Nursing is both a challenging and rewarding job, and throughout a nurse’s career, they will face many ethical dilemmas where conflict between policies and laws will force a decision that goes against personal beliefs or what seems humane and just. It is always the nurse’s job to provide safe and effective care for clients while respecting their rights to confidentiality. There are multiple laws in place through Federal and provincial legislations that ensure a client’s information is protected, so nurses must remain vigilant in this regard, so they do not violate the laws or client privacy. The ethical dilemma example has multiple scenarios that make keeping confidentiality and respecting rights a challenge.
End of Life Issues
Often, a gravely ill client will seek an advanced directive that gives them the right to make choices about the end of their life while they are still lucid and coherent. Many will sign a DNR, or do not resuscitate order so that no life-saving efforts will be made should they pass away while receiving medical care. This often conflicts with the families’ wishes and once the client is no longer able to make their own decisions, the family will often step in and demand life-saving measures be taken against the clients wishes. This puts nurses in an ethical imposition as they struggle to follow the client’s wishes, but avoid litigation from an unhappy family who feels you violated their rights. This often leads to clients being put on life-support or having feeding tubes put in place despite the fact that these measures will not change the outcome.
Every woman has access to birth control, but this becomes a sensitive topic when it comes to providing birth control for teenagers. Many teens feel as if talking to their parents about sex or birth control may end in confrontation and an outright refusal to their request. Here in the U.S. certain forms of birth control can be given without parent permission and a teen may seek prenatal care without parent knowledge. This can become a nursing issue as parents request private information on their teen or the nurse must provide care for a pregnant teen without parental consent.
Sexually Transmitted Diseases
When individuals seek treatment for STD’s there are policies in place that allow for notification of sexual partners, but this does not force those who seek treatment to disclose this information to all sexual partners. Nurses face the dilemma of not disclosing information that is harmful and possibly life-threatening. All nurses can do is treat those who seek it.
Those of certain religions have varying beliefs on medical treatment and practices. Some will not have certain surgeries while others do not believe in receiving blood transfusions. This can be a hindrance for nurses who want to provide life-saving measures. At times, hospitals will step in and try to obtain a court order for treatment if it means saving the life of a minor.
Laws like the Freedom of Information and Protection of Privacy Act, Personal Information Act and the Personal Information Protection and Electronic Documents Act all hold the nurse and other medical staff to strict policies for safeguarding information. While these laws were put into place to protect medical information and any negative outcomes that would come from such a disclosure, this often creates an ethical dilemma for nurses who strive to give excellent care to their ailing clients.
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median earnings per week than workers with only a high school diploma.*