Various ethical problems are likely to cause dilemmas in the provision of services for instance, a situation where a patient is suffering from stage four cancer. The family, after discovering, asks the nurse not to break the news to the patient. The family is aware that there is almost no hope that the patient will get better. However, they are afraid that the patient will be broken to learn this situation.
Thesis statement
The ethical dilemma is the protection of the right to privacy and confidentiality in all matters that concern the patient's illness.
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Decision-making
Significantly, using the decision-making model, the first step is to discover the problem before collecting information. Arguably, the problem here is that the nurse must be in a position to tell the patient the situation. There is a high risk that the protection of the privacy of the patient and confidentiality will face challenges. The family's need, on the other hand, is genuine but by allowing that to happen, the nurse will break ethical principles. For instance, this scenario is likely to cause an infringement of the fidelity to the patient. The nurse is ethically supposed to be loyal to the patient and inform them whatever the situation. Additionally, the nurse must prevent harm to the patient. They are not telling the patien9t risks the health of the patient if he discovers or fails to take the right medication.
Essentially, the next step is to collect information. In this case, there is an 80% population of terminal illness cases that involve the intent of non-disclosure. Mostly these cases are due to fear of stigmatization or effects of patients knowing they have less time to live ( Arnold et al., 2019 ). Patients also fail to disclose. The stakeholders, in this case, are the family members, the medical officers or health providers and the insurance companies. Essentially, there is a need for the nurse to be aware of the ethics of nursing. Additionally, the family needs guidance on the importance of disclosure and medical possibilities available.
Additionally, the solution of the problems is in the hands of the nurse being the professional. The family needs to understand that the patient has rights. Though the family members are stakeholders, the patient must decide on what must happen to him. Being of sound mind, the patient is capable. The two steps if followed this way, will work correctly. The issue is how to approach the disclosure to avoid giving harmful information to the patient.
Arguably, there needs to be an analysis of the alternatives available. Apart from telling the patient the truth, one may choose to ask the family to help in the disclosure. This solution may be in the presence of the nurse. However, the ethical issue is that there needs to be confidentiality ( Bastable, 2017 ). The patient's condition and information are meant for the patient. By letting the family know, legal issues like medical fraud may occur. Mostly, due to the empathy, the members may want to seek other means to get cure which may predispose the patient to fraud.
However, as a nurse, the belief is that the patient must come first. Therefore, any decision to make must involve the patient. The nurse's obligation is to the patient first. Additionally, the hospital's policy outlines that sharing of information must be to the insurance company or with the permission of the patient unless the patient is a minor
The next step needs to enable the selection of the appropriate alternative. Essentially, the best option is to inform the patient about the details of the condition. However, to prevent harm, there need to be counselling sessions for both the patient and the family. After the patient is aware, then guidance on best practice in terms of medication and nutrition should be done in the presence of the close family members. However, all crucial decisions about the procedures like surgery or patient’s future in medicine should be made by the patient. This alternative is legal and ethical as the patient will be in the know. The family is likely to be reluctant, but with proper guidance and engagement of ethical standards, they will agree.
Significantly, there must be tenable action after this whole process. The implementation of the solution is the last step ( Ling & Hauck, 2017 ). In this case, the problem is the confidentiality of the patient. There must be a proper intent to ensure the patient is the one receiving the information ( Arnold et al., 2019 ). In the first place, the nurse must ensure that the patient is given knowledge about the illness after the results are out.
Additionally, the nurse should ask the patient for permission to share the informat0ion with close family members. In this case, for there to be confidentiality, the patient needs to direct the nurse on who they prefer as the right recipient. After this disclosure, the nurse must seek the help of a professional counsellor attached to the hospital to help in counselling the patient. This counselling is also essential for the family members to avoid any fatalities such as suicidal or depression cases.
To ensure that the family is satisfied, the members need to be allowed to take charge of the care provision. This provision will be through bringing the patient regularly to attend treatment appointments such as chemotherapy. Additionally, a close member of the family, for instance, the patient wife should help with ensuring the dose is taken at home. Delivering information to both the patient and his family is the right decision since acceptance is needed on both sides. However, protection of confidentiality and privacy must be ensured.
In conclusion, ethically, the nurse must be aware that the patient has every right to know their health condition. Non-maleficence and fidelity are crucial, especially in the ethics of practice. The nurse faithfulness is first to the patient, especially in cases where the patient is an adult of sound mind.
Reference
Arnold, E. C., & Boggs, K. U. (2019). Interpersonal Relationships E-Book: Professional Communication Skills for Nurses . Elsevier Health Sciences.
Bastable, S. B. (2017). Nurse as educator: Principles of teaching and learning for nursing practice . Jones & Bartlett Learning.
Ling, T. J., & Hauck, J. M. (2017). The ETHICS Model: Comprehensive, Ethical Decision Making. VITAS online retrieved from https://www. counseling. org/knowledge-center/vistas/by-year2/vistas-2017/docs/default-source/vi stas/the-ethics-model
