1

ETHICAL DECISION MAKING

Ethical Decision Making

Ahsan Arca

Grand Canyon University: NSG-436

April 14, 2020

2
ETHICAL DECISION MAKING

Ethical Decision Making

Nurses are often faced with ethical dilemmas within the workplace, and they are

obligated to make the right choice with guidance (Huber, 2018). Such guidance aid in alleviating

moral distress that may develop when making decisions, and prompt them to initiate actions that

are congruent with the nursing philosophy. One example of an ethical dilemma is seen in the

palliative care setting, where nurses make difficult decisions when administering medications.

This paper will analyze and justify this dilemma, ethical models used to resolve the issue, and

solutions used to address the situation.

Analysis and Justification

One of the main goals in palliative care is to facilitate a “peaceful death” by

administering sedating and “comforting” medications (Vries & Plaskota, 2017). The ethical

dilemma that nurses encounter is questioning whether these pharmacologic treatments enhance

the deteriorating conditions the clients are in, therefore hastening death. Some nurses question

whether it is morally acceptable to be administering medications, such as morphine, that could

produce respiratory distress in someone that already has breathing difficulties (Vries & Plakosta,

2017). The author’s stance on this issue is to continue providing comfort and evaluate the

benefits of such measures to the patient. Moreover, patients/caregivers are aware that care

provision in this facility is comfort, as the client’s condition can no longer be cured (Tavares et

al., 2016). Therefore, the author would provide patient-centered care and act according to the

patient’s request for comfort measures.

Standard Application and Providing Safe Client Care

Hospital policies and standards will be implied by the nurse to provide safe care. When

administering these “comfort” medications, the nurse will be sure to use the six rights of
3
ETHICAL DECISION MAKING

medication administration and perform vigilant assessments. It is common to forget nursing

standards when one is focused on difficulties, hence, remembering to use hospital policies can

guide the nurse to making reasonable decisions that promotes wellness (Solari, 2017).

Ethical Decision Model, Skills, Standards, and Morals

The nurse leader will utilize nursing models and morals to resolve the issue that is seen in

palliative care. One nursing model is the Code of Ethics, which sets forth instructions and

expectations to guide nurses (Solari, 2017). Nurses are granted the power to manage issues in

healthcare and be able to provide valuable care; to aid in this aspect of the profession, the Code

of Ethics provides a focus on nursing standards that values human rights and dignity (Solari,

2017). With the use of this model, the author could resolve the issue when caring for patients in

palliative care. How this could be done is by implementing each code to correspond with the

author’s decisions, such as provision 2 that states that the “primary commitment” is the patient,

in which the author can guide comfort treatment based on what the patient wants (Solari, 2017).

Having the Code of Ethics as the backbone of ethical decision making, the author is able to

provide safe and competent client care.

Solution

Possible solutions to the aforementioned dilemma include self-reflection and team

collaboration. To be culturally competent and address the differences among patients, the nurse

must evaluate one’s beliefs in order to cope effectively and have the ability to accept different

values (Cheng & Hsaing, 2015). For example, the nurse can still believe that administering

morphine can worsen the work of breathing in a client with a respiratory disease, but to the

client, it allows them to feel less pain and live the rest of his/her life free of distress. The author
4
ETHICAL DECISION MAKING

can self-reflect and realize that she is there to support the client’s choices on their plan of care,

despite the idea that it may not be the same route she would choose.

A component that a nurse leader upholds is accountability; one must be responsible for

not just making moral decisions, but also guiding others to do so (Huber, 2018). Organizations

employ ethic committees in the hospital setting, supplying team members with resources to aid

in resolving ethical dilemmas (Huber, 2018). With the utilization of these resources, the nurse

can collaborate with others to produce anticipated outcomes. Democratic leadership style

influenced these solutions, as the leader assists in “group decision making” and evaluates the

relationship between her beliefs and the patient’s beliefs.

A component of the nursing profession is facing ethical dilemmas, typically seen in

palliative care, where the nurse may question the morality behind the medications administered

to patients. With guidance of the Code of Ethics in nursing and applying democratic style of

leadership, the nurse is able to justify the decision made to administer medications based on the

patient’s needs.
5
ETHICAL DECISION MAKING

References

Cheng, E. & Hsaing, P. (2015). Determinants of nursing competence of nursing students in

Taiwan: The role of self-reflection and insight. Nursing Education Today, 35(3), 450-

455. doi: 10.1016/j.nedt.2014.11.021

Huber, D. L. (2018). Leadership and nursing care management. St. Louis, MO: Elsevier-

Saunders. 

Solari, P. (2017). Ethical decision making and moral choices: A foundation for nursing practice.

Issues and Trends in Nursing. Retrieved from https://books.google.com/books?

hl=en&lr=&id=b9zPDQAAQBAJ&oi=fnd&pg=PA347&dq=related:etaieU9EFX4J:schol

ar.google.com/&ots=LxDZGor1jc&sig=DPdEfg8KAaZU-EJY-

ep0Xv377sc#v=onepage&q&f=false

Tavares, A., Paparelli, C., Kishimoto, C., Cortizo, A., Ebina, K., Braz, M., Mazutti, S., Arruda,

C., & Antunes, B. (2016). Implementing a patient-centered outcome measure in daily

routine in specialist palliative care inpatient hospital unit: An observational study.

Palliative Medicine, 31(3), 275-282. doi: 10.1177/0269216316655349

Vries K. & Plaskota, M. (2017). Ethical dilemmas faced by hospice nurses when administering

palliative sedation to patients with terminal cancer. Cambridge: Palliative and

Supportive Care, 15(2), 148-157. doi: 10.1017/S1478951516000419