Ethical Dilemmas in Nursing

This nursing assignment delves into the complex ethical dilemmas encountered by nurses in clinical practice. It focuses on the tension between respecting patient autonomy and providing beneficent care, particularly when patients refuse treatment like antiretroviral therapy (ART) due to personal beliefs. The paper analyzes a case study of a patient with AIDS who refuses ART, highlighting the conflicting ethical principles involved. It also discusses the impact of unresolved ethical dilemmas on nurses' well-being and patient safety, emphasizing the importance of ongoing ethical reflection and education in nursing practice.

Running head: OPINION EDITORIAL ARTICLE
Opinion editorial article
Name of the Student
Name of the University
Author note

1OPINION EDITORIAL ARTICLE
In the recent years, nurses face ethical dilemmas regarding the treatment and access to
care, end-of-life care, palliative and treatment of vulnerable populations in the present clinical
scenario. The most significant ethical challenge faced by the nurses is “respect for autonomy vs
beneficence” (Oh & Gastmans, 2015). Although the patient has the right to refusal to treatment,
he or she does not have any right to demand any kind of treatment. As a nurse, one has no duty
to offer inappropriate medical treatment to patients and ethical principle that takes priority
depends on the medical case.
This stark finding is serving as reminders for nurses in our community, locality and
globally. My research focus is on the ethical dilemma and moral distress; the worrying fact is the
debate that arises when the nurses are unclear about right thing that they should do or can view
what should be done, however, unable to do it (Johnstone & Hutchinson, 2015).
In an ethical scenario, a patient was experiencing AIDS complications like
cytomegalovirus retinitis, gastrointestinal and pulmonary tuberculosis and central nervous
toxoplasmosis. The patient was in full control of faculties; however, he required frequent
hospitalizations and dependent for activities of daily living. Now, the patient agreed to take the
prescribed medications, however refused for antiretroviral therapy (ART) as he believes that it
would reveal AIDS diagnosis to his family.
The patient directly said that he would rather die than confessing the AIDS to his family.
I feel the patient will die of AIDS complications if ART does not begin soon. My response to
this scenario is qualified yes, as we have an ethical obligation to treat his complications of AIDS.
Some researchers can argue that patient’s unreasonable refusal to ART has put the hospital in an
ethical bind and nurses should not be manipulated that end up delivering inadequate treatment

2OPINION EDITORIAL ARTICLE
(Brinkmann, 2014). In some views, it can be argued that the principle of respect for autonomy is
being violated by the hospital. On the other hand, it is against slippery slope where treatment is
withheld from patient where the disease is self-inflicted in some sense. Principle of justice is also
violated where the hospital is providing inadequate or partial care at great expenses and
argument arises that there is risk for the HIV infection being transmitted through the family
(Preshaw et al., 2016).
There are differing views where informing his family about AIDS diagnosis would break
the principle of confidentiality or disguise medication as his family is not aware of the diagnosis.
However, my response to this situation is that why ART technique could not have been
confidentially dispensed which a technical matter is.
In nursing practice, the ethical scenarios are not rare. They grapple with these issues and
in the daily grind; ethics are not discussed very often. When ethics are not discussed and ignored,
it leads to nurse burnout. This ultimately results in staffing shortages and affecting the quality of
care and patient safety that affects the community, the local area and globally. Although, ethics
affect every healthcare worker, research experts say that nurses face unique ethical challenges as
they spend more time with patients and more likely to understand their feelings, needs and how
their families feels (Holm & Severinsson, 2014).
Nurses are the ones who understand whether patients and their family members are
struggling to make crucial and excruciating decisions. They understand if the patient or family
members are comfortable with the current medical treatment or not. As stated, they are put into
thick of ethical things that collide with patient’s preferences making it complex and messy. We
nurses have personal values and at times, they are in conflict with patient or family needs. I think

3OPINION EDITORIAL ARTICLE
we have to find a way to reconcile our own moral values within the obligations of nursing
profession. On a contrary, during an unsafe situation, it is not a heroic act where we as nurses
compromise the ethical values (Poikkeus et al., 2014).
As a nurse, I believe that I would treat my patient’s beliefs and values as it may be an
exclusion or contradiction from treatment. I have to respect the principle for autonomy, as
treatment is always elective no matter how much necessary it is. It is through the learning
experiences that nurses understand ethics and its implications on nursing practice and ways to
respond to it.

4OPINION EDITORIAL ARTICLE
References
Brinkmann, S. (2014). Interview. In Encyclopedia of Critical Psychology (pp. 1008-1010).
Springer New York.
Holm, A. L., & Severinsson, E. (2014). Reflections on the ethical dilemmas involved in
promoting self-management. Nursing Ethics, 21(4), 402-413.
Johnstone, M. J., & Hutchinson, A. (2015). ‘Moral distress’–time to abandon a flawed nursing
construct?. Nursing ethics, 22(1), 5-14.
Oh, Y., & Gastmans, C. (2015). Moral distress experienced by nurses: a quantitative literature
review. Nursing Ethics, 22(1), 15-31.
Poikkeus, T., Numminen, O., Suhonen, R., & Leino‐Kilpi, H. (2014). A mixed‐method
systematic review: support for ethical competence of nurses. Journal of advanced
nursing, 70(2), 256-271.
Preshaw, D. H., Brazil, K., McLaughlin, D., & Frolic, A. (2016). Ethical issues experienced by
healthcare workers in nursing homes: Literature review. Nursing ethics, 23(5), 490-506.