Case Study: Ethical Decision-Making in Healthcare - Nursing

This case study examines an ethical dilemma faced by a registered nurse, focusing on the disclosure of a patient's medical condition. Mrs. Brown, admitted with chest pain and high fever, was diagnosed with pulmonary embolism. The nurse struggled with whether to inform Mrs. Brown, who lived alone, about her condition. The assignment analyzes the nurse's unethical decision to withhold information, violating the patient's right to know. It highlights the importance of the ethical decision-making model, which emphasizes identifying the problem, stating treatment options, applying ethical principles, and implementing an ethical decision. The case study underscores the need for effective communication skills in nursing to ensure patients are fully informed and involved in their care, with references to relevant research in nursing ethics and patient rights.

Running Head: HEALTHCARE
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Name of the student
Name of the university
Author note

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Introduction
The report addresses an ethical dilemma that is being faced by the nurses at the time
of providing treatment to a particular patient. The ethical dilemma that is faced by the nurse
is the disclosure of the medical condition to the patients. This ethical dilemma is often faced
by the nurses at the time of a chronic disorder to the patient and the treatment demands
disclosure of the medical conditions to the patient (Esmaelzadeh et al., 2017).
A similar situation was faced by the registered nurse when Mrs Brown was admitted
to the hospital for a chest pain and high fever. It was suspected that the patient was having a
cardiovascular disease and thus it was important for the staff of the hospital to carry out all
the necessary diagnosis for the detection and further treatment of the patient. However, after
primary diagnosis it was found that she was suffering from pulmonary embolism. As the
patient used to stay all alone thus, it was difficult for the nurse to disclose all the medical
details directly to her. Thus, she decided to stay quiet and not the patient know about her
clinical condition. This created the ethical dilemma in the treatment of Mrs Brown as she had
the complete right to know about her health conditions and the future treatment options.
Discussion
As the above situation describes the unethical practice done by the nurse thus, there is
a need to highlight the ethical practice that should have been undertaken by the nurse. This
can be done by the application of the ethical decision making model. The ethical decision
making model is a technique that is used by the healthcare personnel in order to develop the
ability to think in an ethical manner and also to arrive at an ethical decision (Esmaelzadeh et
al., 2017). The model considers the ethical principles, values and obligations.
The decision making model provides a process for the critical thinking and also for
the planning in order to reach an ethical decision. The model is also being employed in the

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above situation in order to reach the decision which is ethical. The main goal of the model is
the identification of the problem. In this case, the problem is the disclosure of the medical
condition to the patient. It was identified that it is the right of the patient to know the details
of the treatment options as well as the results of the diagnosis (Mallari, Grace & Joseph,
2016). Thus, the non-disclosure of the medical condition is a violation of the ethical principle
of the nurse which gives the patient the right to know and also to take decision of the method
of treatment.
The next step of the model is stating the options that are available for the treatment. In
this case, the nurse had two options either to disclose or to remain silent about the medical
condition of the patient (Esmaelzadeh et al., 2017). The nurse chose to stay silent and decided
not to tell the patient about the medical condition. After the application of the ethical
principles to this situation it was identified that the nurse was not right and she should have
told the patient about the disease. Then Mrs Brown should have decided about the treatment
and also about her needs and requirements. Thus, the nurse took a decision which was against
the ethics of nursing profession.
The next step of the model is to take the decision ethically and finally the
implementation of the decision (SHAPIRA‐LISHCHINSKY, 2014). In this case, the ethical
decision will be the disclosure of the medical condition to the patient. After that the patient
should be a part of the decision making process for the process of diagnosis and the
treatment. This should have been done by the registered nurse in order to make the treatment
process more beneficial and ethical (Papastavrou, Andreou & Vryonides, 2014).
The case study also shows that the nurse lacked the effective communication skills
and thus could not relay the important messages to the patient. It is very important for a nurse
to have effective communication skills in order to facilitate the easy transmission of the

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information from the healthcare staff to that of the patient (Mallari & Tariman, 2017). The
effective communication skills includes the non-verbal as well as verbal skills that has to be
learnt by the nurse in order to provide high quality of care.
The verbal skills include the proper listening, deliver of the messages to the patient in
a proper and organized manner and the non-verbal skills included the display of emotions,
empathy and care towards the patient (Aitamaa et al., 2016). In the above situation the
registered nurse takes the decision in a very rationale manner without considering the feelings
and the sentiments of the patient. The nurse did not even inform the patient about the disease
and the effect the disease could have on her. This was strictly unprofessional and unethical on
the part of the nurse as the nurse barred the patient from having complete knowledge of her
health condition (Utkualp, 2015).
After the entire analysis, the unethical situation was corrected by the help of the
decision making model. The nurse manager asked the nurse to deliver all the information
regarding treatment and diagnosis to the patient. This will help the patient to know the details
of her own medical conditions and she can decide whether she wants to carry out the
treatment or not (Park et al., 2014). It is also important to deliver the information to the
patient in order to be sure about the needs and requirements of the patient.
Conclusion
Therefore, it can be concluded that the patient has the right to know about every step
of the treatment. It is unethical on the part of the nurses and the other healthcare staff to hide
any information from the patient. The nurse should always take decision on the basis of the
ethical decision making model as it helps the healthcare professionals to arrive at an ethical
decision. The case study also suggests that ethical decisions are an integral part of the

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healthcare system as they might affect the recovery rate and the patient outcome after the
implementation of a particular treatment process.

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References
Aitamaa, E., Leino-Kilpi, H., Iltanen, S., & Suhonen, R. (2016). Ethical problems in nursing
management: the views of nurse managers. Nursing ethics, 23(6), 646-658.
Esmaelzadeh, F., Abbaszadeh, A., Borhani, F., & Peyrovi, H. (2017). Strengthening ethical
decision-making: the experience of Iranian nurses. Nursing Management-UK, 24(6).
Mallari, G., & Tariman, J. D. (2017). Ethical Frameworks for Decision Making in Nursing
Practice and Research. Journal of Nursing Practice Applications and Reviews of
Research (JNPARR), 7(1), 50-57.
Mallari, M. S. N., Grace, M., & Joseph, D. (2016). Ethical frameworks for decision-making
in nursing practice and research: An integrative review.
Papastavrou, E., Andreou, P., & Vryonides, S. (2014). The hidden ethical element of nursing
care rationing. Nursing Ethics, 21(5), 583-593.
Park, M., Jeon, S. H., Hong, H. J., & Cho, S. H. (2014). A comparison of ethical issues in
nursing practice across nursing units. Nursing ethics, 21(5), 594-607.
SHAPIRA‐LISHCHINSKY, O. R. L. Y. (2014). Simulations in nursing practice: toward
authentic leadership. Journal of Nursing Management, 22(1), 60-69.
Utkualp, N. (2015). Ethical issues and dilemmas encountered in nursing practice in Turkey.
International Journal of Caring Sciences, 8(3), 830.