Analysis of Ethical Dilemma: Patient Refusing Medication in Nursing

This essay examines an ethical dilemma in nursing practice, focusing on a 68-year-old patient, Eliane, who refuses pain medication (M-Eslon) despite experiencing acute pain, weight loss, dyspnea, and confusion. The dilemma highlights the conflict between respecting patient autonomy and the nurse's duty to provide comprehensive care. The essay explores various ethical considerations, including the patient's right to refuse treatment, the potential benefits and risks of medication refusal, and the importance of empathy and communication. It references the New Zealand Code of Conduct, emphasizing the need for nurses to balance patient preferences with their professional responsibilities. The analysis considers the impact of the patient's decision on her well-being, the role of family involvement, and the potential for seeking support from doctors and counselors. The essay underscores the importance of critical thinking, respecting individual choices, and minimizing risks while advocating for the patient's best interests within ethical and legal frameworks. Several studies are cited to support the arguments, including the importance of psychosocial support and nurses' views on assisted dying.

Running head: NURSING
Ethical Dilemma In Nursing
Name of the Student
Name of the University
Author’s Note

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Eliane is a 68 year old lady refusing pain medication M-Eslon. In this situation, there
is a dilemma between professional value in nursing practice and ethical frameworks. It is the
duty of the nurse to provide comprehensive care in time of need to minimize the risk of the
patient (The Code of Conduct New Zealand, 2012). Eliane is resenting M-Eslon, however,
she is showing symptoms of acute pain, weight loss and having dyspnoea and confusion. In
this situation, her daughter Deborah informs that taking the pain meds helped her with her
appetite. If she continues to refuse the medicine, she is at immediate risk of appetite loss,
further loss of weight and improper bowel movement. As a nurse, one must show patience
and empathy to deal with the situation (Gallagher, Moriarty, Huthwaite & Lim 2017).
The next point to assess for reflective practice is the benefit of individual from the
outcome. Discontinuing the pain meds can help the patient with remaining conscious and
decrease her state of confusion to a certain extent. Elaine is a widow, and only gets to visit
her daughter and grandchild in the scheduled time of the facility, and so feels lonely. As a
nurse, a person can give her company and support, engage her in mild conversations, and can
enquire about her happy memories and keep her cheerful. Now, with no pain meds she might
be able to enjoy such moments without the prevailing dizziness. Wilson and Oliver (2018)
suggested that nurses of New Zealand have assisted patients in legalised dying and fulfilled
their wishes, filling them with a feeling of contentment at their last time.
The third point to be considered in the decision making is minimising the risk of the
process. Elaine is refusing her medication, and it is the duty of the nurse to convince her to do
the same in her interest, but again, not force her. So, she must be approachable to the patient
and be empathetic enough, as diminishing her risk by pain management strategy is essential.
She can seek help from the doctor, because a doctor is the best person to impart knowledge
about health and medication. Then again if she refuses, she can consult a professional
counsellor to guide the patient. Aldaz, Treharne, Knight, Conner and Perez (2016) delineated

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that psychosocial help had significant patient outcome in oncology patients, to deal with their
diverse problems.
The fourth point to emphasize in the process of critical thinking is respecting
each person equally. The Code of Conduct New Zealand (NZ) (2012) suggests to work in the
best interest of the patient and respect their preferences. The legislation clearly emphasizes
the fact that patient can refute treatment and if the person is capable of proper decision-
making, the health-professionals must abide by her decision. The nurse can accompany her,
let her daughter and granddaughter spend more time with her. She can insist her colleagues
and doctors to show empathy and respect to her decision. In her absence, she can insist one of
her colleagues to accompany her. Sinclair, Papps and Marshall (2016) mentioned it is ethical
obligation and duty of a nurse to understand and cooperate with the decision of the patient.

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References
Aldaz, B. E., Treharne, G. J., Knight, R. G., Conner, T. S., & Perez, D. (2017). Oncology healthcare
professionals’ perspectives on the psychosocial support needs of cancer patients during
oncology treatment. Journal of health psychology, 22(10), 1332-
1344.https://doi.org/10.1177/1359105315626999
Gallagher, P., Moriarty, H., Huthwaite, M., & Lim, B. (2017). Challenging some assumptions
about empathy. The clinical teacher, 14(6), 437-440.
https://doi.org/10.1111/tct.12607
Nursing Council of New Zealand. (2012). Code of Conduct. Access Date: 25th July, 2019.
[Online]. Retrieved from: http://www.nursingcouncil.org.nz/Nurses/Code-of-Conduct
Sinclair, J., Papps, E., & Marshall, B. (2016). Nursing students' experiences of ethical issues in clinical
practice: A New Zealand study. Nurse education in practice, 17, 1-7.
https://doi.org/10.1016/j.nepr.2016.01.005
Wilson, M., Oliver, P., & Malpas, P. (2019). Nurses’ views on legalising assisted dying in New
Zealand: A cross-sectional study. International journal of nursing studies, 89, 116-124.
https://doi.org/10.1016/j.ijnurstu.2018.03.012