The aim of this study is to look at ethical dilemmas of staff nurses that often arise across a variety of work settings and how nurses resolve ethical dilemmas. Every nurse differs in educational preparation and experience. The impact of the dilemma can vary and influence decision-making, and the complexities caused by legalities often impact the nursing roles during the dilemmas. The role of self, support to patients and families, patient educator and communicator are necessary during the ethical dilemmas.
Nurses face ethical challenges daily when providing quality care and can remain highly dissatisfied in their struggle when faced with ethical challenges in patient care.
Were there ethical violations? Yes Medical errors occur, and although according to Hospital's Code of Conduct, such information should be discussed with the patient, most doctors and institutions do not reveal such mishaps to patients and their families. In this case, the doctor was careless about the old patient and assumed it was just one of the vague symptoms that elderly patient come with. He did not examine her carefully and ignored the patient when she came back again after one week, complaining of stomach ache. The doctor wanted a cover up in this case and by not disclosing a medical error, the doctor places his own interests above that of the patient.
Medical errors and negligence are likely to continue, but they should not be taken as a matter of fact. According to Code of Conduct, the doctors are ethically bound to disclose errors and non-disclosure of medical errors is a serious violation of ethical principles. The doctors and other hospital staff (Ulrich, 2010) should be given emotional support for making the procedure easier and encourage them to disclose medical errors. Opinions demonstrate the disclosure of medical errors to patients to be justified on moral grounds. Why doctors fail to disclose errors to patients is because of several reasons such as loss of reputation, as legal liability, license revocation, etc. The threat of legal accountability (Silverberg, 2000). is real and a danger in medical practice, especially when things do not go the way as expected. Doctors often get sued, and it is seen that poor communication after a medical error is another reason patient or his family seek a legal redress.
This is precisely what happened in this case of old woman patient, where she was not diagnosed correctly, and her family was not given accurate information in time. A major part of patient dissatisfaction is created more because of the doctor attitude and denial, rather than the negligence or medical error itself. Ethics must be learned and reinforced with continual training (Bickerstaffe et al. 2006) that shows the hospital staff and caregivers on how to apply theoretical principles in real life conditions. The right education gives the nurses and doctors tools for decision making when they encounter moral dilemmas in clinical practice. An environment that supports nurses in raising ethical concerns should be practiced and empower them to address those vital issues.
Ulrich, C. M., Taylor, C., Soeken, K., O'Donnell, P., Farrar, A., Danis, M., & Grady, C. (2010). Everyday ethics: Ethical issues and stress in nursing practice. Journal of Advanced Nursing, 66(11), 2510.
Silverberg, L. I. (2000). Survey of medical ethics in US medical schools: A descriptive study. The Journal of the American Osteopathic Association, 100(6), 373.
Thompson, S. E. "., Morton, J., Wornhoff, B., & Spoonmore, P. (2013). Creating a magnet[R] culture using the ANA code of ethics: One hospital's magnet workgroup used a code of ethics program to transform nursing practice. American Nurse Today, 8(1), 66.
R. Bickerstaffe, P. Brock, J-M. Husson, I. Rubin, K. Bragman, K. Paterson, & A. Sommerville. (2006). ETHICS: Guiding principles for pharmaceutical physicians from the ethical issues committee of the faculty of pharmaceutical medicine of the royal colleges of physicians of the UK. International Journal of Clinical Practice, 60(2), 238.
Leave Copy for the Compliance Committee.