Ethical Considerations in Nursing: Patient 'W' Case Study Analysis

This assignment delves into an ethical dilemma encountered in nursing practice, centered around a patient, identified as 'W,' who has a phobia of cancer, and whose family wishes to keep her critical health condition a secret. As the nurse, the student faces a challenging situation, with the patient seeking the truth about her condition. The assignment analyzes the ethical considerations, including the application of ethical principles such as autonomy, beneficence, non-maleficence, justice, and veracity, and ethical theories like utilitarianism and deontology, to determine the appropriate course of action. The student argues against disclosing the patient's condition, prioritizing beneficence and non-maleficence, and outlines the chosen approach, which involves providing palliative care, communicating with the patient to address her concerns, and involving her family in the process. The assignment concludes by emphasizing the importance of considering all ethical aspects in patient care and the role of ethical theories and principles in guiding decisions.

Running head: LAW AND ETHICS
NURSING PRINCIPLES AND ETHICS
Name of the Student
Name of the University
Author note

1LAW AND ETHICS
Ethics is a set of principles and moral values that helps people to lead a life with moral
principles and take decisions that will further help the society. Ethics possess higher importance
in the life of nurses, as it is important for them to understand ethical consideration of their
practice more than the state’s law. Ethically incorporated nursing practice helps them to take
effective decisions for patient safety, security and autonomy (Sellman, 2017). This assignment
discusses about an ethical situation in which a patient ‘W’ have phobia of cancer and therefore
her family did not want her to know about her critical situation and palliative care. As a nurse to
patient ‘W’, I am very close to her, and according to her words, she can accept the truth,
regardless of its harshness, from my mouth. This assignment will provide the answers to this
ethical dilemma of and will provide the course of action of such situation, in the light of ethical
principles and ethical theories. Further, this assignment will include the reason due to which, I
will not inform her about her deteriorated health condition and considering non-maleficence and
beneficence over autonomy, justice and veracity.
The ethical principles of nursing care are autonomy, beneficence, non-maleficence,
justice and veracity. These principles are of much importance, as while facing any ethical
dilemma, nurses need to think of these principles to take any further step (Ellis, 2017). In the
mentioned case study, my relationship with the patient was the prime reason for the ethical
dilemma, as I was very close to the patient. As a result, as I came back from two days off, the
patient shared all her speculations about her health condition to me and asked me to reveal the
truth about her health. In such situation, the course of action should be according to the ethical
principles and laws (Goethals, Dierckx de Casterlé & Gastmans, 2012). The first principle talks
about the autonomy of the individual and states that every individual under care provision has
the right for self-determination, independence and freedom to take his or her own decisions.

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Therefore, it is important for the clinicians and nursing staff in the clinical settings to respect the
autonomy of the patient and create situations to take care of the autonomy of the patient. This
includes examples such as allowing the patient to check his/her, medical documents and seek
assistance to understand their health condition. Further, it is the duty of the healthcare worker to
make the patient understand the risk associated with the health condition (Goethals, Dierckx de
Casterlé & Gastmans, 2012). However, according to the principles of ethics related to autonomy,
if the clinician or the family of the patient thinks that the knowledge about the disease can affect
the mental condition of the patient then they possess the right to hide the information from the
patient as per the ethics of beneficence (Johnstone, 2015). The second and third principle
beneficence and non-maleficence tells that nurses should utilize every step to make the patient
healthy again and in this course of action, they should not hurt the patient intentionally or
unintentionally. Beneficence and non-maleficence are ethical principles to save the patients from
causal harming. It allows the clinicians to take decisions for the welfare of the patient and
provide them with possible benefits instead of possible risks. Whereas the non-maleficence
involves protecting the rights and patients as well as their families and involves norms to help
people who are in danger or want clinicians support to achieve health (Johnstone, 2015). Further,
the principle of justice and veracity determines that patient has the right of equality, fairness and
impartiality and veracity seeks the nurses to be truthful and honest to the patients (Krishna,
Watkinson & Beng, 2015). Hence, the principle of justice determine the equal distribution of
available resources among each patients, who can recover using that resource and makes the
healthcare process more consistent and transparent. On the other hand, veracity wants the
healthcare professionals to be truthful to the hospital authority, patient and the families so that
while taking decisions about surgery or harsh medical treatments, the patient and the families can

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trust upon the healthcare facility (Krishna, Watkinson & Beng, 2015). While providing care to
patient W, I realized that she tensed about her physical condition and speculating that her family
and doctors are hiding any important fact from her. In such situation, the truth about her health
can affect her mental state and degrade her health condition. (Singapore Nursing Board, 2018)
Therefore, I will not disclose the truth about her health condition. According to the principle of
beneficence and non-maleficence, she will be provided with best possible care while in palliative
care and disclosure of such facts can affect her mentally. Therefore, in the case of ‘W’, the
principle of beneficence and non-maleficence overrules the principles of justice, veracity and
autonomy. Hence, the patient will not be informed about her actual health condition
(SINGAPORE NURSING BOARD, 2018).
However, while finalizing the further course of action, the nursing ethical theories should
also be taken into account. These theories are utilitarianism and deontology. According to the
theory of utilitarianism, if any action provides better outcome of the entire population in course
of action, then it is morally right (Lowry & Peterson, 2012). This theory determines greatest
good as more important than individual rights and laws. Therefore, in this situation, the patient
should not be informed about her health condition as her individual right was less important than
her palliative care that can make her family members happy. On the other hand, the theory of
deontology determines that core fundamental rights should be provided to every individual,
irrespective of the consequences it brings to their lives (Crossan, Mazutis & Seijts, 2013). These
rights are right for privacy, truth and fulfilment of promises. This theory helps to decide the right
and wrong of any given situation without thinking about the consequences. This theory provides
a contradictory opinion and determines the action of hiding facts from ‘W’ as wrong and allows
me to state truth in front of the patient. However, I will not disclose her health condition as,

4LAW AND ETHICS
according to the utilitarianism theory, and principles of beneficence and non-maleficence, she
should be provided with best care while in palliative care and disclosure of her health condition
can affect her mentally (Lachman, 2012).
Hence, the course of action to deal with this dilemma should be consoling the patient and
clearing her doubts about her husband and the physician hiding truth of her physical state. I will
be choosing appropriate words to make the patient stress free and positive about her health
(Shapiro & Stefkovich, 2016). Further, I will try to communicate few of health conditions as
during palliative care, she might develop symptoms that can affect her mental health. Under-
communication of her state can lead to adverse situations and to prevent that, I will try to
communicate the reason of her health condition eventually. I will try to maintain the relationship
with her so that she can state all of her problems to me without any hesitation, which can further
help me to take necessary interventions (Aguinis & Bradley, 2014). Finally, I will ask her family
member to talk to her and resolve her confusion so that she can get over the feeling of being
uninformed about the health condition.
It is very important for any health care provider to take care of every ethical aspect of
care process and provide the patients with their rights. In this discussed case study, the family
members of the ‘W’ kept her uninformed about her serous health condition and as I was close to
the patient, she wanted me to disclose her health condition to her. However, in this dilemma, the
principles and theories of nursing ethics helped me to understand the fact that the theory of
utilitarianism and principles of non- maleficence and beneficence overshadows the principles of
autonomy and justice as the patient can loss her mental strength. The theories and principles of
nursing ethics helped me to prepare the course of action for this situation.

5LAW AND ETHICS

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