Nurses face ethical dilemmas on a daily basis regardless of where they practice. No matter where nurses function in their varied roles, they are faced with ethical decisions that can impact them and their patients. There is no “right” solution to an ethical dilemma.
So what is an ethical dilemma? It is a problem without a satisfactory resolution. The significance of ethical decision-making lays in the fact that very different ethical choices regarding the same ethical dilemma can be made resulting in neither choice being a “right or wrong” decision.
Ethics involve doing “good” and causing no harm. But how one defines what is ethical can vary differently from nurse to nurse. Classes on the principles of nursing ethics give the nurse the tools to base ethical decisions upon. However, this knowledge is then shaped by the values, beliefs and experiences of the nurse. Consequently, very different choices may be made involving the same dilemma.
There are many ethical issues nurses can encounter in the workplace. These include quality versus quantity of life, pro-choice versus pro-life, freedom versus control, truth telling versus deception, distribution of resources, and empirical knowledge versus personal beliefs. Quantity may address how long a person lives or perhaps how many people will be affected by the decision. Quality pertains to how “good” a life a person may have and this varies depending on how a person defines “good”.
So how does the nurse support a patient deciding between a therapy that will prolong life but the quality of life will be compromised? The person may live longer, but will likely experience significant side effects from the therapy. What should the nurse’s position be?
- Pro-choice versus pro-life. This issue affects nurses personally. Many of the positions nurses assume in this dilemma are influenced by their own beliefs and values. How does a nurse care for a patient who has had an abortion, when the nurse considers abortion murder? Can that nurse with very opposing values support that patient’s right to choose her autonomy?
- Freedom versus control. Does a patient have the right to make choices for one’s self that may result in harm, or should the nurse prevent this choice? For example, a patient wants to stop eating, but the nurse knows the consequences will harm the patient. Does the nurse have the “right” to force the patient to eat?
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