Ethical Dilemma In Nursing Essay Example


The national code of ethics provides a direction, sets standards, and informs the nurse and the public on the obligations and duties the nurse must provide society (Guido, 2020). Several factors influence the response to ethical dilemmas including clinical experience, degree of concern, and past experiences (Guido, 2020). Models provide nurses with a systematic framework to assist in decision making during ethical dilemmas (Guido, 2020). Ethical dilemmas may be classified as moral distress, moral uncertainty, or as a moral dilemma (Guido, 2020).  

Healthcare workers, nurses, and providers may feel the strain of moral distress and moral conflict while caring for someone that is close to expiring or who has died (Anderson-Shaw, & Zar, 2020). The ethical principles of beneficence and non-maleficence are deeply ingrained into the standards and duties of nurses.  Honoring these ethical principles to promote health wellness and to complete the necessary treatments to prolong life must be discussed first with the patient. The values, beliefs, and customs of the patient must be addressed before discussing a treatment plan.  The nurse may need to step back from the situation and re-evaluate personal beliefs and opinions, so that unbiased care is given to the patient (Guido, 2020).  

Caring for patients that have died has provoked different feelings based on the cause of death, age, and condition of the patient.  For example, one of my patients an elderly man that was diagnosed with end-stage liver cancer, requested to have Hospice. The patient, however, at the time was basically asymptomatic and his family were opposed to what they considered him to be giving up on life.  He was committed to a long term forensic psychiatric hospital due to a crime he committed while off his psychiatric medication over five years prior, and pled NGI.  The patient’s condition deteriorated rapidly over the next few months and the patient reported being in continuous severe pain, despite the pain medications ordered. The patient eventually refused to eat, walk, or talk.  The patient’s family continued to oppose Hospice, and eventually the provider and judge had to override their decisions in his care. This situation provoked a variety of feelings based off the situation; however, the end feelings was relief for the pain and suffering this patient had to endure while fighting his family to complete the end of life wishes of the patient. 

 Personal past experiences play a major role in the way moral distress is viewed and the care that is given to patients (Guido, 2020). Values, beliefs, and customs of the patient plays a role in the acceptance of death and the grieving process (Nichols et al., 2018).  Nurses must provide the necessary resources and support for both the patient and family during these times, despite opposing personal beliefs on the circumstance (Guido, 2020).  Nurses must also allow for personal decompression of stressful events for personal growth and one own’s mental health stability (Anderson-Shaw, & Zar, 2020).  

Anderson-Shaw, L. K., & Zar, F. A. (2020). COVID-19, Moral Conflict, Distress, and Dying Alone. Journal of Bioethical Inquiry, 17(4), 777–782. https://doi.org/10.1007/s11673-020-10040-9.

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