It is challenging to engage in meaningful discussions with patients when moral and ethical dilemmas present themselves.
How we engage with our patients can have a profound impact on the care they receive and the decisions they make.
The following exercise will present you with moral and ethical dilemmas common to many clinical practices. The moral and ethical challenges here are often ones the practitioner will have strong, personal feelings about.
Your task in this exercise is to serve as the practitioner advocate for the patient by engaging in dialog that does not project personal bias or prejudice while also providing the patient with the medical information needed to make an informed, personal decision. As you choose your responses, try to use one of the ethical decision-making models we’ve explored to systematically evaluate each dilemma and choose the best way to engage the patient in dialog.
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The following questions refer to your experience in this week’s exercise, Conducting Moral and Ethical Dialog in Clinical Practice. Describe your overall experience with the moral and ethical dialog exercise, and address at least three (3) of the following:
- Did you find any of the scenarios more difficult to deal with than others?
- Did you feel any internal conflict with any of the scenarios?
- How did your personal and professional background impact how you decided to interact with the patient?
- Do you feel the responses the patient gave to the practitioner’s response were reasonable or typical?
- Were you taken aback by any of the patient reactions?
- How might this activity contribute to your role as a nurse advocate in a moral and ethical practice?
- Did you utilize an ethical decision making model to explore a systematic way to evaluate any of these ethical dilemmas? If so, describe the effectiveness.
- Difficulty of Scenarios: Ethical dilemmas can vary widely in complexity and emotional impact. Some scenarios may indeed be more challenging to deal with than others, depending on factors such as the severity of the patient’s condition, the cultural or religious beliefs involved, and personal values. It’s not uncommon for healthcare practitioners to find some dilemmas more emotionally taxing.
- Internal Conflict: Ethical dilemmas often trigger internal conflicts because healthcare professionals may have personal values or beliefs that conflict with what is best for the patient. It’s crucial to recognize these conflicts and strive to separate personal values from professional responsibilities.
- Personal and Professional Background: Your personal and professional background can significantly impact how you interact with patients facing ethical dilemmas. For instance, your cultural background, religious beliefs, and past experiences may influence your perspective on certain issues. It’s essential to be aware of these biases and work to ensure they don’t compromise patient-centered care.
- Patient Responses: Patients’ responses to ethical discussions can vary widely based on their beliefs, experiences, and emotional state. Some patients may be receptive to discussing difficult topics openly, while others may be defensive or resistant. It’s essential to approach each patient with empathy and adapt your communication style to their needs.
- Role as a Nurse Advocate: Engaging in ethical dialogues with patients is a fundamental aspect of being a nurse advocate. This activity can enhance your ability to support patients in making informed decisions that align with their values and preferences while respecting ethical principles.
- Ethical Decision-Making Models: Ethical decision-making models, such as the four principles approach (autonomy, beneficence, non-maleficence, and justice) or the ACE model (Assess, Choose, Execute), can provide a structured framework for evaluating ethical dilemmas. They can help you systematically analyze the situation, consider relevant ethical principles, and arrive at a well-reasoned decision.
To be an effective nurse advocate in moral and ethical practice, it’s crucial to continually reflect on your own values and biases, engage in ethical dialogue with colleagues, and seek guidance from ethics committees or ethics consultants when needed. Additionally, ongoing education and training in medical ethics can further enhance your ability to navigate complex ethical dilemmas in clinical practice.