Ethical Dilemma In Nursing

A dilemma occurs when there are options that seem equally unattractive. Ethical dilemma is defined as a situation whereby there is a need to select from two or more ethically acceptable alternatives, but they are in disagreement with one another (Ong, Yee, & Lee, 2012). Nurses often face ethical dilemmas during their course of work. Regardless of the different workplaces, nurses are faced with ethical dilemmas that can influence them and their care of patients (Fant, 2012). An ethical dilemma can be affected by the personal beliefs, feelings, past experiences, values, and morals of the nurse (Fant, 2012; Thompson, Melia, Boyd, & Horsburgh, 2006). It may also be influenced by the different beliefs of the patients and their relatives. Combined

Who else have the greatest right to know about the impending death other than the patient? Are the family members authorized to keep the truth from the patient (Melia, 2004)?

In Singapore, the Code of Ethics and Professional Conduct provides a guide for all nurses to uphold the expected standard of care (Singapore Nursing Board [SNB], 1999). The 10 value statements in the Code of Ethics are aligned with the major ethical principles of autonomy, beneficence, non-maleficence, justice, veracity, fidelity, and fiduciary (Appendix B). According to SNB (1999), this aims to provide a framework to help nurses with the ethical decisions that they may need to make daily. In this scenario, value statements 1, 2, 4, and 7 are closely involved.

One major ethical principle involved in the scenario is autonomy. Autonomy is “the quality or state or being independent, free, and self-directing” (“Autonomy”, 2015). It is the patients’ right to make their own informed decision without any influences from others. The respect for persons is often related to the respect for autonomy. The respect for autonomy includes disclosing information about their medical condition to patients (Pantilat, 2008). It is Pansy’s right to have full knowledge about her condition unless she states otherwise. It is Natalie’s responsibility to respect Pansy’s autonomy and to provide her with the necessary information.

It suggests that a correct decision must produce a good outcome or result and that is the most important component of all. The ends must justify the means. Utilitarianism is a type of consequentialism theory that is widely discussed. It supports the choice that has the greatest outcome to the most people (Rainbow, 2002). It is further divided into two types, the act utilitarianism and rule utilitarianism. Act utilitarianism is when a decision benefits the most number of people and disregards personal feelings or laws. Rule utilitarianism considers the law and prefers the fairest, unbiased way. Rule utilitarianism incorporates the added principles of justice and beneficence. Utilitarianism theory requires the ability to predict the consequences involved (Rainbow, 2002). A utilitarian must be able to compare the predicted consequences on the same scale. However, this is often not possible as people value tangible gains and intangible gains differently. In the scenario, it may be difficult to predict the consequences involved, as only Pansy can compare the consequences on her own personal