The Nursing Dilemma
Using a Microsoft Word document, record your responses to the critical thinking questions based on the scenario provided. Each response should be original (in your own words) and a minimum of 2–3 sentences in length.
Scenario
A military RN is ordered to force-feed a terrorist prisoner while they are undergoing interrogation. The prisoner is on a hunger strike protesting their capture and highlighting his cause. The nurse is to ensure the prisoner remains hydrated and fed so they can provide information and do not starve. The nurse is torn. On the one hand, the nurse has a strong loyalty to the military objective of ensuring public safety by uncovering terrorist plots and fear of reprisal if orders are disobeyed. Yet, the nurse is appalled at overriding a patient’s wishes by force-feeding him.
Male RN in Military Uniform
Critical Thinking Questions
Is this an ethical dilemma or a moral dilemma?
What ethical principles are in contention? How?
Are there any virtues at risk? Whose? Why?
What justifies overriding an individual’s autonomy to make his own choices?
How does the Code of Ethics guide the nurse in invoking conscientious objection?
What lessons can be learned from this nurse’s dilemma?
Sample Solution
This is a moral dilemma for the military RN, as one’s sense of morality and personal convictions about right and wrong are in conflict with following orders. The ethical principles at risk include autonomy (the patient's right to make his own health care decisions) as well as beneficence (the nurse’s obligation to do good) and non-maleficence (do no harm). There is also a risk to virtues such as loyalty and integrity, if the nurse decides not to follow orders.
The justification for overriding an individual’s autonomy lies in ensuring public safety by uncovering terrorist plots that could threaten the lives of many people. Furthermore, due to their knowledge of military protocol, nurses have been entrusted with responsibility and authority over certain decisions which often override what would be considered standard medical ethics in civilian settings.
In this case, the Code of Ethics recommends invoking conscientious objection when it is “consistent with law or policy”; however, it can also provide direction on how best to balance conflicting interests especially when those interests involve questions of moral values or beliefs. For example, nurses should always strive first for dialogue between all involved parties so that mutual understanding can be achieved about any conflicts between professional obligations/responsibilities and personal convictions/values. This may help them reach a resolution without having to resort to acts like force-feeding against the patient's will.
The lesson from this nurse’s dilemma is that nurses must remain mindful of their ethical duties while serving in situations where conflicts may arise from multiple sources—such as conscience versus orders—and practice critical thinking skills so they can weigh up different options before making a decision that best serves both their professional obligations/responsibilities as well as their personal values/beliefs. Furthermore, they need to understand how their actions affect patients directly and indirectly in order to maximize beneficence while minimizing any potential harms caused by scenarios like these ones mentioned above—scenarios wherein there is no clear-cut answer but instead involves complex considerations related both within an individual context (e.g., ethical principles) but also extending beyond into broader social contexts (e.g., laws).