Describe a situation of ethical dilemma as a nurse or healthcare worker that you have experienced in practice and how it was resolved.
Title: Ethical Dilemma in Healthcare: Balancing Patient Autonomy and Beneficence
Introduction
In the healthcare profession, ethical dilemmas are an inevitable part of daily practice, requiring healthcare workers, particularly nurses, to navigate complex situations that often involve conflicting values and principles. One such ethical dilemma I encountered during my nursing practice involved balancing the principle of patient autonomy against the obligation of beneficence. This essay will describe the situation, discuss the ethical dilemma, and explore how it was ultimately resolved.
The Ethical Dilemma
I was assigned to care for Mrs. Smith, a 75-year-old woman diagnosed with terminal cancer. Mrs. Smith had expressed her wish to discontinue aggressive treatments and transition into hospice care, emphasizing her desire for a peaceful and comfortable end-of-life experience. However, her adult children, who were heavily involved in her care decisions, were adamant about pursuing aggressive treatments in the hope of extending her life, despite the limited prognosis and potential for increased suffering.
This situation presented a significant ethical dilemma, as the principles of patient autonomy and beneficence were in direct conflict. On one hand, respecting Mrs. Smith’s autonomy meant honoring her wishes to forgo further aggressive treatments and embracing a palliative care approach. On the other hand, the children, driven by their love and concern for their mother, believed that aggressive treatments would offer a chance of prolonging her life and potentially improving her quality of life.
Ethical Analysis
The ethical dilemma in this case revolved around the tension between patient autonomy and beneficence. Patient autonomy emphasizes an individual’s right to make decisions about their own healthcare, even if those decisions may not align with the recommendations of healthcare professionals or family members. Beneficence, on the other hand, requires healthcare providers to act in the best interest of the patient, often involving interventions that may conflict with the patient’s autonomy.
Resolving the Ethical Dilemma
To address this ethical dilemma, a collaborative and multidisciplinary approach was adopted. The healthcare team, including nurses, physicians, and ethicists, engaged in open communication with Mrs. Smith’s family. This involved empathetic listening, sharing medical information transparently, and exploring the potential benefits and risks of further treatment. Additionally, the team facilitated a family meeting, providing a platform for Mrs. Smith, her children, and healthcare professionals to express their concerns, values, and perspectives.
Ultimately, the resolution was centered on a compromise that respected both patient autonomy and beneficence. Mrs. Smith agreed to a modified treatment plan that focused on comfort measures and symptom management rather than aggressive interventions. This decision was reached through shared decision-making, acknowledging the importance of Mrs. Smith’s autonomy while addressing the family’s desire for a sense of proactiveness in her care.
Conclusion
Ethical dilemmas are inherent in healthcare, demanding careful consideration and collaborative decision-making. In this case, the conflict between patient autonomy and beneficence was successfully navigated through open communication, shared decision-making, and a commitment to finding a compromise that respected the patient’s wishes while addressing the family’s concerns. This experience highlights the importance of ethical reflection, communication skills, and a collaborative approach in resolving complex ethical dilemmas in healthcare practice.
References:
American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements. Silver Spring, MD: American Nurses Association.
Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics (8th ed.). New York: Oxford University Press.