Ethical Dilemmas in Nursing Practice

This assignment analyzes a case study involving a terminally ill patient requesting to meet his mistress. The nurse grapples with ethical dilemmas, prioritizing patient autonomy and beneficence while considering the implications of deception. The analysis delves into ethical principles like justice and non-maleficence, personal beliefs, and self-care strategies for the patient.

Running head: ETHICAL PRINCIPLES
ETHICAL PRINCIPLES
Name of the Student
Name of the university
Author’s note

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My response to Mr. Newcomb’s request
The case study reveals the fact that Mr. Newcomb wanted to see his mistress in spite of
having a loving wife. Knowing that Mr. Newcomb is in the edge of his life, I would try to keep
Mr. Newcomb’s request and would certainly make arrangements, so that he could meet his
mistress. At the same time I would also remind Mr. Newcomb of his duty towards his loving
wife, who had remained beside him all these years and have shared both joy and sorrows with
him. I would keep the decision entirely to him, whether he should cheat his wife who had been
with him through ups and down or he would spend his last days with his wife. In spite of
knowing the harsh reality I will have to lie to his wife for making the arrangements as it is my
duty to think about the physical and the emotional wellbeing of the person rather than sticking to
the truth.
Application of the principles of ethics
For practicing nursing with competence and integrity, there are few codes of ethics that
needs to be followed for guiding the professional practice (Karen Tomajan, 2012). Nursing can
be defined as promotion, protection and optimization of the health and the abilities, prevention of
injury and illness, alleviation from the sufferings by diagnosing and treating of the human
response and advocacy in the care of the individual (Lachman, 2012). Hence in this situation, the
physical well being of the patient is my first priority, rather than my personal interest.
According to Chadwick & Gallagher, (2016) there are our commonly accepted principles
of ethics, that is respect for autonomy, principles of beneficence, non maleficence and justice.
The four principles are non hierarchical and specifically do not trump another. One might argue

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that we are required to consider all the principles in to account while considering a clinical case.
Yet, when two or more principles apply we can find conflict in them. Beneficence in nursing
refers to the actions taken to prevent harm in patients (Huston, 2013). In this case study it is
evident that Mr. Newcomb wanted to see his mistress for one last time, and refraining him from
his last wish may bring him emotional distress preventing a peaceful and dignified death.
Furthermore, the principle of autonomy states that the every patient has got the right to choose
his treatment above the consent of any physician and it is evident that Mr. Newcomb does not
want to continue any further treatment (Karen Tomajan, 2012). Although it is visible that such an
act is actually deteriorating his health condition as a nurse one cannot force Mr. Newcomb to
continue the care if he himself does not want to. Allowing Mr. Newcomb to meet his mistress
might be injustice to Mrs. Newcomb, but according to the principle of non maleficence it is the
duty of a nurse to inflict the least harm possible for reaching a beneficial outcome. Already Mr.
Newcomb had been suffering from emotional turmoil owing to the deadly disease and the sorrow
of leaving his wife forever, any kind of refrainment may lead to emotional distress in him.
Personal beliefs and values
I have learnt that nurses are often confronted with complex concerns in their practice and
hence codes of ethics are the fundamental guidance for nursing. I am well acquainted with the
fundamental codes of ethics, ethical decision making and entirely believe in providing high
quality of care to the patient. I am well aware of the fact my act of lying to Mrs. Newcomb is
questionable and can be morally wrong, but the nursing codes of ethics have helped me to
overcome all the professional obligations and provide the care that is appropriate for the patient.
Nurses have to suffer from ethical dilemmas just as in this case, but a nurse should entirely focus
on patient advocacy by setting aside her personal obligations. The nurse should entirely look out

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for the patient's best of interests and help them to navigate the patient through the complicated
health care system (Battié & Steelman, 2014).
Promoting self care strategies
According to Blais (2015), self-care is considered as the primary form of care for patients
suffering from chronic conditions so that they can self-manage their condition and engage in
day-to-day decisions. The three strategies for promoting self-care for Mr. Newcomb are as
follows-
 The most crucial step would be to set a shared agenda for self-care for the patient. The
nurse must be having a clear idea of the aspects that are to be discussed in light of self-
care requirement. Similarly, the patient must also be encouraged to put forward queries
and concerns. Setting the agenda for self-care in collaboration with the patient conveys
interest in the preferences and priorities of the patient and enables the patient to have an
active role in the overall care process.
 The second strategy would be to provide the patient with tailored information as per the
physical and emotional wellbeing needs. It is advised to inquire and gather additional
information by asking a set of questions. A nurse must then respond accordingly by
providing in-depth information.
 Setting self-management goals by indentifying incremental changes in health behaviors is
essential. Goals must be realistic for the patient to achieve so that self-care is effective.

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Conclusion
The case of Mr. Newcomb presented an ethical dilemma wherein the response was to
fulfill the patient’s request to arrange for a meeting with his mistress. The decision was guided
by the ethical principles of beneficence, autonomy, justice and non-maleficence. Further, my
personal beliefs and values guided me to act in the best interest of the patient. Since the patient is
in about to avail hospice care, self-care would be crucial for his wellbeing, and thus effective
strategies are to be applied to promote the same.

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References
Battié, R., & Steelman, V. M. (2014). Accountability in nursing practice: why it is important for
patient safety. AORN journal, 100(5), 537-541.
Blais, K. (2015). Professional nursing practice: Concepts and perspectives. Pearson.
Chadwick, R., & Gallagher, A. (2016). Ethics and nursing practice. Palgrave Macmillan.
Huston, C. J. (2013). Professional issues in nursing: Challenges and opportunities. Lippincott
Williams & Wilkins.
Karen Tomajan, M. S. (2012). Advocating for nurses and nursing. Online journal of issues in
nursing, 17(1), A1.
Lachman, V. D. (2012). Applying the ethics of care to your nursing practice. Medsurg
Nursing, 21(2), 112.