Nursing is a crucial job that involves constant interaction with patients, their family members, and other staff. In the course of nursing practice, some ethical dilemmas are encountered and the available options may not be ideal for either or all the parties. When decisions are made to overcome such dilemmas, there might be cases in reduced quality of patient care or moral distress for the nurse who is ethically disallowed to carry out certain activities. Nurses may consult nurse managers for advice but in some cases, decisions have to be made promptly (Haahr et al., 2019) .
In the course of my professional life, I have faced the dilemma of autonomy vs beneficence on two occasions. In these scenarios, the patients refused to take their prescribed medication yet they were in critical conditions. I understand that patients have a right to refuse or select the medical care that is administered to them. I applied the value of autonomy and gave the patients their medication. Both of them were well and I was happy that I made that decision.
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Since nursing is a caring profession, nurses apply several means to help patients and their families. There are three ethical theories in the nursing field that help nurses in justifying their actions based on their values and beliefs. The most relevant nursing theories are utilitarianism, deontology, and principlism. The theory that closely aligns with the solution of my ethical dilemma is utilitarianism. The principle of utilitarianism provides a balance between good and bad deeds. In this principle, the moral correctness of an action is dependent on the outcomes of that action. The bad deed, in this case, was infringing the right of the patients to select medical care that is administered to them. The good deed was the practice of autonomy and administering the medication. The outcome which justified my actions was the recovery of the patients. The theory of utilitarianism assists nurses in making decisions that produce the maximum benefit for most people.
If I had applied the theory of deontology in dealing with the dilemma, the consequences would have been negative for the patients. This is because this theory determines the rightness or wrongness of an action based on the action itself. Autonomy would have been wrong in my dilemma and the patients would not have received their medication since the right action would be upholding the right of the patient to choose medical care. The theory of utilitarianism overshadows deontology since it achieves more benefits.
The core professional nursing value that guided my actions was autonomy. Autonomy can be defined as the ability and freedom to make decisions based on one’s professional knowledge. The dimension that was applied in this scenario was clinical autonomy which is the self-governing and responsible decision-making by nurses for the principal and direct advantage of the patient. Autonomy by nurses produces great benefits to patients through the reduction of complications and mortality rates. Nurses are given professional training that guides them on how to help patients and reduce the risk involved. Health organizations and hospitals should provide appropriate resources to ensure that nurses act autonomously during their practice of service delivery. Measures that can be used to aid nurses in acting autonomously in different situations are the formulation of clear functions, duties, and conduct, and promoting proficiency in practice and decision-making. Autonomy is a crucial element that ensures that nurses have a conducive work environment. Some organizations require consultation by nurses before practicing autonomy. However, nurses who are permitted higher levels of autonomy seem to perform efficiently, are committed to their work and are more satisfied. Therefore, autonomy for practicing nurses should be promoted through the formulation of favorable policies, training, and support (Oshodi et al., 2019) .
References
Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2019). Nurses' experiences of ethical dilemmas: A review. Nursing Ethics , 27 (1), 258-272. https://doi.org/10.1177/0969733019832941
Oshodi, T., Bruneau, B., Crockett, R., Kinchington, F., Nayar, S., & West, E. (2019). Registered nurses’ perceptions and experiences of autonomy: a descriptive phenomenological study. BMC Nursing , 18 (1). https://doi.org/10.1186/s12912-019-0378-3
