Ethical Issues in Nursing: How Do You Respond to a Hopeless Patient?
There are many ethical issues that nurses face everyday. Grounded on the principles of nursing ethics, nurses provide decisions that are geared to providing good and causing no harm. However, our ability to make the most ethical decision are challenged at times when niether choice can be either right or wrong.
One of the most challenging ethical dilemmas in nursing is handling patients who want to die despite the possibility of surviving severe illness. Recently we asked our Facebook audience the question, “If a patient has a good chance of recovery but tells you "let me die," what would you say or do?”
The responses fell into three categories. Many of you would respect the patient’s wishes. Nearly as many were adamant that it would not happen on your watch. But a quite a few of you were determined to talk to the patient first. Those in the third category would prefer to wait and make sure that all the relevant people were onboard and that all the options were discussed before a decision was made.
Here are a just a few of your reactions:
- "Tell me why you feel that way.”
- Natali Patterson RN
- “I'll respect their wishes.”
- Simone Tricia Grant
- “Get a psych consult.”
- Tara L. Wigfall
- “Wait a few days to see if you feel better, then decide.”
- Norma Plowman
- “Why do you feel this way? And I would actively listen to them.”
- Syble Kirby Burnett
- “A lot would depend on age and circumstance, of course. Bottom line, respect their wishes. They have the right to refuse treatment.”
- Debbie Moriarty
- “Call a family conference to include: the patient, the family, the physicians, the nurse, social work, chaplain and palliative care. Regardless of the decision, everyone must be on the same page.”
- Solana RM
- "That's not in my job description."
- Tammy Lang Rush
- “Being that I'm a hospice nurse, I would respect their wishes. But I would definitely talk with the patient and family first!”
- Deirdre LilDobby Johnson
- “That might be just a temporary wish! I will continue enable and support him to achieve his maximum level of wellness. I will continue empowering, motivate and give hope but yet respect patient’s wishes once they have reach informed decision-making!”
- Anna Marinova
- “I would spend some time talking about why he/she felt that way. If they were truly serious, I would ask for a social services consult and discuss living wills.”
- Cathy Quillen Dodds
- “A lot of family members don't want to be a burden to others because they have been so independent. I would remind them it’s okay to get help from others when needed. I also ask them if they have helped others when they needed it. They always say yes! I kindly remind them it is their turn now and to accept it! They usually see things from a different point of view then!”
- Marian Cassell Arbogast
- Not while I am on duty. God has his job, I have mine.”
- Angela Baker Billings
- “Depends on the patient. I'm not there to judge or impose my values on someone but I'm not there to withhold treatment either. It is a decision the patient makes with their doctor.”
- Christine Southerington
The decision we make as a nurse can be affected by a variety of factors but our nursing ethics should always be our guiding principle. If you are faced with this dilemma, how would you respond to a patient who wants to die? Share your answers below.
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