There are many ethical issues in nursing that we face every day. Grounded on the principles of this profession, we must make decisions that are geared towards creating good and causing no harm. However, our ability to make the most ethical decision is challenged at times, when neither choice can be either right or wrong.
One of the most challenging dilemmas is handling patients who want to die despite the possibility of surviving severe illness. So we asked our Facebook fans this question: “If a patient has a good chance of recovery but tells you ‘let me die,’ what would you say or do?”
The responses to this ethical issue in nursing 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, 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
As we all know, the decisions we make can be affected by a variety of factors. However, our ethics should always be our guiding principle.
If you are faced with this ethical issue in nursing, how would you respond? Share your answers below.