Describe a situation of ethical dilemma that you have experienced in practice and how it was resolved. (Saunders, 2014)
Submission Instructions:
- Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Reviewed on TURNITIN, no repeat work.
One example of an ethical dilemma I experienced in practice occurred during my clinical rotation in a psychiatric unit, where I was caring for a patient with severe depression who expressed suicidal ideation. The patient, a young adult, had initially been open about their mental health struggles and actively participated in therapy. However, over time, they became increasingly withdrawn and refused to participate in group sessions or individual counseling. The dilemma arose when the patient confided in me during one of our routine interactions that they had developed a specific plan for self-harm but insisted I keep this information confidential, stating they would never trust another healthcare provider if I disclosed it.
In this situation, I faced conflicting ethical principles. On one hand, the principle of autonomy dictates respecting patients’ rights to privacy and confidentiality (American Nurses Association, 2015). However, as a healthcare provider, I am also obligated by the principle of nonmaleficence to prevent harm, especially when a patient is at risk of self-harm or suicide (Beauchamp & Childress, 2019). The ethical challenge here was balancing respect for the patient’s autonomy and the need to intervene to protect their safety. Additionally, I was mindful of the potential impact on the therapeutic relationship, which could be compromised if the patient perceived my intervention as a breach of trust.
After consulting with my supervising nurse and reviewing the unit’s policies on patient confidentiality and suicide prevention, I decided to escalate the matter to the treatment team. I explained the patient’s disclosure in a way that highlighted their immediate risk while maintaining as much of their privacy as possible. As per protocol, the treatment team then conducted a thorough risk assessment and involved the patient in developing a safety plan, which included regular check-ins and a temporary increase in observation.
This resolution helped in several ways. First, it honored the patient’s autonomy by involving them in the development of their safety plan, which they eventually accepted. Although there was some initial tension, the patient later acknowledged that the intervention made them feel supported rather than judged or betrayed. This approach aligns with ethical guidelines that advocate for transparency and patient-centered care, especially when handling sensitive mental health concerns (APA, 2017). The patient’s trust was gradually restored, and they re-engaged in therapy, recognizing the team’s commitment to their well-being.
In retrospect, this experience underscored the complexity of ethical decision-making in mental health care. It highlighted the importance of open communication, collaboration with the healthcare team, and adherence to professional ethical guidelines to navigate such dilemmas effectively. Utilizing resources like the American Nurses Association Code of Ethics and consulting with experienced colleagues proved invaluable in upholding both patient safety and respect for their autonomy (ANA, 2015).
In conclusion, addressing ethical dilemmas in practice requires balancing competing ethical principles, prioritizing patient safety, and involving patients in decision-making whenever possible. This situation reinforced my understanding that ethical decision-making in healthcare is rarely straightforward, but a thoughtful, team-based approach can provide a resolution that supports both patient trust and ethical integrity.
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. American Nurses Association.
American Psychiatric Association. (2017). The principles of medical ethics: With annotations especially applicable to psychiatry.