Ethical dilemmas in nursing practice
Ethical dilemmas are a section in nursing practice that has been overlooked for quite some time. Leaving doctors and nurses confused whenever they come across them. An ethical dilemma is a situation where there are two conflicting ideologies or options that are morally correct. For example in a case where a patient is HIV/AIDS positive and requests the nurse not to inform the patient’s partner. This puts the nurse in a complicated situation he/she isn’t sure whether to inform the partner about the results to prevent him/her from getting infected or to keep silent as this would lead to a breach of confidentiality.
Ethical decision-making models.
Ethical dilemmas are rampant. Particularly in the end of life issues and strategic pain management where at times the family and the patient’s wishes conflict with nurses’ code of conduct. This points out the urgent need for techniques to solve these ethical problems whenever they arise. Ethical dilemmas require reasoning and decision making. There is also a need for dialogue and workshops to shed more light on the subject.
According to the Canadian Nursing Association. There are several approaches used in decision making whenever one comes across an ethical dilemma. Consequential approach base its decisions on the outcomes or the consequences. It considers the opinion of the majority and ignores the minority. Non-consequential decision-making approach is based on moral standards that nurse practitioners are expected to adhere to. It is widely accepted in most health facilities.
Ethical decision making based on virtues states that nurses should have good characters and attitudes that will guide them to operate efficiently during decision making. They should be honest, truthful, courageous and trustworthy. Principles of autonomy, justice, beneficence, and non-maleficence state that nurses should operate in a just and fair manner without influence or coercion from outside forces that intend to cause harm to the patient.
Steps involved in decision making
Nurses can use any of the above decision-making models whenever they are faced with an ethical dilemma. These approaches act as a map to help them navigate through challenging situations. Several steps are involved in decision making. The first step is data collection, the second one involves identifying the dilemma, wishes and beliefs of those who are involved. The third step is analyzing different decision-making models to find out the advantages and disadvantages of each approach and forming a committee to discuss the way forward. The fourth step is picking the best approach and making a decision based on it.
De Casterlé, Bernadette Dierckx, et al. “Nurses’ responses to ethical dilemmas in nursing practice: meta‐analysis.” Journal of advanced nursing 63.6 (2008): 540-549.
de Casterlé, Bernadette Dierckx, et al. “Nursing students’ responses to ethical dilemmas in nursing practice.” Nursing ethics 4.1 (1997): 12-28.
Cohen, Jeryl S., and Jeanne M. Erickson. “Ethical dilemmas and moral distress in oncology nursing practice.” Clinical journal of oncology nursing 10.6 (2006).
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