Advanced Directive: Ethical Dilemma Case Study Analysis in Nursing

This assignment presents a case study involving an ethical dilemma in nursing, specifically concerning a patient named Jim who has an advanced directive. The dilemma arises when Jim's wife requests CPR, which contradicts his previously stated wishes. The assignment explores the ethical considerations, including patient autonomy, non-maleficence, and the nurse's role in upholding patient rights. The analysis considers the potential consequences of both applying and withholding CPR, weighing the legal and professional implications. It references key principles from the National League of Nursing and relevant literature on moral distress and ethical decision-making in healthcare. The solution highlights the complexities of balancing patient wishes with the potential for saving a life, and the importance of respecting patient autonomy and privacy. The assignment emphasizes the need for nurses to advocate for their patients and navigate difficult ethical situations.

Running Head: ETHICAL DILEMMA IN NURSING
ETHICAL DILEMMA IN NURSING
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ETHICAL DILEMMA IN NURSING 2
Advanced Directive Ethical Dilemma
The issue concerning Jim is a form of an ethical dilemma. It lies under the category of the
dilemma of disclosing the medical conditions of patients. Under the medical condition ethical
dilemma, the National League of nursing published a declaration that comprised all the rights
that a patient should be accorded. Nurses are expected to espouse those rights of patients, and to
advocates for these patients who cannot be their own advocates.
Nurses respect the autonomy of patients through the recognition and the enhancement of
the freedom of choice for the patient, respect for the decisions made by the patients, and the
provision of privacy (Ganz, Wagner, & Toren, 2014). Nurses are supposed to uphold the rights
of the patients and support the patients who are not able to support themselves. Nurses ought not
to harm the patients. The latter refers to the principle of no maleficence (Ganz, Wagner, &
Toren, 2014).
As a nurse, I am supposed to perform procedures that make the patient comfortable. I
believe in the application of justice and fairness in nursing care during the delivery of services to
patients. Controversies arise on what is fair and just for the patient and economically feasible
(McCarthy & Gastmans, 2015). However, using the training and skills instilled in me, I value
decision making and can assist in policy development in all stages of the healthcare system. I
value the patient's decisions and respect their will.
The problem in the case of Jim is evident because he did not inform his wife that he does
not prefer and CPR being done on him in case his ailment became worse. The wife realizes that
in the last minute and calls for immediate action to be taken so that the life of her husband could
be saved, which is against the wishes of the husband (Ganz, Wagner, & Toren, 2014).

ETHICAL DILEMMA IN NURSING 3
In this case study, the possible causes of action are to practice nonmaleficence and let the
client die, or the nurse can apply the CPR process, and this will be an intrusion and invasion to
the rights of the patient. The application of CPR will have several impacts on Jim. He possibly
will be able to live for longer (Oh & Gastmans, 2015). Failure to initiate the CPR procedure can
also make the patient die. Failure to apply CPR can also lead to the wife issuing a petition in
court and the doctors, and I will have to face the court of law (Ganz, Wagner, & Toren, 2014).
The initiation of CPR can save the life of Jim. However, when Jim gets healed, he can
file a petition that his rights in the hospital were abused and this can make me lose my job and
career. Failure to apply CPR will probably lead to the death of the client (Ganz, Wagner, &
Toren, 2014).

ETHICAL DILEMMA IN NURSING 4
References
Ganz, F. D., Wagner, N., & Toren, O. (2014). Nurse middle manager ethical dilemmas and
moral distress. Nursing Ethics, 22(1), 43-51.
McCarthy, J., & Gastmans, C. (2015). Moral distress: a review of the argument-based nursing
ethics literature. Nursing ethics, 22(1), 131-152.
Oh, Y., & Gastmans, C. (2015). Moral distress experienced by nurses: a quantitative literature
review. Nursing Ethics, 22(1), 15-31.