Today’s health care environment gives nurses many reasons to be conflicted. Genetic testing, abortion, and end of life care are just some of the areas in which nurses may face ethical dilemmas. Consider how you feel about the following issues:
• Respecting the wishes of a suffering client that he is permitted to die with dignity, • Respecting the health surrogate’s wishes regarding termination of life support, • Or even observing another nurse take two tablets of oxycodone as ordered but
keeping one for herself.
Then give an example of an ethical dilemma you may have confronted in your own clinical experience or workplace. How did you come to the decision you made? What feelings did you experience while coming to that choice? (If you have not yet faced an ethical dilemma, research one and comment on it, answering the same questions.)
### Ethical Dilemma in Healthcare: Respecting End-of-Life Wishes
In the healthcare environment, nurses often encounter ethical dilemmas that challenge their values and decision-making. One significant issue is respecting the wishes of a suffering client to die with dignity, particularly when faced with conflicting viewpoints from family members or legal directives.
#### Personal Experience:
**Scenario:** During my clinical rotation in a hospice care setting, I cared for an elderly patient with terminal cancer. The patient had previously expressed a strong desire to avoid prolonged suffering and to be allowed to pass away peacefully when the time came.
**Ethical Dilemma:** The patient’s family, however, held differing opinions. While some members understood and supported the patient’s wishes for comfort-focused care, others were adamant about pursuing aggressive treatments despite the terminal prognosis.
**Decision-Making Process:**
1. **Understanding Patient Autonomy:** I began by reviewing the patient’s advanced directives and discussing their wishes with them directly. The patient reaffirmed their desire for palliative care and comfort measures only.
2. **Consultation and Team Discussion:** I engaged with the healthcare team, including the attending physician, social worker, and ethicist, to ensure a comprehensive understanding of the patient’s medical condition and legal considerations.
3. **Family Communication:** I facilitated family meetings to openly discuss and clarify the patient’s wishes, providing emotional support and education about end-of-life care options.
4. **Navigating Legal and Ethical Frameworks:** Considering legal frameworks and ethical principles such as beneficence and non-maleficence, I advocated for honoring the patient’s autonomy while ensuring the family understood the medical prognosis and ethical obligations.
**Feelings and Reflection:**
Navigating this ethical dilemma was emotionally challenging. I felt a deep sense of responsibility to advocate for the patient’s autonomy and dignity, balancing this with the need to support the family through their grief and decision-making process. Emotions of empathy, sadness, and professional obligation guided my interactions, ensuring that the patient’s wishes were respected within the bounds of ethical and legal standards.
**Conclusion:**
In conclusion, the experience reinforced the importance of patient-centered care and ethical decision-making in nursing practice. By prioritizing open communication, respect for autonomy, and collaboration with the healthcare team, I navigated a complex ethical dilemma to ensure the patient’s end-of-life wishes were honored sensitively and compassionately.
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