ETHICAL ISSUES IN NURSING PRACTICE

MRS. P. ATTAFUAH Nursing Department Valley View University Oyibi-Ghana

No matter where nurses function in their varied roles, they are faced with ethical decisions that can impact them and their patients. There is no right solution to an ethical dilemma. The significance of ethical decision-making lies in the fact that very different ethical choices regarding the same ethical dilemma can be made resulting in neither choice being a right or wrong decision.

BIOETHICAL ISSUES
Are

concerned with problems associated with biology or the field of medicine, mainly that are related to birth and to death, and life supporting measures. ..To birth: Involve: Processes that prevent conception. Terminate pregnancy maturity. Process that enable conception and pregnancy to occur through direct intervention rather than through normal developments.( Sterilization, contraception, and abortion on the one hand, and test-tube conception and artificial insemination.)

SOME ETHICAL ISSUES

quality versus quantity of life, pro-choice versus pro-life, freedom versus control, truth telling versus deception, distribution of resources, and empirical knowledge versus personal beliefs.

QUALITY VERSUS QUANTITY OF LIFE

Quantity

may address how long a person lives or perhaps how many people will be affected by the decision. Quality pertains to how good a life a person may have and this varies depending on how a person defines good. So how does the nurse support a patient deciding between a therapy that will prolong life but the quality of life will be compromised? The person may live longer, but will likely experience significant side effects from the therapy. What should the nurses position be?

PRO-CHOICE VERSUS PRO-LIFE.

This issue affects nurses personally. Many of the positions nurses assume in this dilemma are influenced by their own beliefs and values. How does a nurse care for a patient who has had an abortion, when the nurse considers abortion murder? Can that nurse with very opposing values support that patients right to choose, her autonomy?

FREEDOM VERSUS CONTROL.

Does a patient have the right to make choices for ones self that may result in harm, or should the nurse prevent this choice? For example, a patient wants to stop eating, but the nurse knows the consequences will harm the patient. Does the nurse have the right to force the patient to eat?

TRUTH TELLING VERSUS DECEPTION.

This is another issue that nurses may have to deal with, especially when families want to deny telling the patient the truth about the medical condition. What is best for my patient to know? What should a nurse do when a family insists telling the patient the prognosis will cause harm? How can a nurse know if this is true? Does the patient have the right to know?

THE DISTRIBUTION OF RESOURCES.

Who

should get the limited resources? For example, nurses working with patients that are in a vegetative state; should these patients be left on life support? Look at the cost of maintaining these patients. These patients are consuming resources that could be used for patients in whom such costly interventions, if available, could save their lives. What is the role of the nurse when a family wants to continue life support for a medically futile family member?

EMPIRICAL KNOWLEDGE VERSUS PERSONAL BELIEF.

In these dilemmas, research based knowledge in nursing is contrasted to beliefs gained from such things as religious beliefs. For example, what should a nurse do when a patient is admitted to the hospital that desperately needs a transfusion to live but has the belief that transfusions are unacceptable? The nurse knows this patient will die without the transfusion. How does that nurse deal with the patients family who supports the family members choice and still be supportive of the patients and familys right to this decision?