Ethical Decision Making in Health Care

A professional code of ethics helps to distinguish between different professions and guide them in their settings and is especially important in the nursing profession. As nurses care for the sick people, they may face more difficult and immediate ethical dilemmas in their jobs (Hall, 1996)Therefore, in order to practice competently and deliver a professional care which is ethical and legal, understanding of ethics is an essential. This essay will discuss and illustrate how ethical principles help to guide in making the best decision for Mr Tony, an elderly patient diagnosed with advanced pancreatic cancer who refused treatment and had signed an advanced medical directive(AMD).

Patient is a devout Christian and he wanted to face death with dignity. However, his family members insist to have treatment for him. An ethical dilemma rises on whether patient’s treatment should be continued. The ethical issues involved are autonomy, beneficence, sanctity of life and non-maleficence. The legal considerations are consent and battery, Advanced Medical Directive Act and Mental Capacity Act.

Autonomy is a person’s right to make decisions, or speak and act on their own behalf based on own principles, values and beliefs, without interference from another party (, n.d.). Since Mr Tony is competent, therefore he has the right to refuse any treatment and nurses should respect his choice according to principle 2 in Code for Nurses and Midwives, which states that nurses have to respect people’s autonomy and right to self-determination (Singapore Nursing Board, 2018). No treatment for Mr tony should be continued unless a consent is obtained otherwise a lawsuit of battery may be filed if patient is touched unwillfully, even without causing any harm.

Besides, Mr. Tony had signed an Advanced Medical Directive which is a legal consent made to reject any life-sustaining treatment to prolong his life in the event he is terminally ill and unconscious in the future. The making of AMD is a voluntary decision. Thus, family members or even the person appointed as lasting power of attorney (LPA) have no authority to override the effect of AMD when it is executed (Hui, 2019).

The principle of beneficence addresses the idea that a nurse’s actions should promote good and in the thought of doing what is best for patient (, n.d). The principle sanctity of life believed that human life is sacred and all human beings should be perceived as a person with immeasurable worth and hence life should be saved under all conditions no matter which stage of life the person is at (Gushee, 2006). Respecting both ethical principle mentioned, treatment should be continued even though death is imminent as Mr Tony’s life is valued and his life will be prolonged. However, beneficence does not only apply to doing physical good but also to psychological, social and spiritual well-being (). By continuing treatment, which is against Mr. Tony’s will, an ethical conflict arise as harm is actually done to his psychological and spiritual well-being and patient’s autonomy is not respected. This action will also be violating the principle of non-maleficence which mandates nurses to do no harm to patient.

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