The Nursing Dilemma
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 an ethical dilemma, which involves weighing the competing moral values and obligations of loyalty to one’s profession and country, against autonomy and respect for a patient’s wishes. The conflicting ethical principles at play are nonmaleficence (the duty to do no harm),beneficence (the duty to do good and help others), respect for autonomy (the right of all patients to make their own decisions, including those related to healthcare), justice (the obligation to treat all persons fairly) and fidelity or loyalty (the obligation to be loyal and abide by the orders of one’s professional organization or country).
At risk are both the individual virtues of compassion, empathy, integrity, honesty, honourable service and courage; as well as broader societal virtues such as respect for human rights. Invoking conscientious objection may justify overriding an individual’s autonomy in circumstances where it is deemed necessary in order save lives or prevent catastrophic harm from occurring. However, this should only be done after careful consideration of its implications which include potential legal/negative career consequences due to disobeying orders from higher up authorities.
The Code of Ethics provides guidance on how nurses can balance their duties with that of respecting patient autonomy by providing information about options whilst respecting their choices even if they go against medical advice or established standards of care. This includes recognizing when a nurse needs conscientiously object due to personal beliefs versus professional requirements. In addition, nurses should seek support from colleagues if they feel unable handle certain situations while still carrying out their duties in a safe manner without compromising their sense of ethics or morality.
Ultimately, lessons that can be drawn from this particular dilemma include: understanding the limits placed on a professional nurse's ability act autonomously; being aware that there are occasions where adhering strictly to one's professional requirements could potentially result in causing more harm than good; using available resources such as codes of conduct/ethics in order determine what measures may provide the least amount damage with maximum benefit; seeking counsel from peers when faced with difficult situation requiring ethical decision making; practicing self-care when facing complex moral dilemmas so as not burnout; being open minded enough consider alternate viewpoints from stakeholders who may have different perspectives on same issue.