Nurses frequently face ethical dilemmas when patient needs, family wishes, organizational policies, and resource limitations conflict.
Common Dilemmas
- Respecting patient autonomy when family disagrees with treatment choices.
- Managing confidentiality in small communities or shared wards.
- Providing care during severe staffing or supply shortages.
- Balancing pain relief with concerns about sedation or dependency.
- Deciding how to allocate scarce equipment or attention among patients.
- Reporting unsafe practice by colleagues.
Ethical Decision-Making Framework
- Identify the ethical problem and everyone affected.
- Gather clinical, legal, and cultural information.
- Clarify the patient’s values, wishes, and capacity.
- Consider ethical principles: autonomy, beneficence, nonmaleficence, and justice.
- Consult the care team, ethics committee, or supervisor when needed.
- Document the decision, actions, and rationale.
Nursing Advocacy
Nurses advocate by communicating patient concerns, protecting privacy, challenging unsafe practices through proper channels, and ensuring patients understand their options. Ethical practice requires courage, reflection, and teamwork.