Whether you are working as a nurse traveler or in a permanent position, you are likely to encounter ethical dilemmas in your nursing career. One of the reasons you may have chosen the nursing profession was to help people. Although your goal is always to provide the best care possible and help your patients, sometimes it can become complicated.
End of Life Care
In September 2015, the governor of California followed other states in signing the End of Life Option Act, which allows patients who are terminally ill to end their own life. The patients would be prescribed a lethal dose of medication by their doctor. The patient must be of sound mind when they make the decision and must self-administer the medication. Advocates of the End of Life Option Act believe it will alleviate the pain and suffering that can occur in a patient’s final stages of life.
While nurses will not be administering medication to help patients end their life, they may still be faced with ethical issues involving end of life care. For example, even if they disagree with the decision, nurses may have to withhold care or hold off resuscitating a patient if they have a “do not resuscitate” order in place. The opposite is also true. A nurse may feel continuing to prolong a patient’s life is futile and only causing suffering. But they may still have to provide all types of invasive care even if they disagree with the patient’s or the family’s wishes.
Personal Beliefs Verses Patient’s Wishes
Patients have the right to refuse care and leave the hospital against medical advice (AMA) even if it leads to their death. If a patient is not capable of making their own medical decisions, their advanced directive will be followed, or their next of kin will make decisions.
It’s important for nurses to remember that they do not always have to agree with the decision of the patients or their family. Nurses are there to provide care and give the facts, not to influence a patient or try to talk them into making a certain medical decision.
There can be instances where it is difficult to understand why a patient or family member is making certain choices. For example, you may disagree with a patient refusing a blood transfusion when it is lifesaving. But religious and cultural differences may play a role in a patient’s choices, and you do not have to understand every decision. But you do need to respect the choices patients make.
Handling Ethical Dilemmas
Dealing with ethical dilemmas as a nurse is often a challenge, but there are things you can do to make the situation easier.
- Become Informed: Make sure you know the physician’s orders on code status, and be aware of your patient’s advanced directives regarding care.
- Get Support: If you have an ethical dilemma at work, get support as needed. Talk with a supervisor or charge nurse if you have concerns. In addition, most medical facilities have ethics committees to review difficult cases.
- Maintain Confidentiality: Remember that gossiping about a patient’s situation violates their privacy and is not acceptable. Only discuss the situation when it is relevant to the patient’s care.