Nursing Ethical Dilemmas

Addressing end-of-life measures is a common ethical issue that nurses experience on a daily basis, especially nurses who work in the critical care setting. Ethical concerns dealing with this particular type of care normally revolves around the interest of patients, commonly known as autonomy or self-determination. The Code of Ethics defines autonomy and self-determination as the philosophical basis for informed consent in healthcare giving the patient the right to determine what healthcare measures will be done as well as the right to their own medical information. Ethically, patients are allowed to end care in the environment of their choice, whether it be at home, in hospice, or in the healthcare facility. This allows the patient to be surrounded
Her patient was around 84 years old and was admitted due to acute on chronic renal failure. The physician discussed with the patient that the only option left to help with her critical condition would be to begin dialysis. The patient was against this idea due to the dedication with dialysis and having treatments three days a week. The patient was actively participating in her own care and felt comfortable enough to voice her opinion about her treatment options. The nurse as well as the healthcare provider supported this decision, even though dialysis is the only effective treatment for this patient’s condition. After discussing dialysis with the patient and the family members, they also discussed withholding medical treatment including resuscitation and mechanical ventilation. The client and the family members decided together that these measures were not wanted in the client’s future medical
The Code of Ethics discusses the right to self-determination and goes on to explain that patient’s have the moral and legal right to determine which medical measures are to be performed, even if they choose to terminate treatment. The nurse can help with this process by giving accurate information to the client regarding treatment options in order for the client to make an informed decision regarding future medical treatments. Most importantly, the nurse should provide the client with support throughout this process including providing the client with medical advise on which treatments would be most beneficial, as well as including family members if the client requests. After researching, I also found an article related to kidney dialysis when dealing with critical patients like the patient my nurse had during my ICU rotation. Choosing to discontinue dialysis is actually a common request for critical patients due to it being time consuming and a physical burden, and eventually patient’s feel as if the negatives outweigh the positives. Withdrawal from treatment can occur in three different situations: when a patient is capable of making decisions and decides to discontinue dialysis, a written directive states the desire to discontinue dialysis, or if the healthcare provider feels as if dialysis is no longer beneficial to the patient. One other life supporting