Abstract
Case description
`Nurses are usually faced with dilemmas all through their profession. The worst dilemma that nurses face is when a patient asks for an easy death or assisted death. When nurses are faced with such a situation a lot of questions run through their minds, is it ethical to assist in suicide while I took an oath to save lives? If I do this how will my other patients feel about me? (Stokes, 2017) ,The case study used in this article is about an ethical dilemma faced by nurses at Minnesota department of health when dealing with a patient suffering from leukemia. The patient Mr. Murphy asked a nurse at the hospital to keep the secret.
Ethical dilemma identification
The ethical dilemma that the nursing faced was if she could keep the secret of the patient’s suicide thoughts from his colleagues. Keeping in mind the issue of patient-doctor confidentiality that also applies to nurses.
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Analysis
In order to come up with the best ethical decision, there are several things that have to be analyzed, and that is all the ethical theories, ethical principles and other associated literature that fit this case
Ethical decision making
After great consideration of all the theories and factors, the best decision that the nurse had to take was to share about Mr. Murphy’s suicide attempt with her colleagues.
Results
For this case, the nurse thought that the best ethical decision was to share Mr. Murphy’s suicide attempt with other health officials. Every hospital; has a self-harm or suicide protocol and that is what the nurses of Minnesota health department used. The nurses created a good communication line with Mr. Murphy and came with an appropriate method of dealing with the patient. The hospital also outsourced other health professionals to deal with him to perfect the healthcare. The patient was discharged from the hospital without any suicidal thoughts. Three months later Mr. Murphy passed away peacefully at home while in the company of his family and pastors.
Keywords
Ethical dilemmas, Suicide attempt, Ethical theory, and principles
Since the beginning of the nursing profession, nurses have always been faced with ethical dilemmas. Today these dilemmas have become more complex especially when dealing with patients suffering from terminal illnesses like cancer and HIV (Stokes, 2017) . The case study is about a nursing stuff that is faced with a dilemma when a leukemia patient tells the nurse that he is thinking of suicide and asks the nurse to keep it between them. This article will look at the case study from every angle and identify the ethical dilemmas that the nurse faces. The article will also discuss ethical theories and principles that relate to this case. The article will also come with solutions that can be used to deal with such ethical dilemmas.
1. The case description
The patient Mr. Charlie Murphy is a 50-year-old gentleman. He has suffered from leukemia for the better part of his adult life. He has been under the care of nurses and doctors at the Minnesota health department for some years. Charlie has been refusing to take prescribed medication and looking for other alternative medications. When the illness got worse that’s when he started seriously considering prescription meds that’s what brought him to Minnesota health department.
2. The ethical dilemma arises from this clinical case
The doctors had estimated that Mr. Murphy had only 6 or 4 weeks to live. This frustrated Mr. Murphy a lot that he contemplated on suicide and confided on one nurse about his plans. This revelation put the nurse between a rock and a hard place in other terms it can be said that the nurse faced an ethical dilemma. An ethical dilemma is defined as a situation where a person has to make a choice between two mutually exclusive alternatives (Stokes, 2017) . In the case of Mr. Murphy, the nurse had two morally correct choices either to keep the secret as the patient asked and by doing so the patient may commit suicide without any intervention by the medical department. On the other hand, if the nurse tells other officials in the hospital she would have violated patient confidentiality. The major ethical dilemma is whether the nurse violates patient’s confidentiality.
3. Analysis of the ethical dilemma
3.1. Ethical principles
There are several ethical principles that apply to this case. In Mr. Murphy’s case, there are two principles that cause ethical dilemmas and is one principle is used it will violate the other. The incompatibility between the two principles autonomy and beneficence is what has caused the ethical dilemma. Then there is the non-malfeasance principle that can fit in this situation it will infringe on autonomy principle and on the other hand support beneficence principle. In this case study, it is evident that there are three ethical principles of play (Stokes, 2017) . Beneficence principle is where one does all he can by taking positive steps to help another person. Non-malfeasance I whereby a person makes sure no one is harmed. Autonomy is whereby a person has the liberty to do what he or she pleases.
3.2. The ethical theory apply to this case
Other than principles there are some theories that can be used to address these ethical issues. The theory that best suits this situation is consequentiality this is where a person performs a good action with the aim to maximize pleasure and reduce pain (Stokes, 2017) . The principle of utility also suits this case. This principle claims that a morally right action is the action that has the best outcome for everybody, in the case of Mr. Murphy there are a lot of people involved there is his family, the nurse and the hospital fraternity and the best choice is what will benefit the entire group. In contrast, the best choice would have been telling the other nurses about Mr. Murphy’s plans this is because it will prolong Murphy’s life and protect him making his family and the nurses a happy lot
4. Results
The nurse in Mr. Murphy’s case made the right choice by informing the other healthcare officials about the patient’s plans.
As soon as the nurse noticed that the patient was seriously considering suicide she offered some psychological help to comfort the patient and change not only his mindset but also his mood. After stabilizing the patient, the nurse informed her manager. The manager called for a meeting with all the nurses in the meeting they discussed the self-harm and suicide protocol and advised the nurses to use them when dealing Mr. Murphy. Effective communication was what was insisted at the meeting and keeping Mr. Murphy in a good mood all the time. During the communications with Mr. Murphy, the nurses noticed that a lot of pain that leads to the suicidal thoughts was caused by his family he complained that his family was not so concerned about him. So the hospital contacted his family and canceled them on how to treat Mr. Murphy. The hospital also outsourced some psychologist to talk to Mr. Murphy after some time Mr. Murphy returned to normal mentally. After some days he was discharged from the hospital and went home to stay with his family, three weeks later he passed away in a home full of love in the company of his family and priest.
5. Conclusion
These days it is very common for patients to express suicidal thoughts or self-harm. Because of this, nurses are usually trained to deal with such situations in the most professional and ethical manner. However, there are some cases that invoke ethical dilemmas, and they should be solved efficiently and in a rational manner (Stokes, 2017) . The best way that nurses can deal with such issues is by using the ethical theories, principles, and the nurse’s code of ethics. By using these methods, the nurses can make ethical decisions.
Reference
Stokes, F. (2017). The Emerging Role of Nurse Practitioners in Physician-assisted Death. The Journal for Nurse Practitioners , 13 (2), 150-155.
