Daily moral conundrums that confront nurses

Ethical Dilemma
Introduction
Daily moral conundrums confront nurses. Frequently, some nurse decisions will be uncontroversial. In other cases, such as Robbie’s dilemma, the ethical dilemma can easily lead to heated disagreement.
How Should You Respond to Robbie’s Question?
As a professional and a person of conscience and compassion, honesty is the virtue that would guide a nurse in this situation. The advantage of honesty is that it increases self-respect for moral consistency as well as for helping patients live with dignity. The disadvantages are that truth-telling can lead to anger or depression in the patient or caregiver or may contribute to negative emotions while impacting their health status. The nurse must be cautious about telling the patient that they might die. Patients may become less compliant with treatment because they feel hopeless about long-term survival.In addition, honesty may lead to legal liability if the patient is psychologically damaged. Again, this is a consideration in personal moral decision-making and would be based on informed consent informed as well as informed consent. Integrating this value with legal concerns still needs to be resolved by ethics in nursing practice.
It is ethically questionable to withhold such information, even when it could be upsetting to the patient. In my case, I would enquire about Robbie’s viewpoint on the situation and find out whether he believes he will pass on.If Robbie is aware of his probable death, I would then speak to him about it in a non-judgmental manner. If he is not, I would then explain the situation so that he is not upset by what I have to say.It is the nurse’s decision to tell or not tell Robbie that he may die, as long as they do not violate any legal or professional guidelines and follow the ethical tenet of truth-telling.
In this case, the authorised decision-maker is Robbie’s family members and caretakers with his best interests in mind. Other considerations, such as how much time will be needed for recovery and physical activities, can play a part in how a nurse decides what to do.

What are Three Options You Could Select?
One option would be to reassure Robbie and tell him he’s loved and cared for while at the hospital. One may choose to provide a different opinion, such as telling Robbie he will be in the hospital for a week or so; this provides some hope but does not address his fears of dying. Thirdly, a nurse can simply tell him he’s going home in a couple of days, which is an option that does not provide any more information about his condition.
How Does the Code Of Ethics for Nurses Guide You In The Virtue of Truth-Telling?
As nurses, we respect our patient’s rights to be informed about their health care, and we comply with laws requiring us to provide clear written information. We respect our patient’s right to privacy, including confidentiality and autonomy, and we protect their rights. We advocate for all patients and we honor their choices. We work to identify cultural and individual needs of each patient. We strive to deliver excellent, safe care that fulfills the healthcare needs for the local community (ANA).As a nurse, you are bound by the Code of Ethics for Nurses in acting truthfully. It would be best if you filled Robbie in on his condition as long as the information is shared in his best interest.
The American Nurses Association (ANA) Ethical Standards detail that nurses should inform patients of any significant diagnostic findings, including terminal diagnoses (Laura Sedig, 2016). The ANA Code also states that you should even inform the patient of information which might be hard for them to hear, as long as the information is within their best interests.
Who is the Authorized Decision Maker in this Case?
Robbie’s father gives a conflicting answer stating he wants Robbie to keep hope and bring him home, but he does not want the truth about his condition known.
This conflicts with what is in Robbie’s best interest, appropriately making Robbie the authorized decision-maker in this situation because he is a minor.
What Other Considerations Play a Part in Your Response?
Other considerations include whether Robbie has parents or caretakers who have been involved throughout his time at the hospital.While being truthful to Robbie is the best option, providing information that will help him cope with his situation is also advisable.Robbie is a part of a different culture than you or I, which may cause shame or fear if he were to be told he may die.Providing him with hope may help him through this challenging situation.

References
Laura Sedig, L. (2016) “What’s the Role of Autonomy in Patient- and Family-Centered Care When Patients and Family Members Don’t Agree?,” AMA J Ethics [Preprint]. Available at: https://doi.org/10.1001/journalofethics.2017.18.1.ecas2-1601.