March 01, 2011
Ethical Dilemma Debate
As the population ages in America, the dilemma of end-of-life care becomes an important issue for the professional nurse. As reported in Evidence-Based Geriatric Nursing Protocols for Best Practice, the Patient Self Determination Act (PSDA) of 1991 establishes advance directives and decision making for those when capacity to make their own health care decisions is impaired (Capezuti 2010). In light of this PDSA, nurses often find themselves involved in end-of-life situations that conflict with patient’s wishes for themselves and family’s wishes for the patient. The dilemma presents itself in this area of conflict between the conflicting desires of patient and family. The nurse must completely support the patient’s wishes while assisting the family to do the same. The nurse is advocate for the patient, educator of the family, and liaison between the interdisciplinary team. The debate arises within those conflicts; the ANA Code of Ethics binds nurses to respect the autonomy of each patient and their decision to choose the healthcare options they believe are correct for them based on their religious, social, cultural and personal desires for end-of –life care (ANA Code of Ethics 2001). Nurses are also bound to participate in advocating for the patient to alleviate unnecessary treatment for the patient who has designated they do not want treatments that doctors and/or families may be advocating for the patient against that patients wishes (ANA Code of Ethics 2001). The nurse must be familiar with the end-of-life wishes of their patients otherwise; the patient looses a valuable advocate to assist in achieving their goals for end-of-life care. Nurses must also be aware of their own personal values and beliefs surrounding end-of-life care for their patients’ choices to advocate adequately. The dilemma during end-of-life issues arise when there are differing...