Ethical Dilemma for Registered Nurses. Explain the statement, “What may be an ethical dilemma for one registered nurse may not be an ethical dilemma for another registered nurse.” Be sure to define an ethical dilemma in the course of your discussion. Describe a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. (Be sure to respect and maintain patient and colleague confidentiality.)

Ethical Dilemma for Registered Nurses

The statement, “What may be an ethical dilemma for one registered nurse may not be an ethical dilemma for another registered nurse,” highlights the subjectivity and variability in how healthcare professionals perceive and approach ethical dilemmas. An ethical dilemma is a situation in which a person is faced with a difficult choice between two or more morally conflicting options, where no single choice is clearly superior to the others. These dilemmas often involve complex moral, ethical, and professional considerations. Ethical Dilemma for Registered Nurses

Here’s a breakdown of the statement:

  1. Subjectivity: Ethical dilemmas are often subjective because they depend on an individual’s values, beliefs, cultural background, and personal experiences. What one nurse considers a significant ethical dilemma may not have the same impact on another nurse because their values and perspectives differ.
  2. Context Dependency: Ethical dilemmas are context-dependent. The same situation may be perceived differently in various healthcare settings, such as a hospital, home care, or a long-term care facility, and by nurses working in different specialties, such as pediatrics, oncology, or critical care.
  3. Professional Judgment: The role of professional judgment is crucial in determining whether a situation constitutes an ethical dilemma. A nurse’s knowledge of ethical principles and guidelines, as well as their ability to analyze the situation, contributes to their perception of the ethical dimensions of a case.

Now, let’s discuss a challenging situation in nursing that required considering the ethical dimensions:

Challenging Situation in Nursing:

In my nursing career, I encountered a complex ethical dilemma while working in the intensive care unit (ICU). We had a terminally ill patient in their late 80s who was admitted with multiple organ failure. Despite aggressive medical interventions, the patient’s condition continued to deteriorate, and it was clear that there was no chance of recovery.

The ethical dilemma arose when the patient’s adult children, who were emotionally distraught, requested that all possible measures be taken to keep their parent alive, including invasive procedures and mechanical ventilation. On the other hand, the patient had previously expressed their wishes not to undergo extraordinary measures to prolong life.

In this situation:

  • Autonomy: The patient’s autonomy and previously documented wishes were in conflict with the family’s desire to “do everything.” Respecting the patient’s autonomy was an ethical imperative.
  • Beneficence and Non-Maleficence: The ethical principles of beneficence (doing good) and non-maleficence (avoiding harm) were in tension. Continuing aggressive interventions could be seen as causing unnecessary suffering, while withholding them could be perceived as allowing a peaceful, dignified death.
  • Family Dynamics: Understanding the family dynamics and providing emotional support to the patient’s children while maintaining a focus on the patient’s best interests added complexity to the situation.

In this case, I had to engage in careful communication with the family, the healthcare team, and the patient’s advance directive to find a resolution that respected the patient’s autonomy while addressing the family’s concerns. Ultimately, a family meeting facilitated by a healthcare ethics committee helped clarify the ethical dimensions and led to a decision to transition the patient to comfort-focused care in alignment with their previously expressed wishes. This scenario illustrates how ethical dilemmas in nursing can be deeply influenced by the specific circumstances, values, and perspectives involved, highlighting the subjectivity and complexity of ethical decision-making in healthcare.

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