Ethical Dilemmas in Nursing: Legal and Ethical Implications Report

This report delves into the ethical dilemmas encountered by nurses in the healthcare field, examining three key issues: the disclosure of medical information to patients, the withholding of sensitive information from patients and their families, and the use of restraints. The report analyzes how nurses navigate these dilemmas, providing examples of both effective and ineffective practices. It emphasizes the importance of professional collaboration, education on ethical issues, and adherence to the NMC's code of conduct. The report also explores the different types of restraints used to ensure patient safety, discussing the legal and ethical implications of each approach. Through case studies, the report highlights the challenges nurses face and the importance of ethical decision-making in providing quality patient care.

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Ethical Dilemmas

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Table of Contents
Task 1....................................................................................................................................................3
Three ethical Dilemmas faced by the nurses in their work place according to given case studies.....3
Task 2....................................................................................................................................................4
How nurses handled such type of dilemmas in their work place with some good or bad examples.......4
Task 3....................................................................................................................................................5
Different types of restraints to be used for legal and ethical implication to manage their patients and
their safety.............................................................................................................................................5
References.............................................................................................................................................7

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Task 1
Three ethical Dilemmas faced by the nurses in their work according to given case
studies
In the nursing felid, it is a very difficult job for the nurses to work in an ethical manner. It is
the most challenging tasks for nurses to deal with patients in an ethical manner at all times.
Most of the times the nurses need to compromise their values and duties for the sake of
professional liabilities at the workplace. There are many different reasons that lack them to
fulfill their duties and obligations due to limited resources, time, patient condition and other
management issues (Chadwick and Gallagher, 2016). It is important for them to continue
their profession for a long time so that they cannot avoid these issues in their profession.
Below given are the following possible ethical issues that are selected from the case studies
a) Not disclose the full information of the medical conditions to the patients: It is the
major ethical dilemma that can be faced by the nurses at the workplace. They are not
supposed to tell the full information or condition of the patients to their families and
patients as well due to maintaining some consent from their profession. They are not
able to disclose the full information to them as per their professional liabilities. In the
context of the case study of Azad, he is not prepared for the treatment of the Alan and
provides full information to the Alan and it can be possible that Alan denies for the
treatment once they get the full consent from the Azad. In this issue, the ethical
dilemma needs to be maintained from Azad’s side at the workplace for better
treatment and cooperation from Alan side. Similarly, in another situation, Sabina was
the nurse and specialist in the profession of disability and Mary was the patient having
the problem of learning disability (Daly, et al., 2017). In this case, Sabina not
supposed to disclose the full information to Mary due to lack of cooperation from her
side. It is the situation for an ethical dilemma for Sabina due to maintain professional
responsibilities and give treatment to Mary.
b) To hide the actual facts from the patients and their families: In most of the critical
cases, it is very important for the nursing staff to hide the actual facts about the
diseases or illness from the patients or their families to increase their will power. It is
important in the medical profession to accept this ethical dilemma for the well being

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of the patients and their families. In the case of Jaymee, the same thing happens the
actual truth can be hidden from her father. Due to different opinions of different teams
or the nursing staff from USA and UK, it is revealed that no one can tell the exact fact
about their condition and most of them indicate that her life expectancy is high. It is
the ethical dilemma for the medical or nursing team to tell the exact truth to degrade
their will power or mental condition of the patient (Kangasniemi, et al., 2015).
c) To restrain the patient in some conditions: Restraint means to punish or stop
somebody to perform some tasks. It is also the major issue in the medical defiled to
use this activity to stop the unwanted behavior of the patients. It is also an ethical
dilemma to stop someone to perform something by their patients. In the case of
Derek, Graham behavior of restraint by someone in his staff shows the ethical
dilemma for him due to the unwanted condition of his father namely Derek to stop
him from wandering. This step is necessary for Graham to stop the unwanted behavior
of his father due to critical illness namely dementia. It is the only option to protect his
father for some injuries and give proper treatment.
Task 2
How nurses handled such type of dilemmas in their workplace with some good or bad
examples
In the nursing profession, ethical dilemmas are the major issue for the nurses to maintain their
profession in a significant manner. In their training and modules, it is implied that the nurse
should face the ethical dilemmas in their career and they need to handle in patiently and
professional manner without any harm to their patients. Sometimes it becomes difficult for
them to handle such dilemmas because the condition of the patient is destructive and they
attempt to injure the staff due to their ineffective medical condition. In most of the cases, the
nurses cannot disclose the full information to their families and patients that creates the issues
at the workplace. Similarly, the first ethical dilemmas are related to the disclosure of medical
condition to their patients and families. In these cases, the nurses try to persuade the families
and the patients according to the mental and psychological level of the patients. In most of
the cases the nurses disclose full information to the patients and their families according to
their behavior, support, illness and understanding level of the individuals (Kon, et al., 2016)
Similarly, in case of Azad, Azad should discuss the problems with their senior staff for full

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disclosure of information to their patient namely Alan. They should disclose to the patient
according to the mental capacity of the patient. Moreover, in the second case related to the
ethical dilemma like disclosure of full facts to their families with the discussion of senior
doctor teams and nursing staff to provide the full information to the patient or not. It can be
discussed by the staff at senior level before giving full information to the patients and their
families. It can be assessed on the basis of some important factors like budget, patient
condition and so on (Milliken, 2018). Below given ethical issues can be handles through
below given methods or ways to resolve the ethical dilemmas.
To behave in a professional and collaborative manner with patients and staff
As per the examples from case study 2 and 3 the patients do not cooperate with the nursing
team and other staff members. In this case, the nursing staff behaves in a professional and
collaborative manner to communicate positively with their families and guardians to persuade
the problem and their solutions in a professional manner to convince them for their well
being.
Provide training and education on ethical dilemma issues
In the above case studies of 1 and 4, it is analyzed that patients were not in a condition to
express their issues feelings and conditions to their families and nurses. In this case, special
training and guidelines provide to them to handle these situations (Pecanac & Schwarze,
2018). The importance of nursing programs and education is given to the staff to combat
these issues.
Code of Conduct related to the NMC
The health care companies follow the code of conduct set by the NMC that specified the
relevant education, performance of nursing staff, qualification and training to their nurses so
that they can easily handle the critical situations related to the ethical dilemmas.
Task 3
Different types of restraints to be used for legal and ethical implication to manage their
patients and their safety
Physical restraint

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It is related to the control of the situation of the patients in different conditions like violent
behavior and nonviolent behavior. In the context of the case study 4, the management uses
the nonviolent restrained method where the patient can be controlled through ropes tied from
the bed or lock into the room where the nursing staff can observe their activities. This method
is used for those patients who are not violent but they are escaped in some conditions that are
important for nursing staff to control them. Similarly, restraints gave to the violent behavior
of the staff in some situations like fighting, destruction and physical injury to the staff
(Rainer, et al., 2018). In this case, the management provides the hallucinations techniques to
the patient to control the behavior of the patient. This technique is viable in a case study of 1
and 2 to control patient behavior in an appropriate manner.
Chemical restraint
This type of restraint given to the patent in their uncontrollable situations the patient totally
becomes out of control from the nursing staff and escaped here and there. In case study 4, it is
important for the nursing staff to provide some dose or medicine that controls the activities of
the patient. In this case, Derek wandered here and there and not control from his son namely
Graham. So it is important from the nursing staff to implement chemical restraint method to
control the situation of the Derek.
Ethical Justification for complex Decisions
It is very difficult for the nursing staff to take an ethical decision in complex situations. In
these situations, the management needs to follow the systematic steps or procedures to
resolve the issues. In these situations, the management evaluates the legal proceedings or
ethical considerations. The management makes the report on the basis of different conditions
and takes advice from the senior staff to combat the situation (Reid, et al., 2018). On the basis
of different views, reports, facts and benefits, the decision maker select the best option or
alternative to resolve the issue that is ethical and beneficial for the patient and their families.

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References
Chadwick, R. and Gallagher, A., (2016) Ethics and nursing practice. Macmillan International
Higher Education.USA
Daly, J., Speedy, S. and Jackson, D., (2017) Contexts of nursing: An introduction. Elsevier
Health Sciences.
Kangasniemi, M., Pakkanen, P. and Korhonen, A., (2015) Professional ethics in nursing: an
integrative review. Journal of advanced nursing, 71(8), pp.1744-1757.
Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., and White, D. B. (2016) Shared
decision making in intensive care units: An American College of Critical Care Medicine and
American Thoracic Society policy statement, Critical care medicine, 44(1), pp. 188.
Milliken, A. (2018) Nurse ethical sensitivity: An integrative review. Nursing ethics, 25(3),
pp.278-303.
Pecanac, K. E., & Schwarze, M. L. (2018) Conflict in the intensive care unit: Nursing
advocacy and surgical agency. Nursing ethics, 25(1), pp.69-79.
Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018) Ethical Dilemmas in Nursing: an
Integrative Review. Journal of clinical nursing.
Reid, A. M., Brown, J. M., Smith, J. M., Cope, A. C., & Jamieson, S. (2018) Ethical
dilemmas and reflexivity in qualitative research. Perspectives on medical education, 7(2),
pp.69-75.