It is common for nurses to struggle with ethical dilemmas in patient care. As nurses are bound by foundational moral virtues, principles, and duties essential to the professional such as integrity which at times may crush in practice, they must at times make decisions that are not favorable to one or more ethical principles. In my practice, I have, on several occasions, face moral dilemmas that put a toil on me as a professional and aspiring leader in the field.
One of the most recent ethical dilemmas that I faced in practice is that of disclosing medical conditions to patients. In one case, I had a patient who was diagnosed with the condition that is often subject to stigmatization in the community. While the patient was in comma, I approached his relatives and informed them of the problem to get consent to proceed with treatment. On advising the relatives, first, they were extremely shocked and could not see the possibilities of having such a condition in their son. Secondly, upon deliberating, they asked me not to tell the patient of the requirement stating that it would devastate him and cause him emotional pain that would affect his general health.
Delegate your assignment to our experts and they will do the rest.
The dilemma I faced was whether to go on with the plan and deceive the patient or tell the truth and risk the consequences. According to Salas (2017), the dilemma of telling the truth vs. being deceptive is a common phenomenon among nurses, especially when the fact may have negative consequences on the patient. Considering the patient's right to know and whether what the family was saying was right about the nurse gave me a hard time, especially when he later woke up. For the next three weeks that the patient was present in the hospital, there were awkward encounters as I took care of him. At times, he would question what was being treated and how far we were towards full recuperation.
As a nurse, I was held by the obligation to meet the principles of nonmaleficence and fidelity. With nonmaleficence, a nurse is expected to prevent harm and apply all the measures to prevent the occurrence of injury from achieving a benefiting outcome (Ong-Flaherty et al., 2016). By divulging information on the condition to the patient, there was expected harm that could befall them in the form of negative emotions. Fidelity, as a principle, means that the nurse must be faithful to colleagues and the profession by telling the truth (Salas, 2017). Consequently, in taking any of these alternatives, there would be a breach of ethics by the nurse. This presented a severe ethical dilemma to me as a nurse who needed thinking and rethinking in line of the scenario. Not only did this case offer a moral issue on me as a nurse but also as a person who holds integrity in esteem.
In dealing with this case, I considered both the principle of nonmaleficence and that of fidelity. First, regarding the possible consequences of telling the patient of the diagnosis, I decided to be deceptive and not to give all the information. Having seen the shock in the relatives, I could tell there would be a similar response by the patient. Consequently, after the comma, I opted to keep information about the diagnosis away from the patient as it would result in harm of cognitive and emotional health which had the possibility of causing trouble with the healing process. However, the deception could not be kept for long.
After spending three weeks in the hospital, the patient started to ask questions about his diagnosis and what he was being treated for. Also, other healthcare personnel was concerned about keeping information away from the patient. Considering that he was expected to be actively involved in the treatment process, it was necessary to inform him of the diagnosis. However, the information was given when the patient was quite stable and robust enough to take it. True to the family’s concern, the patient was thoroughly shocked with his health deteriorating a bit before he could recover.
References
Ong-Flaherty, D. N. P., Banks, Ph.D., A., Doyle, M. S. N., & Sharifi, C. O. (2016). The meaning of evidence and nonmaleficence: cases from nursing. Online Journal of Health Ethics , 12 (2), 2.
Salas, E. C. (2017). Using Simulation to Train Nurse Residents on Bedside Legal Ethical Dilemmas (Doctoral dissertation).
