Ethical Dilemmas in Healthcare: Case Studies and Solutions

This report delves into the complex realm of ethical dilemmas encountered by healthcare professionals, specifically focusing on nursing practices. It begins with an introduction to ethical dilemmas and their significance in healthcare, followed by an analysis of various case studies. These case studies highlight the challenges nurses face when making crucial decisions, such as balancing beneficence and autonomy, and adhering to the principles of non-maleficence. The report examines how individual care workers and agencies handle these dilemmas, referencing the NMC code and its standards. Furthermore, it explores the ethical justifications for conflicting decisions from contrasting ethical perspectives, using the example of restraint in patient care. The conclusion summarizes the importance of ethical decision-making in healthcare and the role of individual care providers and agencies in solving ethical dilemmas. The report utilizes academic references to support its findings.

Ethical Dilemmas

Table of Contents
INTRODUCTION...........................................................................................................................1
TASK 1............................................................................................................................................1
1.1 Range of dilemmas faced by health and social workers...................................................1
TASK 2............................................................................................................................................2
2.1 Handling of range of dilemmas by individual care workers and agencies.......................2
TASK 3............................................................................................................................................3
3.1 Ethical justification for conflicting decision from contrasting ethical perspectives........3
Conclusion.......................................................................................................................................4
REFERENCES................................................................................................................................6

INTRODUCTION
Ethical dilemma is nothing but a situation in which nurses got stucked and cannot find
the best one option out of 2 (Sari and et.al., 2018). They have to make a difficult decision
between 2 courses of actions as selection of the one can also hurt someone. This study is going to
show some ethical dilemmas which nurses face while providing care services to their patients. It
will also show some ways by which individual care workers handle situations or ethical
dilemmas.
TASK 1
1.1 Range of dilemmas faced by health and social workers
Here are 3 case studies and examples of nurses in which they find difficulties in making
decision and selecting the best one option. In the case of Azad who is a mental health student,
were asked to take care of with a sectioned patient at his placement. But the problem is Azad’s
continuous presence make the patient feel uncomfortable and if Azad live with the patient than it
would be the breaching the principle of beneficence. On the other hand, if Azad leave the patient
and respect the right of the patient than it would be breach of his duties of care to the patient
(Björk, 2019). So, here one of the ethical dilemmas for Azad is taking responsible decision
making. Beneficence is one of the main ethical principles which help nurses in addressing idea of
their actions should promote well. So, in this case, it is important for Azad to take care of the
patient because it will be good for both. In some cases where nurses think that it would be good
for patient and them to allow them to die. But here the situation of the patient (Alan) is not
severe. But he has threatened to attack himself if Azad makes his continuous presence. So, here
is the ethical dilemma is autonomy in the area of privacy and beneficence (Sussman and
DeJong, 2018).
In the other case of Sabina who is a learning disability student nurse is placed to take care of
a patient, resident (Marry). The patient has a disability as she diagnosed with schizophrenia. It is
also stated that boyfriend of Marry often collect or asked for money to Marry and if she denies
than he hits her. The patient does not want the police to get involved in her case and also say that
her boyfriend does not abuse her. In this case, nurse (Sabina) feeling confused as what to do. If
she respects, her patient’s autonomy than it will increase abusing by her boyfriend and if she take
action against her boyfriend than it will also be breach of the principle of non-malfeasance
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(Lawrie and et.al., 2019). She need to make a choice as whether without taking permission of
Marry, she can take action against her boyfriend and protect her or she will let her boyfriend do
whatever he is doing. So, here the ethical dilemma is autonomy and non-malfeasance. Here the
main principle which needs to be followed by the nurse is to protect the patient in order to
prevent her from hurt and any type of harm (Välimäki and et.al., 2017).
In the other case of Jayme, who is 10 year old patient suffering from cancer for 5 years. In
this case doctors believe that she cannot survive more than 8 weeks for further treatments. But
father of the patient asked 2nd opinion from USA and doctors of USA said that there are 18% life
expectancy or chances of full recovery. Doctors of the UK now facing ethical dilemmas and the
situation in which they have to decide whether it will be ok to support and permit Jaymee’s
father to take her for treatment to the USA or not. In this case Jaymee has definitely a moral right
to get treated but chances of successful treatment is very low,. And if nurses of the UK allow her
father than it would be the breach of the principle of non-maleficence because during this
Jaymee will have to go through a lot of pain. And if they do not allow her father than it would be
breach of their duty of care as well as negligence that Jaymee may die. So, here is the ethical
dilemma is the value of autonomy and the need to prevent distress with the principle of non-
maleficence (Jansen and et.al., 2019).
TASK 2
2.1 Handling of range of dilemmas by individual care workers and agencies
Nurses face several problems or ethical dilemmas where they got confused in selecting the one
options so, it is important for them to inform their superiors and asked for the best one option.
There are several individual care workers and agencies who handle such kinds of ethical
dilemmas. There are mainly 4 NMC code standards such as: professional values, nursing
practices with effective decision-making, interpersonal and communication skills and
collaboration and management. As per the NMC code all nurses are required to focus on
prioritising people, practicing in an efficient manner, preserve safety and promoting trust. In the
case of Azad, it can be said that delegation of task and supervising the patient is the main task in
order to provide safe care to the patient (Alan). It would be a good practice if Azad completes his
duty of providing care and completing his task (Jansen and et.al., 2019). The bad duty or practice
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will be to leave the patient as there is no surety that the patient will not hurt himself if Azad leave
him lonely.
In the other case of Sabina and Marry, it can be said that Sabina should inform the patient
about what is she going to do against her boyfriend. It is the right of people to know about their
problems as Marry does not consider that the reason of her problem is because of her boyfriend.
So, as a care provider the good practice will be to inform the patient by the nurse and respecting
rights of privacy as per the NMC code. On the other hand, the bad practice will be to take action
against the patient’s boyfriend by Sabina without informing Marry. To lie to the patient that she
will not tell anyone and tell to police will be the bad practice and unethical act (Tompkins,
Hobelmann and Compton, 2017).
In the other case of Jaymee and her nurse, the main dilemma is whether to permit father of
the patient to go USA for further treatment of Jaymee or to deny. Here standard of practice and
behaviours of nurses should be applied for nurses and midwives. So, in this case it would be
better to respond preferences of patient and her father and let them involved in the decision
making process about her own health and well being. So, it would be the good practice that if
nurses let them know about both advantages and disadvantages and allow them to take decision
which is good for the health of the patient as per the NMC code. On the other hand, if nurses
directly allow the father of the patient without providing them enough informations about the
pain which Jaymee will have to go through as well as hope as maybe she can cure. It would be a
bad practice.
TASK 3
3.1 Ethical justification for conflicting decision from contrasting ethical perspectives
Restraint refers a condition which keeps something or someone under control. In nursing it
is being used when, an individual does not have capacity to even complete their day to day
activities like feeding dressing up own self etc. In the case of Derek who is an 80 years old
widower suffering from dementia. He goes 3 days in a weak to mentally ill assessment unit for
therapy. But it is stated that his condition is getting worst as he needs to be restrained by nurses.
One of the main reason of providing restraint to Derek is he often lost his memory and it can lead
several problems and accidents as well. His son Graham suggested to get use of some form of
restraint on Derek because currently he is becoming aggressive. So, it can be said that nurse in
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this case can use some form of restraint because it is being used in cases where patient are not
capable enough. It is also stated that by using some other strategies like wrist tagging and door
alarm, wandering of Derek and accidents which might be happen by his wandering can be
managed (Øye and Jacobsen, 2020).
But as per the law or legal implication nurse will be sued if he/she restraint on the patient
because as per the act of mental capacity, the patient has right to make his own decision. On the
other hand, if nurse allow the patient to wander than also she will be sued because of breaching
principle of not to care patient and negligence. So, overall by ethical and legal point of view it
can be said that nurse can give her some form of restraint because as per the act treatment and
care provided to the patient who lacks capacity should be the least restrictive of their basic rights
possible.
Conclusion
From the above study it has been summarized that ways by which individual care providers
and agency solve problems and ethical dilemmas which nurses face played a vital role. This
study has discussed several ethical dilemmas related to care studies which create several
problems for nurses. It has also discussed a framework which justifies for conflicting decision
from contrasting it with ethical perspectives.
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REFERENCES
Books & Journal
Björk, J., 2019. A common ethical dilemma in the clinical setting concerns the trade-off between
beneficence and respecting patients' autonomy. Lakartidningen. 116.
Jansen, T.L. and et.al., 2019. Moral distress in acute psychiatric nursing: Multifaceted dilemmas
and demands. Nursing ethics, p.0969733019877526.
Lawrie, S.M. and et.al., 2019. Predicting major mental illness: ethical and practical
considerations. BJPsych open. 5(2).
Øye, C. and Jacobsen, F.F., 2020. Informal use of restraint in nursing homes: A threat to human
rights or necessary care to preserve residents’ dignity?. Health. 24(2). pp.187-202.
Sari, D. and et.al., 2018. Ethical decision making levels of nursing students. Pakistan journal of
medical sciences. 34(3). p.724.
Sussman, N. and DeJong, S.M., 2018. Ethical considerations for mental health clinicians
working with adolescents in the digital age. Current psychiatry reports. 20(12). p.113.
Tompkins, D.A., Hobelmann, J.G. and Compton, P., 2017. Providing chronic pain management
in the “Fifth Vital Sign” Era: Historical and treatment perspectives on a modern-day
medical dilemma. Drug and alcohol dependence. 173. pp.S11-S21.
Välimäki, M. and et.al., 2017. Connectivity to computers and the Internet among patients with
schizophrenia spectrum disorders: a cross-sectional study. Neuropsychiatric disease and
treatment. 13. p.1201.
Vandevelde, S. and et.al., 2017. Dilemmas in applying strengths-based approaches in working
with offenders with mental illness: A critical multidisciplinary review. Aggression and
violent behaviour. 32. pp.71-79.
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