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Nurses face a number of stressful demands each hour on the job. Ethical dilemmas can add to this stress. Nurses must adhere to a strict set of bioethics in order to ensure the highest quality of care and respect for each individual patient. Ethical dilemmas arise largely because of differences of opinion, budget and culture. There are a number of key principles to remember when it comes to ethical dilemmas in nursing.
Common Ethical Dilemmas
Common ethical dilemmas that nurses may face on a daily basis include cost-containment issues, or funding and hours allotted for nurses. Lack of funds may jeopardise patient care. Nurses may also face dilemmas when it comes to patient confidentiality, cultural differences, illegal practices of colleagues, incompetent actions of colleagues, end-of-life decisions and protecting patient privacy and modesty.
The principle of autonomy indicates that nurses must respect the rights of patients and their caregivers when it comes to making their own medical decisions. Nurses need to provide patients with all the adequate information and support necessary for the patients to make informed decisions about their health. A nurse should not pressure patients into making decisions based on the nurse's personal beliefs. Nurses need to collaborate with doctors and other nurses in order to determine a health care plan that meets the needs and concerns of each particular patient. Autonomy is particularly important when making decisions regarding end-of-life care.
Nonmaleficence indicates that nurses need to avoid causing harm. Nurses should not inflict harm; they should prevent harm to patients whenever possible. This harm may come in the form of not respecting a patient's wishes or failure to relay a patient's thoughts and concerns to the rest of the medical team -- including doctors, other nurses and technicians. Nonmaleficence is important when it comes to facing cultural differences in patient care. What a doctor or nurse may deem as a necessary treatment, a patient may be firmly against due to cultural or religious reasons.
Beneficence requires that nurses must weigh the benefits and potential risks of each particular treatment. Nurses need to be sensitive to the fact that what may benefit a patient may become a burden to family or caregivers. This can occur as the result of cultural, religious or financial reasons. Beneficence comes into play when it comes to making end-of-life decisions -- including advanced directives and life support.
- "Fundamentals of Nursing"; Carol Taylor, et. al.; 2008
- New York State Nursing Association: Role of the Registered Professional Nurse in Ethical Decision Making
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