other hand, inaction on the part of the nurse means that the patient's complaints of pain are ignored because the patient is addicted.
How to deal with this ethical dilemma:
It is always appropriate to advocate for the needs of the patient. If the physician refuses to provide pain management options despite the patient's request and the nurse's assessment of pain, the nurse should inform a supervisor.
Example #14:Duty and compassion are not in line with the facility's security protocols.
Screenplay:
Sister Jordan worked in a busy COVID-19 unit caring for Mr. Miller. Sister Jordan promised Mr. Miller and his family, who were not allowed to visit him, that she would not leave him to die alone. The hospital has adopted guidelines to protect nurses and other staff from prolonged exposure to COVID. After lying next to Mr. Miller for an extended period, Sister Jordan's supervisor ordered her to leave the room.
Ethical dilemma:
Due to their roles as patient advocates and nurses, nurses often face ethical dilemmas, especially when it comes to being present at crucial moments in a patient's life. In this scenario, Sister Jordan faced an ethical dilemma because her sense of duty and compassion for the patient did not align with the safety protocols the hospital had established to protect nurses.
How to deal with this ethical dilemma:
Following protocols can seem difficult, especially in situations where you feel your patient needs you at their bedside. Although the nurse understandably wanted to comfort the patient and her family by promising that she wouldn't be alone, it would have been better not to make a promise she didn't know she could keep. When a situation arises where compassion and duty are not consistent with facility protocol, the caregiver should immediately speak with the responsible caregiver, explain the situation, and seek advice or intervention. In this scenario, the charge nurse may not have allowed Sister Jordan to stay in the room, but she could have sent another nurse.
Example #15:The patient does not have an extended regimen
Screenplay:
Ms. Wilhite is a 74-year-old woman diagnosed with stage IV breast cancer with metastases to the lungs. Although Ms. Wilhite spoke to the nurse and told her that she does not want to take life-saving measures, she does not have an advance directive. Ms. Wilhite has experienced a significant decline in cognitive function and is currently unable to make decisions about her care. Her children may not agree on what treatment or life-saving measures are appropriate.
Ethical dilemma:
Unfortunately, this is a common ethical dilemma in nursing. When patients do not have advance directives, caregivers can feel caught between listening to well-meaning family members and doing what the patient asks. The family may want the team to exhaust their efforts to rescue their relative, even if the patient has expressed a desire to discontinue treatment or life support.
How to deal with this ethical dilemma:
Whenever possible, nurses should encourage each patient to prepareadvanced policy🇧🇷 When patients have enhanced directive, healthcare professionals know what patients want when they are unresponsive and need life support. It also helps ease the burden of difficult decisions made by family members, which is important because loved ones can be affected by emotions. In cases where there is no enhanced policy, state law provides provisions that allow delegation of power of attorney to a parent, guardian, spouse, or other person. Hospitals also have ethics committees that intervene when the patient does not have an extended directive or a family member to whom to delegate authority.
Example #16:Incompetence among nursing colleagues.
Screenplay:
Nurse Micah works with Nurse Saundra and cares for patients in the Cardiac Unit. Today, one of Nurse Micah's patients experienced an increase in blood pressure beyond the safe limits of the protocol. Because he was busy taking care of another patient, Nurse Micah forgot to tell the doctor about the change in blood pressure. As the patient's blood pressure returned to normal levels, she did not document the incident. He confided in Nurse Saundra about the patient's blood pressure and that he had not documented the change or reported it to the doctor.
Ethical dilemma:
Although no caregiver wants to believe that another caregiver is incompetent to provide care, incompetence issues are real and can create ethical dilemmas in care delivery. Nurses often develop strong relationships with their colleagues, making the decision to report errors or omissions difficult. However, the primary responsibility of all caregivers is to provide safe and competent care to all patients.
How to deal with this ethical dilemma:
It is never appropriate to shirk responsibility, including documenting changes in a patient's condition or informing physicians when necessary. Nurse Saundra's first response should be to encourage Nurse Micah to document the change in the patient's vital signs and inform the physician of the increase and return to normal. If she is unsure whether Nurse Micah has documented and reported the patient change, or if she is not comfortable with the situation, Nurse Saundra should report the information to her head nurse. As always, the safety and well-being of the patient must be of the utmost importance to all caregivers.
Example #17:Disclosure of disease severity
Screenplay:
Mr. Morris has end-stage renal failure. Despite efforts to control the disease, including dialysis three times a week, his condition worsened. Mister. Morris noted his deteriorating condition and informed the family that Mr. Morris only has a few weeks to live. Mrs. Morris and her children are reluctant to tell Mr. Morris how serious his condition is, and the doctor made no effort to discuss this with the patient. After his family left the hospital for the night, Mr. Morris called the nurse and asked her to tell him what the doctor said, explaining that he felt he did not understand the whole story.
Ethical dilemma:
The decision to disclose the seriousness of a patient's condition is not a new ethical dilemma in nursing. For years, doctors were considered decision makers for patients, deciding whether to withhold information based on whether they felt the information would cause undue stress or do more harm than good. In recent years, the notion that patients have a right to know the truth about their diagnosis and prognosis has become the norm. Unfortunately, caregivers often find themselves caught somewhere between sharing news that may cause the most distress or providing blanket responses to reduce anxiety.
How to deal with this ethical dilemma:
The bottom line, and the most important point for caregivers to remember, is that patients have the right to be informed about their own diagnosis and the possible outcome of treatment, or lack thereof. The physician's first responsibility is to communicate his diagnosis to the patient. However, nurses tend to have more face-to-face encounters with patients and are often the ones patients turn to for clarification. It is best to answer the questions as carefully and completely as possible. If you are unsure of the correct answer, escalate the question to your manager or the patient's physician.
Example #18:question medical orders
Screenplay:
Mr. Wesley was diagnosed with intestinal ambia, so the doctor prescribed tinidazole 2 grams once a day for five days. Nurse Lin points out that Mr. Wesley claims that he is allergic to Flagyl and knows that tinidazole is contraindicated in patients allergic to Flagyl.
Ethical dilemma:
Some of the most common examples of ethical dilemmas in nursing arise from the prescription of inappropriate or questionable medications. As nursing students begin to learn about medications and the administration of drug therapies, they mustFive rights of drug use“This is the right patient, the right drug, the right time, the right dose, and the right way. Although nurses should not arbitrarily choose which medical orders to follow and which to disobey, it is the nurse's responsibility to ensure safe patient care, including reviewing questionable orders.
How to deal with this ethical dilemma:
Nurse Lin should immediately clarify with Mr. Wesley what drug allergies he has and ask him how he reacts to those drugs. Once a Flagyl allergy is confirmed, Nurse Lin should notify the physician and inquire about an alternative option for the patient. In most cases, doctors change the order when a drug is contraindicated. However, if the physician refuses to change the order, the nurse must immediately notify the nurse manager. Nurse Lin is also to tell Mr. Wesley that she is reviewing the doctor's prescription for drug allergy and asks him to wait until the prescription is confirmed or changed before filling and taking the medication.
Example #19:You were asked to work in an unskilled department
Screenplay:
Matron Hale assigned Sister Mary to work in the postpartum ward due to a nursing staff shortage. One of the patients asked for help to breastfeed, explaining that her baby was not latching on. Sister Mary has been a nurse for a year, but she has never worked with postpartum patients. She expressed her concern that she does not have experience working with newborns or postpartum mothers.
Ethical dilemma:
It is not uncommon for nurses to move from department to department during their shifts and throughout their careers. While there is nothing wrong with assigning nurses to different departments as needed, an ethical nursing dilemma can arise when a nurse is asked to provide care that she never provided.
How to deal with this ethical dilemma:
It is important for nurses to understand that clinical experiences in nursing school are broad and may not provide in-depth training in specific areas. This scenario is an example of a nurse graduating from nursing school and obtaining a license, but no experience in the field (postpartum nursing). The appropriate response from the nurses is for Sister Mary to tell Head Nurse Hale that she has not had the opportunity to learn breastfeeding techniques firsthand and that she is asking for guidance. Ideally, the midwife would accompany Sister Mary to the patient's room and give instructions to both Sister Mary and the patient. If the charge nurse refuses to assist Sister Mary or to assign an experienced nurse to assist Sister Mary, it may be appropriate for Sister Mary to turn to the next person in the chain of command.
Example #20:Charity against Autonomy
Screenplay:
Mr. Simms was diagnosed with lung cancer three years ago. He experienced a brief remission after chemotherapy, but recently learned that the cancer had returned. Mister. Simms warned him and his family that the treatment was unlikely to be successful and that while it might offer a few more months of life, Mr. Simms would deteriorate rapidly. The doctor recommends hospice care at home with only comfort measures, including oxygen and opioid pain medications. Despite pain symptoms such as grimacing and crying, Mr. Simms refuses to take pain medication and says he doesn't want to feel the effects of drowsiness and lose quality time with his family. Desperate, her wife asks the nurse if there is a way to administer painkillers without her husband knowing.
Ethical dilemma:
Charity outlines the duty of nurses to act on behalf of patients and uphold moral values to protect patients' rights, prevent harm, and remedy conditions that may cause harm. Autonomy, on the other hand, is an act directed or permitted by the patient without interference or persuasion by medical or nursing staff. Nurses who practice charity without respecting the autonomy of the patient may end up practicing acts that do not benefit the patient.
How to deal with this ethical dilemma:
While the caregiver may mean well, the patient's right to autonomy must be balanced against what the caregiver feels is appropriate. If Mr. Simms can make independent decisions with a clear understanding of the consequences, the nurse must pay attention to her wishes. The nurse should explain to Mrs. Simms that she understands her concern and desire for her husband to be free of pain, but also to explain that the nurse is required by law and by the nurse's code of ethics to allow Mr. The Simms make decisions for themselves. if Mr. Simms does not have a living will, it is also appropriate for the nurse to recommend establishing a living will while she is still able to do so.
4 Consequences of Avoiding Ethical Dilemmas in Nursing
Nurses of all specialties and types of care settings face ethical dilemmas. Nurses must recognize when a nursing ethical dilemma arises and learn to balance their own beliefs and values with these dilemmas. Avoiding ethical dilemmas, such as the examples of nursing ethical dilemmas presented in this article, can have negative consequences. The following are some examples of the consequences of not addressing ethical dilemmas in nursing.
1. Caregivers can quickly experience burnout.
Ethical dilemmas generate a lot of stress. Faced with these dilemmas, it is important that caregivers recognize the problem and resolve it as quickly as possible. Failure to do so can lead to more stress, which can lead to caregiving burnout.
2. Avoiding ethical dilemmas in nursing can lead to legal problems.
Some ethical dilemmas can have serious legal consequences. It is never a good idea to ignore an ethical dilemma. Instead, the issue should be raised with the right person, including supervisors, and handled properly to avoid legal issues.
3. Nurses who avoid ethical dilemmas may lose their job.
Depending on the situation, failure to address an ethical dilemma in nursing can result in consequences such as a reprimand from management or job loss.
4. Loss of license:
There are some ethical dilemmas in nursing that have serious consequences if they are avoided. In that case, the nurse may lose the license to practice medicine. As a general rule, it's always best to recognize dilemmas and seek executive help to handle them before your job or license is on the line.
my last thoughts
Any nurse who has worked in this field long enough will face ethical dilemmas at some point. Perhaps she has experienced ethical dilemmas or has wondered, "What are the most common examples of ethical dilemmas in nursing?" The 20 most common examples of ethical dilemmas in nursing presented in this article provide examples of the types of situations that caregivers face. While it is impossible to avoid all ethical dilemmas, caregivers can equip themselves with the knowledge to help them professionally address and overcome issues, while promoting high-quality, safe, and effective patient care.
Darby Faubion BSN, RN
Darby Faubion is an Allied Health nurse and educator with over twenty years of experience. She has helped develop curricula for nursing programs and has taught students at community colleges and universities. Because of her love of nursing education, Darby became a Test Strategist and NCLEX Preparation Instructor, supporting nursing graduates across the United States in preparing for the National Council Licensing Examination (NCLEX).
FAQs
What are the 7 major Ethical issues in nursing practice? ›
The ethical principles that nurses must adhere to are the principles of justice, beneficence, nonmaleficence, accountability, fidelity, autonomy, and veracity.
What are some examples of ethical dilemmas in healthcare? ›- Advance directives.
- Surrogate decision making.
- Refusal of treatment.
- Conflicts with caregivers.
- Foregoing life-sustaining treatment.
- Do Not Attempt Resuscitation (DNAR) orders.
- Other issues perceived as ethical problems.
The search yielded 10 nursing ethical values: Human dignity, privacy, justice, autonomy in decision making, precision and accuracy in caring, commitment, human relationship, sympathy, honesty, and individual and professional competency.
What are the 2 biggest ethical issues in health care? ›- Do-Not-Resuscitate Orders. ...
- Doctor and Patient Confidentiality. ...
- Malpractice and Negligence. ...
- Access to Care. ...
- Physician-Assisted Suicide.
...
The following are brief descriptions of each of the ethical principles.
- Beneficence: ...
- Nonmaleficence: ...
- Justice: ...
- Accountability: ...
- Autonomy: ...
- Fidelity: ...
- Veracity:
Patient Confidentiality
One of the biggest legal and ethical issues in healthcare is patient confidentiality which is why 15% of survey respondents noted that doctor-patient confidentiality is their top ethical issue in practicing medicine.
In LDRS 111 you were introduced to four different ethical dilemma paradigms: truth vs loyalty, short-term vs long-term, individual vs community, and justice vs mercy.
What are today's biggest ethical issues? ›Harassment and discrimination are arguably the largest ethical issues that impact business owners today. Should harassment or discrimination take place in the workplace, the result could be catastrophic for your organization both financially and reputationally.
What are the top 10 ethical issues in healthcare? ›- Maintaining health and wellness as a physician. ...
- Using social media professionally. ...
- Reporting incompetent or unethical behaviors by colleagues. ...
- Involving medical students in patient care. ...
- Accepting gifts from patients. ...
- Working with surrogate decision-makers.
Unethical accounting, harassment, health and safety, technology, privacy, social media, and discrimination are the five primary types of ethical issues in the workplace.
What is an ethical dilemma in nursing definition? ›
In these situations, nurses may experience an ethical dilemma. An ethical dilemma is defined as a situation where a choice has to be made between competing values, and no matter what choice is made, it will have consequences.
What are the 5 C's in nursing? ›According to Roach (1993), who developed the Five Cs (Compassion, Competence, Confidence, Conscience and Commitment), knowledge, skills and experience make caring unique. Here, I extend Roach's work by proposing three further Cs (Courage, Culture and Communication).
What are the 7 basic ethical principles? ›WHAT ARE THE 7 MAIN ETHICAL PRINCIPLES IN NURSING AND WHY THEY ARE IMPORTANT? There are seven primary ethical principles of nursing: accountability, justice, nonmaleficence, autonomy, beneficence, fidelity, and veracity.
What's an example of ethical dilemma? ›Some examples of ethical dilemma include: Taking credit for others' work. Offering a client a worse product for your own profit. Utilizing inside knowledge for your own profit.
What are the three biggest issues in healthcare today? ›- Cybersecurity Threats.
- Telehealth Implementation.
- Invoicing and Payments.
- Price Transparency Mandate.
- IT Healthcare Investments.
- Patient Experience.
- Effective Payment Models.
- Healthcare Staffing Shortages.
- Emotional Trauma. ...
- Fear of Contracting COVID-19. ...
- Exhaustion and Overworking. ...
- Staffing Issues. ...
- Underpayment.
There are six broad ethical areas that need to be considered in your research. In this chapter, we will discuss voluntary participation, informed consent, confidentiality and anonymity, the potential for harm, communi- cating the results, and more specific ethical issues.
What are the 3 ethical issues? ›- Unethical Accounting. ...
- Social Media Ethics. ...
- Harassment and Discrimination. ...
- Health and Safety. ...
- Technology/Privacy.
“Do unto others as you would have them do unto you.”
What are the 4 pillars of nursing? ›These four pillars are: Clinical/direct care • Leadership and collaborative practice • Improving quality and developing practice • Developing self and others.
What are the 4 main ethical principles in nursing? ›
Nurses are advocates for patients and must find a balance while delivering patient care. There are four main principles of ethics: autonomy, beneficence, justice, and non-maleficence. Each patient has the right to make their own decisions based on their own beliefs and values. [4].
What are 4 ethical behaviors? ›Ethical behavior includes honesty, fairness, integrity and understanding. There are several ways to encourage an ethical workplace culture, including establishing a company-wide code of ethics.
What is the 10 ethical behaviors of counselors? ›These principles are autonomy, beneficence, non-maleficence, fidelity, justice, veracity, and self-respect (American Counseling Association, 2014; British Association for Counselling and Psychotherapy, 2018). They are largely consistent across frameworks aside from some minor variations.
What are the 5 elements of ethics? ›- Dedication. Your strong work ethic shows in every aspect of your business and the way you behave yourself. ...
- Professionalism. When you conduct yourself in a professional way your strong work ethic shines through. ...
- Dependability. ...
- Accountability. ...
- Gratitude.
- Support the nursing code of ethics. ...
- Offer ongoing education. ...
- Create an environment where nurses can speak up. ...
- Bring different disciplines together.
- Harnessing Advanced Health Technology. ...
- Information and Integrated Health Services. ...
- Cybersecurity. ...
- Rising Healthcare Costs. ...
- Payment Processing and Invoicing. ...
- Pressure on Pharmaceutical Prices. ...
- Healthcare Regulatory Changes. ...
- Healthcare Staffing Shortages.
- Physician patient relationship.
- Death and dying.
- Resource Allocation.
- Assisted reproductive techniques and their use.
- Genetic testing and screening.
- Sexuality and gender.
- Environmental ethics.
- Clinical research ethics.
- The Unfaithful Friend. ...
- A Difficult Choice. ...
- An Office Theft. ...
- Midnight Death. ...
- Get Rich. ...
- Telling a Secret. ...
- The Life Boat. ...
- Sarcastic Friend.
- Balancing Care Quality and Efficiency. ...
- Improving Access to Care. ...
- Building and Sustaining the Healthcare Workforce of the Future. ...
- Addressing End-of Life Issues. ...
- Allocating Limited Medications and Donor Organs.
False accounting, sexual harassment, data privacy, nepotism, discrimination—these are just some of the ethical dilemmas that happen in today's workplace. Many business owners and managers will deal with ethical issues at some point in their career.
What does ethical dilemma mean in nursing? ›
Abstract. By definition, an ethical dilemma involves the need to choose from among two or more morally acceptable options or between equally unacceptable courses of action, when one choice prevents selection of the other.
What are dilemmas and example? ›In such a dilemma, choosing one moral will result in violating another; or, doing one thing could bring positive results but is morally wrong. A common example is “stealing from the rich to feed the poor.”
What are moral dilemmas give 2 examples? ›Some examples of moral dilemmas include: The classic “lifeboat dilemma”, where there are only 10 spaces in the lifeboat, but there are 11 passengers on the sinking ship. A decision must be made as to who will stay behind. A train with broken brakes is speeding towards a fork in the tracks.
What are the 6 ethical issues? ›These principles include voluntary participation, informed consent, anonymity, confidentiality, potential for harm, and results communication.