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Ethical Dilemmas

Ethical Dilemmas

Sample Answer 

Ethical Dilemmas

Summary of the Moral/Ethical Issue in the Article

Smebye, Kirkevold, & Engedal (2016) in this article investigate the ethical dilemmas nurses face when caring for elderly patients with dementia, especially those residing in their own homes. The moral dilemma exists between balancing the autonomy of these patients and their well-being and safety. According to Smebye, Kirkevold, & Engedal (2016), nurses often face a moral dilemma between respecting this personal autonomy (the right to make independent personal decisions) when it comes to dementia patients because these patients constantly face the challenge of making rational decisions. As the severity of this condition worsens, the decision-making capacity also drops; thereby, these patients need assistance to compensate for their decreasing abilities. Therefore, nurses caring for these patients are required to uphold the principle of beneficence, which is ‘acting in a manner that prevents harm, reduces pain, and benefits the patient in general.’ Thereby, nurses are sometimes faced with the challenge of respecting the wishes or decisions of patients, even when it is apparent that dementia decreases their rational thinking capacity or make decisions that benefit the general well-being of these patients.

The Moral and Ethical Dilemmas Surrounding the Issue

The moral and ethical dilemmas surrounding the treatment of dementia patients occur when nurses or healthcare providers are split between respecting patients’ autonomy and observing the principle of beneficence. In western culture, the word autonomy is primarily used to refer to self-determination, self-rule, and freedom of self-knowledge, responsibility, independence, individuality, integrity, dignity, and will. In medical ethics, the principle of “respect for autonomy” is mainly used to refer to an individual’s right or freedom to take actions, hold views, and make choices independently (Buppert, 2018). Thereby, nurses or other medical providers are often required by the ‘Hippocratic Oath’ to ensure that they respect the principle of ‘respect of autonomy’ by fulfilling the wishes of their clients or patients.

Similarly, healthcare providers are required by the same ‘Hippocratic Oath’ to uphold the principles of ‘beneficence’ and ‘non-maleficence.’ The beneficence rule requires nurses to act in a way that protects and safeguards the well-being of patients by removing harmful conditions or preventing harm (Buppert, 2018). Non-maleficence, on the other hand, is the responsibility not to inflict harm. Choosing which principle to follow when treating certain life-threatening conditions like dementia often presents nurses with moral or ethical dilemmas. They are often torn between respecting the freedom of these mentally-retarded patients or disregarding this right but acting in a manner that will benefit their health.

Analysis of the Ethical Issue in Comparison to the State Health Laws and Regulations in Alabama

Like other states in the U.S. or other countries in several parts of the world, the state of Alabama has a strict policy regulating the practice of ethics in healthcare. In particular, the Alabama Department of Public Health (2015) has implemented a comprehensive Compliance and Ethics Program for all public health employees, including nurses, physicians, laboratory technicians, and many others. This program is in line with all federal policies. For example, the state has aligned its ethics policy with the HIPAA Privacy Rule, which requires all health officials to respect the rights of patients to choose.

Most importantly, the state has a legally-instituted board (the Alabama Board of Nursing) that sets policies, including nursing ethics, and rules that guide nursing practice in the region. The board has a special committee adjudicates complaints and punishes all individuals who breach these rules. The board requires nurses to uphold all the ethical or moral principles of healthcare, including beneficence, non-maleficence, respect for autonomy, and many others. The board requires all its healthcare workers to respect the wishes of their clients, including those with mental illnesses like dementia. At the same time, it demands that all its members uphold the principle of beneficence and non-maleficence by acting in a manner that benefits patients. However, there are no specific, clear-cut ethical rules that nurses or other healthcare providers should follow.

The Process Of Ethical Decision-Making That Can Be Taken To Address This Ethical Dilemma

According to Buppert (2018), ethical dilemmas are often very challenging to address, primarily because no clear-cut rules define the right principle or denounce the other one. Therefore, it is very challenging to disregard one by upholding the other. The ethical decision-making process takes three major steps, including identifying the ethical dilemma, identifying the key values, and ranking the principles and values. In this case example, the principle of respect for autonomy and beneficence serve two separate moral roles. The first one is specifically intended to ensure nurses or healthcare providers respect the human rights inherent in all human beings, including those with dementia – the right to make independent decisions. On the other hand, the second principle is meant to oblige nurses to protect the human health and well-being of dementia patients. Therefore, from these two values, it is obvious that the principle of beneficence supersedes respect for autonomy, meaning that it is prudent for nurses to protect the well-being of dementia patients that respect their freedoms.

References

Alabama Board of Nursing. (n.d.). Discipline. Retrieved from https://www.abn.alabama.gov/discipline/

Alabama Department of Public Health. (2015). Memorandum. Retrieved from https://www.alabamapublichealth.gov/programintegrity/assets/2015-004ComplianceEthicsPolicy.pdf

Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.

Smebye, K. L., Kirkevold, M., & Engedal, K. (2016). Ethical dilemmas concerning autonomy when persons with dementia wish to live at home: a qualitative, hermeneutic study. BMC Health Services Research, 16 (12). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717656/

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Question 


Ethical Dilemmas

In your role, as an advanced practice nurse, you will encounter several situations that will require your ability to make sound judgments and practice decisions for the safety and well-being of individuals, families, and communities. There may not be a clear cut answer of how to address the issue, but your ethical decision making must be based on evidenced based practice, and what is good, right, and beneficial for patients. You will encounter patients who do not hold your values, but you must remain professional and unbiased in the care you provide to all patients regardless of their sociodemographic and ethnic/racial background. You must be prepared to critically analyze ethical situations, and develop an appropriate plan of action. For this Assignment, you will review the literature and discover the various ethical dilemmas advanced practice nurses encounter and how these issues are typically addressed in your state.

Ethical Dilemmas

Ethical Dilemmas

To prepare:

  • Review literature for moral/ethical issues encountered by advanced practice nurses in clinical practice.
  • Select an article that was published within the last five years.

By Day 7

  • Write a two page paper that answers the following questions:
  • Summarize the moral/ethical issue in the article (no more than 1 paragraph)
  • Describe the moral and ethical dilemmas surrounding the issue
  • Analyze the ethical issue and compare them to the State Health Laws and Regulations in your state
  • Outline the process of ethical decision making you would use to address this ethical dilemma

Textbook

  • Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.
    • Chapter 16, “Resolving Ethical Dilemmas” (pp. 471-479)
      • This chapter provides examples of ethical dilemmas in NP practice and enables you to analyze the ethical choices inherent in these situations. Ethical analyses are provided in this chapter.

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