The Ethical Decision Making Discussion Paper
A nurse’s primary task is to act as a patient advocate. Advocacy includes defending the patient’s autonomy, safety, and right to make informed healthcare decisions (Nsiah et al., 2019). As a nurse, I have worked in a long-term care facility for several months, caring for a patient with advanced dementia. The patient’s family had requested that a do-not-resuscitate (DNR) order be placed for their loved one, which had been done. However, the patient’s condition had recently deteriorated, and the doctor had prescribed medications to address a possible infection. The patient’s family declined the treatment since they did not want their loved one to suffer any longer. I advocated for the medication’s use because I believed it would improve the patient’s quality of life. The Ethical Decision Making Discussion Paper
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I knew I was responsible for looking out for the patient’s interests and advancing their well-being. I was aware that the patient’s wants and best interests came first but that the family also had the right to choose the patient’s treatment. I sought advice from the nurse manager, who suggested contacting the hospital’s ethical committee. Healthcare experts, executives, and community members with experience in ethical decision-making made up the ethics committee. After deliberating on the matter, the committee concluded that giving the patient antibiotics would be in his best interests because it would enhance his comfort and quality of life. The committee instructed me to keep in touch with the family and include them in decision-making while acknowledging their right to make decisions.
During our conversation, I highlighted the potential advantages of giving antibiotics to the family. The patient’s condition improved after the family finally consented to the treatment. The family then filed a lawsuit against the facility, claiming that their loved one’s wishes had not been honored. The defense team for the facility maintained that the ethics committee’s advice and the decision to give the patient antibiotics were made with the patient’s best interests in mind. The facility ultimately proved that the choice was made with the patient’s best interests in mind, and the court decided in their favor. The Ethical Decision Making Discussion Paper
Nurse leaders and managers can use two efficient strategies or models to raise the bar for moral judgment in difficult situations. The first method is a clinical ethics consultation. A team of healthcare experts, including doctors, nurses, social workers, and ethicists, work together to assess and resolve challenging ethical dilemmas in clinical practice (Bell et al., 2022). The nurse leader or manager can conduct a clinical ethics consultation with the ethics committee to examine the case and offer suggestions on how to strike a compromise between the patient’s best interests and the family’s wishes. With the help of this technique, it is possible to identify applicable ethical principles, explain ethical problems, and propose workable solutions that align with the patient’s values, beliefs, and preferences.
Models for making ethical decisions have become crucial tools for addressing dilemmas in the healthcare sector. The “Four-Component Model,” which describes four essential processes, is one such model (Hoskins et al., 2019). Finding the ethical dilemma and the pertinent aspects involved is the first step. The scenario must be examined using ethical principles like autonomy, beneficence, non-maleficence, and fairness in the second phase. The third step involves developing alternative strategies and analyzing their ethical ramifications. The chosen action plan is finally implemented in the fourth step, and its outcomes are evaluated. Nurse leaders and managers can use this model to instruct staff members on how to analyze moral dilemmas and come to judgments consistent with moral values and professional standards of practice. The Ethical Decision Making Discussion Paper
As discussed above, nurses should always act as patient advocates and prioritize their patients’ best interests. In order to make sound ethical decisions, nurse leaders and managers can use techniques such as clinical ethics consultation and the Four-Component Model to analyze scenarios and come to judgments consistent with moral values and professional standards of practice. By using these strategies, nurses can ensure that they are making decisions that are ethically sound and in the best interests of the patient.
References
Bell, J. A. H., Salis, M., Tong, E., Nekolaichuk, E., Barned, C., Bianchi, A., Buchman, D. Z., Rodrigues, K., Shanker, R. R., & Heesters, A. M. (2022). Clinical ethics consultations: a scoping review of reported outcomes. BMC Medical Ethics, 23(1), 99. https://doi.org/10.1186/s12910-022-00832-6
Hoskins, K., Grady, C., & Ulrich, C. (2019). Ethics education in nursing: Instruction for future generations of nurses. OJIN: The Online Journal of Issues in Nursing, 23(1). https://doi.org/10.3912/ojin.vol23no01man03
Nsiah, C., Siakwa, M., & Ninnoni, J. P. K. (2019). Registered Nurses’ description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124–1132. https://doi.org/10.1002/nop2.307 The Ethical Decision Making Discussion Paper
