Question

Ethical decision making framework encourages to look beyond first thought or feelings to basic issues. Explain with an example how would you as a nurse assist the patients and families to make ethical decisions provide an example within today's health care?

Answer 1

Nurses are advocates for patients and must find a balance while delivering patient care. There are four main principles of ethics: autonomy, beneficence, justice, and non-maleficence. Each patient has the right to make their own decisions based on their own beliefs and values

Utilizing the ethical principles of autonomy, beneficence, nonmaleficence, fidelity, justice, and paternalism as outlined by the American Nurses Association (ANA) provides with a firm foundation for ethical decision making.

Autonomy allows healthcare teams to respect and support a patient's decision to accept or refuse life-sustaining treatments. As patient advocates, it's our duty to ensure that our patients receive all of the necessary information, such as potential risks, benefits, and complications, to make well-informed decisions.

nonmaleficence by selecting interventions that will cause the least amount of harm to achieve a beneficial outcome. For example, if a patient verbalizes homicidal ideations with a plan, we may be torn between wanting to ensure patient privacy and our duty to escalate the patient's care to safeguard the public.

Beneficence :We utilize beneficence daily as we administer pain medication or hold the hand of a grieving family member.

fidelity directs us to model care delivery with altruism, loyalty, caring, and honesty.

For example, when an older patient with intact cognitive function is diagnosed with a terminal illness and he or she doesn't want to share that information with immediate family, it can create an ethical dilemma. To maintain the trust established in the nurse-patient relationship, don't share any healthcare information without the patient's consent

Paternalism provides the power for healthcare professionals to make decisions to reveal or conceal a diagnosis, potential treatment modalities, or expected prognosis.

An example of paternalism is when we admit an adolescent with multiple complete cervical spine fractures whose family is stating that the teen needs to participate in a state basketball championship in 3 months. The benefit of sharing the anticipated prognosis of quadriplegia at this time is far outweighed by the potential emotional trauma it may cause the family.

Nurse may even face ethical dilemmas within peer group if witness a colleague exhibiting unsafe practices. When seen an immediate patient safety risk, Nurse must act quickly and seek the guidance of administrative teams and the collaborative expertise of interdisciplinary team members. She may also need to notify security teams and/or local police departments.