Ethical Dilemmas In Nursing

It is not unusual for nurses to face at least one ethical dilemma per shift. Some of the hardest ethical dilemmas that a nurse will face during their nursing career are situations that go against the personal values of the nurse. The following essay will discuss such a dilemma and how the nurse uses a decision-making model to assist in resolving the ethical dilemma.

In the case presented a six-year-old girl contracts meningitis and requires medical treatment. The ethical dilemma becomes apparent when permission to treat is sought from the child’s parents. The child’s non-biological mother, who possesses primary custody, is refusing any medical treatment due to religious beliefs. However, the biological father insists that the little girl
For the meningitis case the six-step process decision-making model that will be utilized. The first step in the six-step process is to “gather relevant information [in order to make an] informed decision (Purtilo, 102, 2011). The second step is identifying the ethical problem. The third step is to analyze the situation using ethical theories. Fourth is to look at all possible alternatives for the situation. Fifth is to decide and follow an ethical theory based on possible alternatives. Finally evaluating the process and outcomes of the situation is completed.

If the writer were the nurse for the meningitis case, the six-step model would be completed as followed. Relevant information would be gathered including a family and prior medical history/treatments. Completion of the first step reveals the ethical dilemma, the second step.

The patient’s mother, though not biological, has primary custody of the patient and will not consent to treatment while the biological father consents to treatment but lacks custody. The nurse has the responsibility to uphold the
“four principles of biomedical ethics of autonomy, beneficence, non-maleficence and justice” (Cooper, 2012), however, this case shows autonomy, beneficence and non-maleficence clashing. The patient and her family have the right to determine the patient’s care; yet, following the patient’s mother’s decision has the potential of causing harm to the
Following utilitarianism the writer would attempt to convince the patient’s mother to allow for medical treatment or determine a way to use the patient’s father’s consent to treat. Using deontology than the writer would follow the mother’s wishes, even though it is against the writer’s personal ethics. To assist in determining what to do in this situation the fourth step is completed, determining all possible alternatives. For this situation the alternatives would require comparing what would happen to the child if the mother’s refusal to treat versus the fathers consent to treat is followed. Questions such as; what would happen to the patient if she did not receive a spinal tap, the primary for of diagnosing and treating meningitis (Bennington-Castro, 2015)? Would there be another way to determine if the meningitis is bacterial or viral that is acceptable to the patient’s mother? What would happen if no antibiotics where administered? Are there other non-medical treatments available? Possible outcomes would be; the meningitis could be viral which would resolve in seven to ten days, however, if the meningitis is bacterial failure to take antibiotics could lead to hearing loss, brain damage, and/or learning disabilities (CDC, 2014). The fifth step, completing an action, would occur after reviewing the alternatives and determining which ethical theory to