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Ethical Dilemma

This paper discusses an ethical dilemma nurses may face when a family requests withholding a patient's medical diagnosis or prognosis. The dilemma arises due to the conflict between respecting patient autonomy and the family's request. The paper explores how a nurse could apply standards like determining a patient's preferences and ensuring appropriate consent. It also examines using the American Nurses Association's Code of Ethics for guidance in upholding principles of autonomy and justice. Ultimately, the paper concludes truth-telling, even of difficult information, is important for building trust in the nurse-patient relationship and providing patient-centered care.

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301 views5 pages

Ethical Dilemma

This paper discusses an ethical dilemma nurses may face when a family requests withholding a patient's medical diagnosis or prognosis. The dilemma arises due to the conflict between respecting patient autonomy and the family's request. The paper explores how a nurse could apply standards like determining a patient's preferences and ensuring appropriate consent. It also examines using the American Nurses Association's Code of Ethics for guidance in upholding principles of autonomy and justice. Ultimately, the paper concludes truth-telling, even of difficult information, is important for building trust in the nurse-patient relationship and providing patient-centered care.

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Running head: BENCHMARK- ETHICAL DILEMMA 1

Benchmark- Ethical Dilemma

Maya Mendez

Grand Canyon University: NSG 436

August 9, 2020
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BENCHMARK-ETHICAL DILEMMA
Benchmark- Ethical Dilemma

Nurses have long struggled with ethical dilemmas. An ethical dilemma is defined to

be the need to choose from two or more morally acceptable or unacceptable courses of action

(Ong, Yee, & Lee, 2012). Ultimately enforcing one to identify fundamental values and

commitments of the nurse, the boundaries of duty, loyalty, and describe the duties that extend

beyond individual patient encounters (Ethical, 2020). This paper will discuss the ethical

dilemma of withholding medical information from the patient at the family’s request, how a

nurse leader could navigate to provide safe care, what decision-making skills, standards, and

morals could be used, and a possible resolution to resolve the dilemma.

Ethical Dilemma and Justification

Requests for nondisclosure are not rare. Typically, the family believes withholding

the diagnosis and prognosis is in the best interest of the patient. It can be presented that it is

the family’s efforts to protect a patient from emotional harm, belief that the patient’s

emotional resilience is not suited, the patient is a pediatric patient, or it is a reflection on how

they believe the patient would prefer to make decisions (Chaitin & Rosielle, 2019). The

dilemma then arises that the healthcare professional would be violating a critical aspect of

healthcare, patient autonomy. Autonomy being the respect to allow one to self-determine

their medical care in addition to the obligation of the healthcare professionals to disclose the

truth. Medical ethics and professional standards state how patients have the right to choose

the medical care that best allows them to meet their goals (Weissman, 2019). However, in

order to make such decisions, it requires them to be fully informed of their condition,

prognosis, and treatment options.

Standard Application and Providing Safe Client Care

A nurse leader can navigate to provide safe patient care by incorporating certain

standards. One being that they should develop a baseline on the patient’s preferences, what
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BENCHMARK-ETHICAL DILEMMA
they already know, and want to know. An article shared how a patient knew the diagnosis

was life-threatening but learning about everything made them anxious. They preferred to only

be told about treatment effects as they arose unless told otherwise and how from the

beginning the healthcare team was made aware that the patient was comfortable with the

family obtaining all the information (To tell, 2016). Acquiring a better awareness of a

patient’s beliefs can help identify gaps between the patients and family’s understandings of

the situation. Ensuring a Health Insurance Portability and Accountability Act release form is

completed, or medical power of attorney is selected and written in legal documents prior to

any diagnostics being done provides an outline of who the information can be shared too and

who can make medical decisions. Another standard is to validate and respect the family's

concerns and perspectives while explaining the importance of the patient knowing and the

rights they are entitled too (Breslin, 2015). By respecting both during such a difficult time, it

can ensure that care and information are being provided compassionately and sensitively.

Ethical Decision-Making Skills

The American Nurses Association’s Code of Ethics is a great framework to use to

resolve such an ethical dilemma. It serves as a guide during challenging situations by offering

an explanation, justification, or recommendation for a course of action while remaining

consistent with nursing responsibilities and ethical obligations (Ethics 2020). In such a

particular situation, it is important the nurse is abiding by the ethical principles of autonomy

and justice. Patients have the right to make their own decision whether or not it is believed to

be in their best interest as well as have the right to be treated fairly in all medical decisions,

treatment options, and resources. To ensure decision-making skills are done ethically and

according to nursing standards, a nurse should put aside any pre-judgments or conflicting

beliefs that may impair the care that will be provided. Regardless of the results, healthcare

professionals have a responsibility to disclose the truth.


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BENCHMARK-ETHICAL DILEMMA
Solution and Leadership Influence

A leadership style that focuses on the nurse-patient relationship is essential to

potentially resolving this ethical dilemma. Withholding the truth can hinder a nurse-patient

relationship and potentially increase the chance of them losing their trust and confidence in

one. When disclosing the truth, one should respond in an empathetic and attentive manner.

Empathy allows one to enter into a helping relationship where they are able to understand the

world of the other person and learn how to communicate with them. Remaining open and

honest can build a therapeutic relationship that encompasses true patient-centered care as it is

the product of genuine engagement.

Conclusion

Often times truth-telling includes transmitting bad news and that can be challenging

for many healthcare professionals to do. So, when a family request that one withholds the

results it can add more of an emotional/stressful toll, creating a dilemma. There are standards,

ethics, and morals implemented that nurses can utilize and abide by to navigate to provide

safe patient-care. The overarching ethical principle is influenced by a patient’s right to self-

determine their medical care, including conveying the truth about their diagnoses and

prognoses despite the unsettling results.


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BENCHMARK-ETHICAL DILEMMA
References

Breslin, J. (2015, August 25). Ask the ethicist: Withholding a cancer diagnosis from the

patient? Retrieved from https://hospitalnews.com/ask-the-ethicist-withholding-a-

cancer-diagnosis-from-the-patient/

Chaitin, E., & Rosielle, D. A. (2019, March 1). Responding to requests for non-disclosure of

medical information. Retrieved from https://webcache.googleusercontent.com/search?

q=cache:6cuMUjr6fyAJ:https://www.mypcnow.org/fast-fact/responding-to-requests-

for-non-disclosure-of-medical-information/

+&cd=2&hl=en&ct=clnk&gl=us&client=safari

Ethical issues in nursing: Explanations & solutions. (2020, June 5). Retrieved from

https://onlinenursing.duq.edu/blog/ethical-issues-in-nursing/

Ong, W. Y., Yee, C. M., & Lee, A. (2012, January). Ethical dilemmas in the care of cancer

patients near the end of life.

To tell or not to tell: When parents want to keep health information from patients. (2016,

July). Retrieved from https://www.seattlechildrens.org/research/centers-

programs/bioethics/about/news/parents-keep-health-information-from-patients/

Weissman, D. E. (2019, February 12). Informed consent in palliative care - Part 2 - Palliative

care network of Wisconsin. Retrieved from https://www.mypcnow.org/fast-

fact/informed-consent-in-palliative-care-part-2/

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