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.
Suicide
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.
