Autonomy in Decision Making
One of the biggest, most common ethical dilemmas in nursing happens when a patient wants something that is against their own good. You clearly know best what can harm someone’s physical well-being, and yet they stubbornly hold on to their detrimental choices. They might behave in such a way that brings them harm or they might reject a procedure or medication that is necessary for their well-being. Regardless of their reason behind this, knowing that they are harming themselves feels contrary to your commitment to bringing them closer to a healthy place. And it truly is. But is a nurse entitled to force someone when they clearly reject your help – regardless of how irrational their reasoning might be?
The answer is, of course, very difficult to point out – especially when it comes to very personal beliefs fueling their behavior, such as religious beliefs. If a patient’s survival relies entirely on a blood transfusion that he opposes to, based on religious convictions, then you might just find yourself stuck. As much as you are committed to saving his life, you are also bound to respect his deepest wishes and his decision on vital aspects.
Having to hide the truth from family members because the patient requires you to do so or because it will be of use for caring more smoothly for the patient can be conflicting for many. Or maybe the family requires you not to inform the patient about a serious life threatening condition they might have. How does a nurse handle such situations when telling the truth and informing the patient feels like an obligation? Or even worse, when it feels that not being truthful will only bring more harm? If you are committed to respecting the patient’s wishes, do you also have to do the same with the family’s beliefs?
All in all, ethical dilemmas are here to stay, and they can only be tackled one at a time. There is for sure, no right or wrong, and there are many considerations at stake. Read more about such challenges here.