- Describe an ethical dilemma from your nursing practice.
- Identify the key stakeholders.
- Describe how the situation impacts the key stakeholders.
Ethical Dilemma:
While working on a medical-surgical unit, I cared for an elderly patient with terminal cancer who had a Do Not Resuscitate (DNR) order in place. The patient’s family, however, insisted that “everything be done” to save their loved one during a cardiac arrest, even after being reminded of the patient’s documented wishes and legal DNR status. The ethical dilemma centered around whether to honor the patient’s autonomy and DNR or to comply with the family’s emotional demands.
Key Stakeholders:
-
The Patient – whose autonomy and legal rights must be respected.
-
The Family – who are emotionally distraught and seeking to prolong life.
-
The Nurse (myself) – responsible for patient advocacy and ethical practice.
-
The Healthcare Team – including physicians, who must make real-time decisions during a code situation.
-
The Hospital/Facility – which has a duty to follow legal documents and policies.
Impact on Stakeholders:
-
Patient: Disregarding the DNR would violate their autonomy and previously stated wishes, potentially leading to unwanted suffering and loss of dignity at the end of life.
-
Family: The emotional stress of losing a loved one can cloud decision-making. If their wishes are not followed, they may feel helpless or betrayed. If the DNR is ignored, they may later feel guilt for not honoring the patient’s wishes.
-
Nurse: I faced moral distress—caught between advocating for the patient’s rights and managing the family’s expectations. Being forced to act against ethical principles could result in burnout or job dissatisfaction.
-
Healthcare Team: Physicians and other staff may struggle with legal implications, professional ethics, and team cohesion when there is disagreement or lack of clarity during such critical moments.
-
Hospital: There’s legal and reputational risk if advance directives like DNR orders are not honored, along with the potential for loss of trust from the community or family.
The post An Ethical Dilemma From Nursing Practice appeared first on Academic Research Experts.