This week’s
blog is about an ethical dilemma that a nurse has faced very long times ago. She
told me about one of her patient that had a stroke and his left side was
paralyzed. And he had a urinary tract infection. The patient had no family
support and wasn't positive about his life. He told her that he was tired of
staying at the hospital and that he had nothing to live for now. He was in a
lot of pain and wasn't moving that much. The treatments were not effective, the patient's condition was still deteriorating. The nurse knew that there wasn't a lot
of choice for the patient but she still had to follow the doctor’s order and
provide treatment to the patient even if he didn't want them and knew they were
ineffective. So the nurse felt that she was not advocating for the patient
because the doctor wouldn't listen to her and she thought she was harming the
patient with no expected goals. Pain medication were not effective and the
patient’s situation was deteriorating.
In this
situation, the patient’s justice of human rights was not listened to. The
principle of non-maleficence was not adopted because the treatment were harming
the patient, he was still in pain, and he didn't want to continue the treatment
but had to. Therefore the autonomy was not taken into consideration because he
was lucid, he was aware of what was going on but still the doctor took a
decision without seeking the patient’s consent.
But on
one side was acting according to duty and not according to kindness or reason. I
think the nurse was facing a moral distress because she wanted to advocate for
the patient but couldn't because she had to listen to what the doctor and
institution ask her to do. I think that things has changed from the nurse’s
time, we now have code of ethics to follow that allow us to advocate and
verbalize our concerns if we are in disagree with something. Therefore, if I
have this kind of patient’s situation, I would talk for my patient and don’t do
the treatment if the patient refuse to and would tell it to the doctor and head
nurse (getting her point of view too).
Qais Khedri
Nursing ethics
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