Nurses interact with people during some of their most vulnerable moments and in highly personal ways.
It’s why they often find themselves confronted with challenging ethical dilemmas that require careful consideration and decisive action.
The American Nurses Association developed a Code of Ethics for Nurses in the 1950s. It has been revised over the years to respond to technological advances and changes in society and the nursing field.
Gallup takes a poll every year asks how the public ranks various professions for having high honesty and ethics. For 22 straight years, nurses come in as the most respected in terms of honesty and ethics. In 2024, 78% of the poll takers perceived them as honest.
Common ethical issues that nurses grapple with are patient autonomy, confidentiality, resource allocation and end-of-life care, nurses must navigate complex situations while upholding ethical standards and providing compassionate care.
Patient Autonomy
One of the fundamental principles in health care ethics is respect for patient autonomy, which emphasizes the right of individuals to make informed decisions about their care. Nurses are expected to provide adequate information to allow patients to make their own decisions based on their beliefs and values, even if they aren’t the ones that the nurse would make.
However, nurses may encounter situations where patients’ autonomy conflicts with their well-being or poses risks to themselves or others. For example, a patient refusing life-saving treatment due to religious beliefs presents a moral dilemma for nurses torn between honoring the patient’s autonomy and their duty to promote health and prevent harm.
Confidentiality and Privacy
Maintaining patient confidentiality is paramount in nursing practice to build trust and safeguard sensitive information. Yet, nurses may face ethical dilemmas when balancing confidentiality with the duty to protect others from harm, such as in cases of suspected child abuse or threats to public safety.
Striking the right balance between respecting patients’ privacy rights and fulfilling legal obligations requires careful judgment and adherence to professional standards.
Resource Allocation
In resource-limited health care settings, nurses often confront ethical dilemmas related to resource allocation, where competing needs and priorities must be weighed against available resources. For instance, deciding how to allocate scarce medical supplies during a public health crisis or prioritizing care for patients with life-threatening conditions can be morally challenging.
Nurses must advocate for equitable distribution while considering the broader effect on patient outcomes and community well-being.
End-of-Life Care
Navigating end-of-life care presents complex ethical dilemmas for nurses, involving decisions about pain management, withdrawal of life-sustaining treatment and advance care planning. Balancing the principles of beneficence and nonmaleficence, nurses strive to provide compassionate care while respecting patients’ wishes and upholding their dignity.
Engaging in open and honest communication with patients and their families, exploring treatment options, and ensuring access to palliative care resources are essential in navigating end-of-life dilemmas.
Ethical Decision-Making
When faced with ethical dilemmas, nurses can employ ethical decision-making frameworks to guide their actions and resolve conflicts. These frameworks typically involve identifying the ethical issue, gathering relevant information, considering alternative courses of action, evaluating potential outcomes and consulting with interdisciplinary teams or ethics committees.
Engaging in reflective practice and seeking mentorship from experienced colleagues can also enhance nurses’ ethical reasoning skills and confidence in decision-making.