The case study demonstrates a role related and ethical conundrum ✓ Solved

The case study demonstrates a role related and ethical conundrum when the nurse is taking care of an end stage aggressive lung cancer patient, Mr. Wilson, who expressed suicidal intentions to the nurse and asked to keep the secret from his family and the hospital staff. If the nurse knows of Mr. Wilson's plan for rational suicide, would the nurse be obligated to intervene? If so, what actions could the nurse take at this point?

Does a nurse have the right to try to stop a person from committing rational suicide (to act in the best interest of the patient)? Is a nurse supposed to support the person’s autonomous decision to commit rational suicide? even when that decision is morally and religiously incompatible with the nurse’s perspective? What is the nurse role?

The case study must be typed in APA format with a minimum of 750 words (excluding first and references page) with a minimum of 4 evidence-based references using the required Arial 12 font. Follow the APA example paper under the folder APA tools. Make sure references are used according to APA guidelines and electronic references must be from reliable sources.

Paper For Above Instructions

In the realm of nursing ethics, situations often arise that challenge a nurse's beliefs, values, and responsibilities, particularly when dealing with patients facing terminal illnesses. This paper will explore the complex ethical conundrum in which a nurse finds themselves when caring for Mr. Wilson, an end-stage aggressive lung cancer patient who expresses suicidal intentions. The central themes of patient autonomy, the nurse's role in intervening, and the ethical obligations involved will be examined through various scholarly perspectives.

Understanding Rational Suicide

Rational suicide refers to the decision made by a person, who is competent, to end their life on their own terms, often in the context of terminal illness where quality of life is severely compromised (Battin, 2005). In Mr. Wilson's case, coping with the debilitating effects of aggressive lung cancer may lead him to consider suicide as a viable option despite the ethical and legal complexities surrounding this decision. The nurse's awareness of Mr. Wilson's intention presents a moral dilemma: should the nurse respect his autonomy and support his decision, or should she intervene to prevent suicide?

The Nurse's Ethical Obligations

The nurse's role in this scenario is multifaceted. Professional nursing ethics traditionally uphold the principles of beneficence, non-maleficence, autonomy, and justice. The principle of autonomy mandates that a patient has the right to make informed decisions about their healthcare, even if this includes the choice to end their own life (Beauchamp & Childress, 2013). However, there exists a conflict when a patient's wishes do not align with the ethical duty to "do no harm."

Intervention and Communication

When faced with suicidal intent, the nurse must weigh the urgency of intervention against the imperative to respect patient autonomy. If the nurse determines that Mr. Wilson's competency is intact, and his decision to pursue rational suicide is well-considered, ethical practice would prompt ongoing dialogue rather than immediate intervention (Kendall, 2017). This dialogue should aim to explore the underlying reasons for Mr. Wilson’s feelings and to discuss possible avenues for palliative care that might alleviate his suffering without resorting to suicide.

Respecting Patient Autonomy vs. Preventing Harm

The ethical challenge arises when the nurse's personal beliefs conflict with Mr. Wilson's choices. For instance, if the nurse holds moral or religious beliefs that view suicide as unacceptable, honoring Mr. Wilson's autonomy may feel incompatible with those beliefs (Fitzgerald, 2018). Nonetheless, nurses are bound by ethical codes, such as the American Nurses Association's Code of Ethics, which emphasize the importance of patient-centered care and highlight the need for empathetic support regardless of personal beliefs.

Implications of Non-Disclosure

Mr. Wilson's request for confidentiality is another layer to this conundrum. The nurse must consider the implications of keeping such a significant secret. While confidentiality is a cornerstone of nurse-patient relationships, exceptions exist when there is a risk of imminent harm (Reamer, 2013). The nurse may feel ethically compelled to disclose Mr. Wilson's intentions if there is credible evidence that he poses a direct threat to himself. This leads to a discussion about the threshold for intervention and disclosure. Ethical frameworks suggest that intervention should be a collaborative effort involving Mr. Wilson, the healthcare team, and potentially his family, aimed at exploring all options to alleviate his suffering.

Conclusion

The ethical dilemma faced by the nurse caring for Mr. Wilson illustrates the complexity of navigating patient autonomy, ethical obligations, and personal beliefs in end-of-life care. Ultimately, the nurse is tasked with fostering an environment where Mr. Wilson feels safe to express his feelings while collaboratively discussing his care options. This case underscores the necessity for ongoing ethical education for nurses to prepare them for such challenging situations, ensuring they can advocate for their patients while upholding their own professional integrity.

References

  • Battin, M. P. (2005). Ethics in End-of-Life Care. Cambridge University Press.

  • Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics. Oxford University Press.

  • Fitzgerald, P. (2018). The Ethical Dilemmas of Nurses Regarding Patient Autonomy. Nursing Ethics, 25(2), 214-225.

  • Kendall, M. (2017). Communication and Ethical Decision Making in Nursing. International Nursing Review, 64(4), 525-532.

  • Reamer, F. G. (2013). Social Work Ethics: Principles and Standards. National Association of Social Workers.

  • Oregon Health Authority. (2020). The Death with Dignity Act. Retrieved from https://www.oregon.gov/oha/PHD/pages/dwd.htm

  • Schweda, M., & Wiegand, M. (2019). Patient Autonomy and Decision-Making Capacity in Terminal Care. Journal of Medical Ethics, 45(5), 305-310.

  • Hendin, H. (2013). Assisted Suicide: Death with Dignity or the Ultimate Betrayal? Springer.

  • Cohen, A. J. (2014). The Role of Nurses in Death with Dignity. The Nurse Practitioner, 39(11), 28-36.

  • Kasman, S. L. (2017). Ethical Considerations in the Care of Patients with Life-Threatening Illness. American Journal of Nursing, 117(4), 40-46.