Ethical Dilemma in Advanced Nursing Practice
Physicians may be confronted with an ethical dilemma where they must decide whether or not provide treatment for themselves, family members, or others close to them(CPSO, 2016). Whereas it may be the physician’s best intentions to provide treatment in this context, there is a growing body of literature indicating that personal or close relationships have the potential of compromising the emotional and clinical objectivity of the physician. This paper examines the process of using ethical principles in decision-making and meeting the Nursing Practice Core Ethics Competencies.
The first step in approaching ethical decision-making is to state the ethical dilemma. It is important for the physician to identify the components of the situation presenting a potential ethical dilemma. In the case scenario, Mrs. ABC’s mother should have first identified the ethical dilemma presented by her undertaking to treat Mrs. ABC. The physician should be able to identify the issue objectively without the influence of subjective perceptions, values or attitudes specific to the issue.
Upon identification of the ethical dilemma, the physician needs to connect ethical theory to the dilemma in practice. Beauchamp and Childress’s ethical theory is often regarded as one of the basic foundations for discussions of this nature. This theory is grounded in four major principles: justice, beneficence, non-maleficence, and autonomy. Justice involves appropriate, equitable, and fair treatment of patients.
Beneficence supports the use of positive steps for benefitting others, which involves the balancing of benefit, risk and costs. Non-maleficence encompasses the intent not to inflict harm. Lastly, autonomy is a principle which requires a professional or client to have the capacity to self-determination in his/her engagement in decision-making (Nagy, 2015).
Exploring an ethical dilemma requires a physician to examine the issue and see the manner in which each of the principles relate to it. In some cases, this examination alone clarifies the issue enough that the resolution of the dilemma becomes obvious to the physician (Forester-Miller & Davis, 1995).
CPSO. (2016). Physician Treatment of Self, Family Members, or Others Close to Them. Retrieved from: http://www.cpso.on.ca/policies-publications/policy/treating-self-and-family-members
Forester-Miller, H., & Davis, T. E. (1995). A practitioner’s guide to ethical decision making. Alexandria, VA: American Counseling Association. Nagy, T. F. (2015). Approaches to ethical decision making. Journal of the Academy of Nutrition and Dietetics. Retrieved from: http://www.eatrightpro.org/~/media/eatrightpro%20files/career/code%20of%20ethics/approaches-to-ethical-decision-making.ashx
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