Ethical Dilemmas Faced By Nurses

Introduction

The field of medical ethics is a subject of international perspective. Though not a new subject, it gained eminence in the period after the Second World War. It involves the analysis and application of moral values, privileges and responsibilities in areas of medical treatment, analysis and research. Decisions with a moral bearing are required everyday in varying cases during the pursuit of medical care. Such questions rotate around the relationship between medical personnel and patients, the procedure of conducting scientific experimentation on human, and the communication conduct during period of natural processes involving life and death are concerned.

Dilemmas Faced by Nurses

Improvement in scientific and medical technologies has raised difficulties in making and executing decisions both to individuals and the society. Nurses are part of the society and are normally in the frontline among healthcare personnel. As such, they form the frontline that normally gets confronted with ethical dilemmas with regard to life and death and a balanced provision of health care. The dilemmas faced by nurses to a great percentage represent the ethical dilemmas faced in the entire medical field. One of the most outstanding dilemmas is allowing a patient to die. Advance in medical technology has made it possible for a patient to be put on life supporting gadgets which can prolong his life even when there is no evidence of any response in another part of the body except the brain. Patients today have a right to make decisions concerning their lives if they deem some situations to be inhuman for their continued existence. A patient may decide to discontinue medical attention for terminal diseases preferring to die in dignity other than being subjected to experiments he may deem too expensive. In such an instance, making a decision becomes complicated since the right of the patient ought to be respected which conflicts with the doctors and nurses responsibility to take care and adopt processes that can prolong life. A decision at that level is complex because of the law requirements to protect patients from harm yet giving room for respect of an individual’s liberty. There are other issues surrounding mortality which raises deep ethical dilemmas. One set of issue surrounds allowing a sick person to die. Another aspect of this is euthanasia, where a patient is actively assisted to achieve death. Another dilemma faced by nurses surrounds the controversial area of reproduction and cloning. The development of the birth control pill raised substantial debate especially from religious circles opposed to artificial birth control. In addition to these are pills which prevent pregnancy or induce abortion. The nurse is faced daily by the challenge of giving advices regarding reproduction, an area which has in the past generated substantial concerns. The nurse is faced by the dilemma of giving in to family’s demands in cases where a nurse is pressurized to respond out of the family’s feeling of pain and duress on their patient. The physicians do not have a lot of time with the patients and hence most of the information regarding the patient is carried by the nurses. The patient is normally a VIP to someone else and this exerts undue pressure on nurses who have to show extreme care for all the patients. The nurse is daily faced with the dilemma of passing on information. Some patients prefer that information regarding their state of health is not passed on to the family yet the family may demand such information. The reverse situation is also true incases where family members knowing the fatality of the disease in their patient may wish that such information be withheld from the patient to avoid unnecessary duress on the part of the patient. There are also situations where family members may wish not to pass on information they may regard terrible to the patient. This may include a tragedy occurring on the home of the patient or a tragedy occurring to a family member when the patient is unwell. A nurse may uphold one principle and violate the other in an attempt to fulfill the wishes of the patient. For instance, a nurse upholds the principle of self determination and mislabels saline solution by fulfilling the patients wish yet in so doing violates the principle of beneficence for failing to provide necessary treatment. The nurse is also constrained to act in regard to administration procedures. For instance, futile CPR may be applied to a patient who is yet to make payment, hence receive less than necessary treatment, whereas the same patient receives effective CPR upon payment. This introduces a twisting between academic ethics and practice in the real world. An increasingly number of nurses in the world works in substandard conditions yet they are expected to deliver services with terms borrowed from the private sector such as customer service and optimal service delivery. And the nurse is always faced with the difficulty of communicating news which are normally not welcome such as death and diagnosis of terminal illnesses.

Conclusion

The subject of ethical dilemmas has been considered an academic exercise which is not applicable in real practice. The nurse who lacks to administer necessary treatment because money is yet to be paid upholds distributive justice yet in so doing creates a dilemma when the principle of ethics is violated. There is however need to actively involve nurses in making and communicating critical decisions regarding patients because of the central role they play in the life of patients.