Ethical Dilemmas for Nurses on End of Life Issues

Ethical dilemmas are the main common challenges faced by nurses, during practice almost on daily basis. These dilemmas can erupt amongst nurses themselves, or nurses and doctors and the worst between nurses and patients.

Before the advancement of medical technology to prolong the lives of patients with lethal conditions, end-of-life care did not involve many discussions of ethics or morals. Even just a hundred years ago, it was common to speak of letting nature run its course. Today, patients and their relatives have many more options to utilize medical devices in hospital intensive care units to prolong life, whether that entails resuscitation, ventilation, or artificial feeding and hydration. As Alan Meisel, director of the Center for Bioethics and Health Law at the University of Pittsburgh, notes, “While the fact of death remains inevitable, its timing is often very much a function of

Nurses are facing many legal or ethical dilemmas in their career. Nurses should combine knowledge of ethical and legal aspects of health care and professional values into nursing practice. It is very essential to know what kind of dilemmas nurses may face during their profession and how they have been dealt with in the past.

Healthcare professionals have an ethical obligation to respect patient’s wishes. Consequently, many legal and ethical dilemmas arise in healthcare in response to clinical decisions related to the needs, beliefs, and preferences of patients and families. Other dilemmas result over concerns about the integrity, competence, or actions of other healthcare professionals. Preserving human dignity, relieving suffering, equality, integrity, and accountability are essential nursing values (Kangasniemi, Pakkanen, & Korhonen, 2015). Nurse leaders have an

Nursing is not an easy job and those who chose it as their profession are truly special people. Nurses are confronted with ethical decisions that need to be made on a daily basis. Often they know the right thing to do but because of circumstances like institutional structure and conflicts with others, obstacles are created and distress ensues (Jenner, 2001). It is during times like these that nurses must rely on the training that they have received as well as the code of ethics that has been set down for their profession in order to do the right thing.

I t is important that end of life care is delivered in respect of patients Autonomy, Beneficence, and in a Truthful way. In what follows I argue that we as nurses need to fulfill obligation to support and assist the dying patient and his family’s right to self-determination as it relates to end of life care. I believe that we have made headway but still have much to achieve. Education and research in these areas by and for health care workers and the general population would do much to improve the quality of end of life care.

The article points out how the American Nurses Association (ANA), the Hospice and Palliative Nurse Association (HPNA), and Oncology Nursing Society (ONS) do not support the use of assisted dying. However, due to recent law changes, the organizations are reevaluating their position on dying with dignity. The article talks about the countries and states that have legalized assisted dying and who can qualify to obtain the prescription. It also points out that nurses who live in these countries and states are more likely to be uncomfortable to talk about this subject with their patients. Either way, patients need to be educated and advocated for while following the code of ethics when dealing with the subject of assisted dying. The article also points out how a nurse needs to be a tentative listener to further assess why the option of assisted dying is being considered. A brief case study demonstrates how a good nurse can reveal the true motives behind choosing the assisted dying as an option. Finally, the article talks about different communication techniques and approaches a nurse can use when discussing the subject of

CNA announces that they will work with Canada’s nurse regulators to define the implications on nursing practice keeping with the code of ethics for registered nurse. CNA focuses more on improving palliative or end-of-life care and advocate that everyone should be able to access it. Also, they believe through the therapeutic relationship with patient and family, Registered Nurses [RNs] can help individuals prepare and share their wishes with others at the needed time. CNA’s role is “to support RNs as they assist patients and families, by informing them of their options, helping them communicate with one another and guiding them to their best decisions” (CNA,

While the nursing profession is fulfilling, it is not without challenges. Nurses are faced with a multitude of ethical dilemmas in clinical practice on a daily basis. According to Fant (2012) no matter where nurses function in their diverse roles, they are faced with ethical decisions that can impact them and their patients. Some examples of moral issues that nurses encounter in contemporary nursing practice and research include but not limited to: refusal of treatment, scarcity of resources, disagreement with caregivers, treating patients with impaired decision-making, futile treatment decisions for cancer patients, end-of-life decisions, advanced treatment directives, and euthanasia (Leuter, Petrucci, Mattei, Tabassi, & Lancia, 2013).

There are so many different pathways for a nurse. Regardless of the area of practice, ethical dilemmas will be faced on a regular basis. Arming oneself with knowledge is important to assist in navigation through moral and ethical situations. Examining one’s own personal values and morals helps provide insight into personal convictions and allows for less internal struggle when facing ethical dilemmas.

The ethical dilemma encountered by the nurse involved a 69 year-old female patient. This patient had cancer that had metastasized to the bones and brain with a diagnosis of approximately one week to live. This patient was alert and oriented times four but very weak and lethargic. The patient was having difficulty swallowing pills, fluids and food. Therefore her intake was very little. She had no advance directives but was of sound mind and could make her own decisions. The patient’s pain level was 10/10 on a pain scale of 0-10 with 10 being the worst pain. “Even before end of life, nearly half of patients with cancer report moderate to severe pain; up to 30% report the pain as severe; and an estimated 25% will die in pain ("End-of Life Care," 2015)”. The patient’s family did not want the patient to take her pain medication during the day because it would sedate the patient. They wanted to spend every waking moment with their loved one. “Often family members of the dying patient cannot make end-of-life decisions or have conflicting desires about the care that should be provided (Blais &

Nurses are expected to provide physicians with quality assessments and needs of their patients to ensure when a change from curative care to palliative care is needed and to ensure good death. Death has always caused an ethical

Ethical issues in nursing will always be an ongoing learning process. Nurses are taught in nursing school what should be done and how. Scenarios are given on tests with one right answer. However, there are situations that nurses may encounter that may have multiple answers and it is hard to choose one. “Ethical directives are not always clearly evident and people sometimes disagree about what is right and wrong” (Butts & Rich, 2016). When an ethical decision is made by a nurse, there must be a logical justification and not just emotions.

Ethics is an essential aspect of health care practice and those working in the nursing profession are often subject to frequent ethical dilemmas. It is essential for all nurses to be aware of the importance of ethics in health care and to practice within the ethico-legal parameters that govern the profession. However, while this is relatively easy in theory, ethics is not a black and white subject and often one’s culture, upbringing, attitudes and beliefs can influence what one views as ethical and this can therefore influence practice. This report will discuss the importance of ethics in nursing practice. The definition of ethics will firstly be presented followed

The American Nurses Association regards active euthanasia inconsistent with the Code for Nurses and is considered ethically unacceptable. It has been the role of a nurse to promote, preserve, and protect human life. As members of the profession, nurses are obligated to offer end of life care, which includes the promotion of comfort for pain and suffering, and foregoing life sustaining treatments. Care does not include deliberately terminating life.