Ethical dilemmas are something that goes hand-in-hand with being a nurse or even a doctor. The patient unit is far more complex than simply caring for patients. As we see in hospice, the patient unit is extended to include the patients’ family. An ethical dilemma is generally a problem that has no right answer, wrong answer or sometimes there is not even resolution.
The argument rages even today about whether or not people have the right to die when they choose to die. Most of the time, these patients are terminal and realize that their quality of life is declining faster than the progression of their disease. Do patients who are terminal and suffering have the right to die through assisted suicide? Nursing is about promoting quality care and saving lives through resources and our own caring capacity for other people. How should nurses approach the topic of assisted suicide?
The Right to say No
In the United States, we have always been granted the freedom of choice, but what happens when our choices impact our health or even endanger our own life. Anorexia is a common eating disorder where patients consume so little resources that the body begins to consume itself. How should nurses deal with an anorexic patient that will not eat? What if the patient is not anorexic, but just terminal and decides that they no long want to live? Do we have the right as health practitioners to override the right of free choice?
Lying to Patients
It is not uncommon for a family member to demand that their loved one not be told they have a terminal illness. It is equally tempting for healthcare professionals to embellish reality by telling a patient that they are worse off than they truly are. How do we deal with alcoholism and substance abuse when the patient is a chronic addict? We know that eventually their addiction will kill them in one form or another, but should we lead them to believe that they are dying now? Even if the motivation behind the lie is for the “good” of the patient?
Utilization of Resources
Resources are defined as tools used to provide patient care. Those tools include bed space, government reimbursements, funding, etc. How should nurses approach ethical dilemma when patients are utilizing resources that might be better used on another patient or population of patients. The example for this dilemma would be a patient that has no brain function, is on life support and has been for several years. Is there an argument that would allow the resources being used on this patient to end? How would the nurse deal with the family of this patient?
Empirical Knowledge and Personal Belief
This is not such an uncommon encounter any more in nursing. The world is changing, and with that change, we see new doctrine, philosophies, religions that are quite different from our own beliefs. One common issues results in religious beliefs and blood transfusions. How should a nurse handle a patient who will die without a blood transfusion, but refuses the transfusion based on religious belief? If the patient is of sound mind, do they not have the right to refuse service?
Ethical dilemmas are faced every day, and those that are listed here are only a partial list of what nurses face while providing patient care. There is no easy answer to any of these dilemmas and ethics course are full of helpful advice, but no real answers. Almost every dilemma in healthcare comes down to the patients’ right to choose their own quality of life. It is difficult to accept that sometimes, but our jobs are to provide the best information that we can so that the patient or family can make an informed decision about how to proceed with care. We may not like the result, but that is not our job. Our job as nurses is to provide the best care possible and sometimes that is simply allowing a patient the dignity to die.
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