Understanding the moral foundation of care, science, and professional conduct
Ethics is defined as:
āThe branch of philosophy that deals with principles of right and wrong conduct, guiding human behavior based on moral values, duties, and responsibilities.ā
In simpler terms, ethics helps individuals and societies determine what ought to be done, particularly in situations involving choices, conflicts, and consequences.
In nursing and healthcare, ethics plays a crucial role in:
Ethical practice means doing the right thingānot just legally, but morallyāeven when it is difficult.
Bioethics is defined as:
āA field of applied ethics that addresses the moral implications of biological and medical procedures, technologies, research, and healthcare practices.ā
Bioethics emerged with the rise of modern medicine, scientific advancement, and the growing complexity of clinical care. It focuses on issues such as:
In nursing, bioethics is central to:
Bioethics asks: Just because we can do something medically, should we do it? And if so, how should we do it ethically?
Ethical principles are the fundamental guidelines that help healthcare professionals make consistent, fair, and morally sound decisions.
The four widely accepted bioethical principles are:
Additional principles often considered in nursing and medical ethics include:
In both education and clinical practice, understanding ethics, bioethics, and ethical principles is essential for nurses, doctors, researchers, and all healthcare professionals. These frameworks guide daily practice, inspire compassionate care, and shape ethical leaders in a world where science must always serve humanity.
āEthics teaches us not just how to actābut how to care, how to respect, and how to serve with conscience.ā
The guiding lights of compassion, justice, and professional integrity
In healthcare, every decisionāwhether clinical, administrative, or interpersonalācarries moral weight. Nurses, doctors, and allied professionals encounter situations where technical knowledge is not enough. They must draw upon deeper values to decide what is right, fair, and dignified. This is where ethical principles come in.
Ethical principles provide a structured framework that helps professionals navigate complex situations, ensuring that the care provided is not only effective but morally sound. These principles are universal in scope, yet deeply personal in application, shaping the heart and soul of ethical nursing practice.
Letās explore each of the primary ethical principles, their definitions, and how they are applied in nursing and healthcare settings:
Definition: Autonomy is the principle that recognizes every individualās right to self-determinationāto make decisions about their own life and body, based on personal beliefs, values, and preferences.
Application in Nursing:
Autonomy means that the nurse listens, informs, and empowers, rather than directs or coerces. It honors the patient as a person, not just a patient.
Definition: Beneficence is the moral obligation to do goodāto promote the health, safety, and well-being of others.
Application in Nursing:
Beneficence requires nurses to be proactive in kindness, skilled in care, and deeply compassionate in service.
Definition: Non-maleficence is the duty to avoid causing harm, whether through action or inaction.
Application in Nursing:
This principle often works in balance with beneficenceāensuring that any action taken is worth the potential risks involved.
Definition: Justice in ethics refers to the obligation to treat individuals fairly and equitably, without favoritism, discrimination, or bias.
Application in Nursing:
Justice calls on nurses to not only treat individuals fairly but also to challenge systemic inequities within healthcare systems.
Definition: Fidelity is the ethical duty to keep promises, remain loyal, and uphold trust in all professional relationships.
Application in Nursing:
Fidelity strengthens the nurseāpatient relationship by building trust, accountability, and reliability.
Definition: Veracity is the principle of being truthful, transparent, and accurate in communication, even when the truth is difficult.
Application in Nursing:
Veracity respects the patientās right to know and to make decisions based on accurate and complete information.
Definition: This principle underpins all others. It is the recognition that every person has inherent worth, simply by being human.
Application in Nursing:
Respect for dignity is not only ethicalāit is deeply human. It is what makes nursing a profession of the heart, as well as the hands.
Ethical principles in nursing are not abstract theoriesāthey are living values, applied every day at the bedside, in clinics, in classrooms, and within communities. They remind us that how we care is just as important as what we do.
āEthical principles are not just rulesāthey are reflections of the kind of world we wish to create through care.ā
By practicing autonomy, beneficence, non-maleficence, justice, fidelity, veracity, and respect for dignity, nurses do more than fulfill a dutyāthey honor the human experience, uphold trust, and build a legacy of compassion in every interaction.
The moral call to do good, to heal, and to serve with purpose
At the very core of every act of nursing lies a simple but powerful intention: to help. This intention is more than kindnessāit is a deep ethical commitment known as beneficence. Whether tending to a wound, educating a family, or advocating for a voiceless patient, nurses continuously strive to bring about positive outcomes and well-being. Beneficence is not just something nurses doāit is a guiding principle that defines who they are as ethical professionals.
Beneficence calls on healthcare workers to not only avoid harm but to actively do good, to promote healing, and to advance the best interests of those in their care. It is the embodiment of compassion and competence, working hand in hand.
Beneficence is defined as:
āThe ethical principle that obligates healthcare professionals to act in ways that benefit others by promoting their well-being, preventing harm, and enhancing the quality of life.ā
It is a proactive principleāgoing beyond merely avoiding harm (non-maleficence) to doing what is necessary to help, even when effort, risk, or difficulty is involved.
In nursing, beneficence is reflected in both clinical interventions and emotional presence. It informs not only what the nurse does, but how and why it is done. A nurse practicing beneficence is guided by a commitment to:
For example, administering pain relief to a post-operative patient, advocating for better nutrition for a malnourished child, or providing emotional reassurance to a dying patientās family are all acts of beneficenceārooted in both skill and moral intent.
Beneficence is not accidentalāit involves deliberate efforts to do good. It requires assessing patient needs and using knowledge, skill, and compassion to respond effectively.
Sometimes, multiple needs compete for attention. Beneficence helps nurses determine what actions will yield the greatest goodāwhether through prioritizing care, allocating time, or choosing treatments.
True beneficence honors the individualās definition of what is beneficial. What benefits one patient may not be valued by another. Thus, this principle must be practiced with respect for autonomy and informed consent.
Beneficence requires the nurse to consider: Will this action truly help the patient? Do the expected benefits outweigh potential harms or burdens? This consideration brings ethical depth and responsibility to every decision.
Each of these actsāwhether small or profoundāis driven by the same ethical commitment: to help, to heal, to uplift.
Despite its noble intent, beneficence can present challenges:
True beneficence does not mean always doing what the nurse thinks is bestāit means working with the patient, using skill, ethics, and empathy to achieve outcomes that respect both health and humanity.
Beneficence is more than a principleāit is the spirit of nursing in motion. It transforms every action, from clinical intervention to emotional presence, into a meaningful effort to make life better for someone else.
āBeneficence is the quiet promise that nurses keep every dayāto help, to heal, and to serve the good of others above all.ā
In a world where efficiency often overrides empathy, beneficence re-centers the human soul in healthcare. It reminds nurses that their role is not just to intervene, but to uplift, comfort, and careāwith courage, clarity, and compassion.
The duty to do no harm: the ethical guardrail of safe, respectful, and responsible care
In the sacred space of healthcare, professionals wield not only knowledge but powerāover decisions, treatments, and lives. With this power comes the timeless ethical responsibility to avoid harm, to safeguard the patient, and to practice with unwavering vigilance and integrity. This foundational obligation is known as Non-maleficence.
Rooted in the ancient maxim āPrimum non nocereāāāFirst, do no harmāānon-maleficence is a central principle in medical and nursing ethics. It demands that nurses not only strive to do good but remain continually aware of how their actions, inactions, or oversights could cause pain, injury, distress, or unnecessary risk
Non-maleficence is defined as:
āThe ethical principle that obligates healthcare professionals to avoid causing harm, injury, or suffering to patients, whether through acts of commission or omission.ā
In nursing, it is expressed through safe practice, ethical vigilance, patient protection, and accountability for all actions affecting human life and dignity.
Patient safety is not just a procedural priorityāit is an ethical imperative. Nurses are entrusted with lives, and non-maleficence guides them to:
Every time a nurse washes their hands, verifies a patient’s identity, or asks questions before administering a drug, they are practicing non-maleficenceānot just technically, but ethically.
Non-maleficence also includes proactive protectionāfrom systems, decisions, and environments that pose risk. A nurse committed to this principle will:
It requires moral courage to confront riskānot only at the bedside but also within the institutional structure.
Even in the most conscientious environments, mistakes happen. A medication is miscalculated. A sterile field is breached. A vital sign is overlooked.
In such moments, non-maleficence demands more than regretāit demands ethical action. Nurses are ethically and professionally obligated to report errors honestly, promptly, and completely.
Why?
Error reporting is not a sign of weaknessāit is a hallmark of ethical strength.
Sometimes, avoiding harm is not straightforward. For instance, chemotherapy causes harm (side effects), but offers greater potential benefit (cancer treatment). In such cases, nurses must use clinical judgment and ethical reasoning to weigh:
Non-maleficence doesnāt mean never causing discomfortāit means avoiding unnecessary harm and ensuring that every action is ethically justified
A nurse is about to administer a medication but notices the physicianās order exceeds the standard dosage. Instead of proceeding, she double-checks the chart, calls the physician, and halts the procedure until clarification is received.
In doing so, the nurse doesnāt just follow a policyāshe practices non-maleficence. She prioritizes patient safety over task completion, showing ethical awareness, accountability, and courage.
Non-maleficence is not about doing moreāit is often about doing less, doing carefully, or not doing at all. It is a principle of restraint, responsibility, and reverence for human life.
āIn every careful step, every error admitted, and every harm prevented, the nurse fulfills their deepest promise: to protect, to care, and to do no harm.ā
In a world where haste can lead to harm, non-maleficence re-centers the nurseās role as protector, ensuring that care is not only skilled but safe, sincere, and ethically grounded.
Ensuring fairness, equality, and dignity in every act of care
In every hospital corridor, emergency room, clinic, or community setting, nurses encounter people from all walks of lifeārich and poor, young and old, educated and illiterate, marginalized and privileged. Amidst this diversity, one question echoes: Can we treat everyone fairly, regardless of who they are?
This is the essence of the ethical principle of Justiceāa principle that compels nurses to treat each individual as equal, with fairness, dignity, and impartiality, no matter their background, condition, or circumstance.
Justice in nursing isnāt just a matter of social valuesāitās a professional duty. It ensures that healthcare is not influenced by bias, favoritism, or discrimination, and that every patient receives what they need and deserve.
Justice is defined as:
āThe ethical principle that obligates healthcare professionals to treat all individuals fairly and equitably, ensuring equal access to care, resources, and respect, regardless of personal or social characteristics.ā
In simpler terms, justice means giving each person their dueānot necessarily treating everyone the same, but treating them with equal respect and fair consideration based on their needs and circumstances.
Justice in nursing practice is rooted in the belief that all human beings have equal moral worth. Therefore, nurses must:
This principle pushes nurses beyond technical skills into the realm of ethical action, social awareness, and compassionate accountability.
Letās explore how justice translates into real-world nursing practice:
A nurse provides the same respectful care to a homeless man with a skin infection as she does to a wealthy executive recovering from surgery. She explains procedures clearly, maintains dignity, and listens with the same attentiveness. This is justice through equality of treatment.
A nurse working in a disaster zone ensures that limited supplies and medications are distributed based on need, not based on who asks first or speaks the loudest. This reflects fair prioritization, a critical part of distributive justice.
A nurse speaks up when she notices that non-English-speaking patients are being ignored during ward rounds. She ensures they receive interpreter services and are included in care planning. Here, she practices justice by advocating for equity in communication.
Justice also extends beyond individual actions to systemic issues. Nurses are responsible for:
Justice, in this context, becomes social and structural, guiding nurses to shape not just patient care but the systems around it.
Despite its clarity as a principle, justice can be difficult to uphold, especially when:
In such moments, justice must be intentionally practiced, not assumed. It calls nurses to reflect deeply, consult ethical frameworks, and act with moral courage.
Justice is more than a legal or political termāit is a moral responsibility that calls nurses to see each patient as equally worthy of care, compassion, and attention. It reminds us that fairness is not the absence of difference, but the presence of empathy and equity.
āJustice in nursing means that no patient is ever less important, less heard, or less human in our care.ā
When justice guides our practice, healthcare becomes more than healingāit becomes a force for dignity, equality, and ethical transformation.
Care without discrimination, equitable access, and protection of the collective good
Justice is not merely a concept to be admiredāit is a standard to be lived. In healthcare, justice goes beyond the bedside, reaching into policies, communities, and public trust. It demands that every individual be treated with fairness, that no one be denied care due to prejudice, and that public health and safety are upheld with ethical integrity.
As a core ethical principle in nursing, justice ensures that every patient, regardless of who they are or where they come from, is treated with dignity, receives needed care, and is protected as part of a larger society. It embodies the professionās promise to serve allānot selectively, but equitably.
In the context of healthcare ethics, Justice is defined as:
āThe moral obligation to treat all individuals fairly, to distribute resources equitably, and to act in ways that protect both individual rights and the well-being of the wider public.ā
Justice includes individual fairness (treating patients without bias), distributive fairness (equitable sharing of resources), and social fairness (addressing broader determinants of health).
Every person who enters a hospital, clinic, or community health center deserves to be treated as a human firstānot defined by their illness, appearance, or social identity. Justice in nursing means that personal biases, social status, or cultural differences must never influence the quality or compassion of care delivered.
This includes:
Justice compels nurses to consciously confront their own unconscious biases, and to ensure that no patient feels āless thanā or invisible under their care.
To be just is to see beyond the labelāand honor the life behind it.
Justice demands not just fairness in individual interactions, but systemic equityāthat is, ensuring that healthcare is available, accessible, and appropriate for all populations, especially the marginalized.
This includes:
Equitable access does not mean everyone gets the same thingāit means everyone gets what they need, based on their circumstances. A just healthcare system doesnāt just respond to diseaseāit corrects disparities and restores balance in who gets care and how.
Justice also has a social dimension: ensuring that the health of the wider public is protected through ethical public health practices. This involves a delicate balanceāprotecting individual rights while promoting the common good.
For nurses, this may include:
Justice in public health means making decisions that may temporarily limit individual freedoms (e.g., quarantine) in order to safeguard many livesābut doing so with transparency, fairness, and compassion.
It is about ensuring that no one is left unprotectedāespecially the most vulnerable.
These actions demonstrate justice not in abstract termsābut in real, tangible impact.
Justice in nursing is the principle that equalizes the care experience, ensuring that bias, barriers, and disparities are not part of a patientās journey. It means that every person, regardless of their identity or background, is treated with equal worth and equal protection.
āTo practice justice is to lift every patient onto level groundāand to raise the standards of healthcare for all.ā
In every decision, every interaction, and every policy we support, justice must be the compassāguiding nurses not only to care with skill, but to care with fairness, vigilance, and unshakable ethical commitment.
Honoring the voice, values, and voluntary choices of every individual
In the heart of every human being is a fundamental desire: to be heard, respected, and in control of oneās own life. In healthcare, where the balance of power often shifts toward professionals and institutions, it is the ethical principle of autonomy that restores this balanceāby ensuring that the patient remains an active participant, not a passive recipient of care.
Autonomy is not just about making decisionsāitās about being respected as a whole person, with the right to decide what happens to one’s own body, life, and future. For nurses, honoring autonomy is more than professional obligationāit is an act of moral dignity and compassionate empowerment.
Autonomy is defined as:
āThe ethical principle that affirms an individualās right to make informed, voluntary decisions about their own life, body, and health, free from coercion or external control.ā
In nursing, this means supporting patients in understanding their options, respecting their decisions, and facilitating their right to self-determination, even when those choices differ from what the nurse might personally prefer.
Autonomy is expressed through:
In short, autonomy is the nurseās way of saying, āThis is your body, your lifeāyour voice matters.ā
Imagine a terminally ill patient who decides to stop curative treatment and choose palliative care. The nurse may feel emotionally conflicted but respects the patientās right to self-determination and offers compassionate support through the chosen path.
Or consider a competent adult who refuses a blood transfusion for religious reasons. The nurse does not argue or override but instead advocates for alternative approaches, ensuring the patientās beliefs are honored while safety is maintained.
These are not just technical decisionsāthey are deep ethical affirmations of the patientās personhood.
There are times when autonomy appears to conflict with beneficence (doing good) or non-maleficence (avoiding harm). A patient might refuse life-saving surgery. A parent might reject vaccination for a child. These moments create moral tension.
In such cases, nurses must:
Autonomy does not mean absolute independenceāit means responsible choice within ethical boundaries.
Respecting autonomy means the nurse becomes an educator, listener, and advocate, not a controller. This includes:
Autonomy is not simply ālet the patient decideāāitās helping the patient feel capable, informed, and free to decide.
Even when autonomy is limited, dignity and choice should never be entirely removed.
Autonomy is not just about decision-makingāit is about upholding the integrity and individuality of every person we care for. It is the foundation of trust, partnership, and ethical maturity in nursing.
āTo honor autonomy is to say: I see you not just as a patient, but as a personāwith voice, values, and the right to choose your own path.ā
In every informed consent, every respectful pause, and every uncoerced choice, nurses affirm the sacred truth: health care is not about taking over livesāitās about walking beside them, with dignity and respect.
Respecting the right to choose, the freedom to decide, and the dignity of self-direction
In the world of healthcare, where lives hang in the balance and decisions often carry profound consequences, the role of the nurse is not just to provide expert careābut also to uphold the human right of autonomy. This ethical principle lies at the heart of patient-centered care. It reminds us that even when someone is vulnerable, ill, or afraid, they still have the right to decide what happens to their body, their life, and their future.
Autonomy is more than a legal concept; it is a moral commitmentāa promise to treat patients not as passive recipients, but as thinking, feeling individuals with values, beliefs, and rights of their own.
Autonomy is defined as:
āThe ethical principle that recognizes an individualās right to make independent, informed decisions about their own health and personal matters, without coercion or undue influence.ā
In the healthcare context, autonomy means:
Autonomy empowers the patient to become an equal partner in careānot someone decisions are made about, but someone decisions are made with.
Respect for autonomy means recognizing that each patient is an expert in their own life. They bring their own hopes, fears, values, and goals into the healthcare setting. The nurseās ethical responsibility is to:
Whether the decision is to continue aggressive treatment, to refuse a procedure, or to seek alternative therapies, the nurse must honor itāso long as the patient is fully informed and competent.
āTo respect autonomy is to say: āYour choice matters. Your voice is heard.āā
Self-determination is the soul of autonomy. It affirms that every competent individual has the right to decide how they live and how they are treated, even if others disagree with those decisions.
In nursing, this means:
For example, a terminally ill patient may choose to stop treatment and opt for hospice care. A nurse honoring autonomy will respect that decision, provide comfort, and ensure the patient is supported with dignity and compassion.
Freedom of choice isnāt just about signing a consent formāitās about genuine, meaningful choice. It involves:
True freedom in healthcare is not just theoreticalāitās practiced at every interaction when nurses explain, listen, and step back to let the patient decide.
While autonomy is a fundamental principle, it can be tested in real-world settings:
In such cases, nurses must approach the situation with sensitivity, cultural humility, and ethical guidanceāensuring that the patientās voice remains central, even amidst complexity.
Nurses are often the bridge between medical decisions and personal understanding. Their role in promoting autonomy includes:
A nurse who promotes autonomy is one who empowers rather than directs, supports rather than controls, and respects even when they disagree.
Autonomy is not just an ethical requirementāit is a recognition of human dignity, freedom, and individuality. It turns healthcare into a shared journey, where patients walk beside the nurse, not behind them.
āTo uphold autonomy is to protect the most sacred right in healthcare: the right to choose oneās own pathāwith clarity, with courage, and with care.ā
When nurses honor autonomy, they donāt just follow ethical codesāthey build relationships rooted in trust, empowerment, and compassion, and they create space for healing that is not only clinicalābut deeply human.
Ethical issues and ethical dilemma: Common ethical problems
When personal interest collides with professional duty: navigating the gray zones of ethics
In the ideal world of healthcare, every decision would be guided purely by the best interest of the patient. But in reality, professionals may face moments when their personal, financial, or relational interests intersectāsometimes uncomfortablyāwith their professional obligations. This is known as a Conflict of Interest, and it is one of the most subtle, yet serious ethical issues in nursing and healthcare.
A conflict of interest doesnāt always involve wrongdoingābut it creates the risk of biased decisions, undermines trust, and can place professionals in ethical dilemmas where values, responsibilities, and outcomes clash.
Understanding and managing such conflicts is vital to upholding the integrity, impartiality, and credibility of healthcare practice.
A Conflict of Interest (COI) is defined as:
āA situation in which a healthcare professionalās judgment or actions regarding their primary responsibilitiesātypically the patientās best interestāare unduly influenced by a secondary interest, such as personal gain, relationships, or financial incentives.ā
It may be actual, potential, or perceived, but in each case, it raises questions of loyalty, impartiality, and ethical accountability.
A true ethical dilemma arises when:
For example, a nurse might face an ethical dilemma if they are asked to recommend a home health agency owned by a family memberāeven if better options are available. They must decide whether loyalty to family or responsibility to the patient takes precedence.
Each of these cases creates an ethical crossroadsāwhere choices must be evaluated not just for efficiency or loyalty, but for ethical alignment with professional values.
Professional codes, including those from the Indian Nursing Council, International Council of Nurses (ICN), and American Nurses Association (ANA), emphasize that:
Ethical practice isnāt just about what we doābut about why and how we do it.
Conflict of interest is not always easy to detect or manage. It often hides in the gray zones of loyalty, habit, and personal benefit. But for nurses and healthcare professionals, choosing integrity over convenience is the true mark of ethical excellence.
āEthics isnāt only tested in grand decisionsābut in quiet moments when we must choose between what benefits us and what is right.ā
When faced with a conflict of interest, the most ethical path is often the one that is transparent, patient-centered, and true to professional values. In choosing that path, nurses uphold the very essence of their roleānot just as caregivers, but as guardians of trust and justice in healthcare.
When doing whatās “best” may conflict with doing whatās right: the ethics of overriding autonomy
Healthcare professionals are trained to care, protect, and act in the best interests of their patients. But what happens when this protective instinct overrides the patientās right to choose? When the professional, believing they know whatās best, decides for the patient, rather than with them?
This ethical tension is known as paternalismāa controversial and often complex issue in nursing and healthcare practice. While it may stem from good intentions, paternalism challenges the foundational principle of autonomy, and forces nurses to confront difficult questions about control, trust, and respect.
Paternalism is defined as:
āAn action taken by a healthcare professional or institution in which decisions are made for the patient, with the intent of benefiting or protecting them, but without their full consent or against their expressed wishes.ā
It often involves withholding information, overriding choices, or making unilateral decisions, typically on the grounds that the patient cannot fully understand or act in their own best interest.
Paternalism becomes an ethical dilemma when two core values collide:
For example, a nurse may withhold a terminal diagnosis from a patient at the familyās request, believing that telling them the truth will cause distress. While the intent is to protect, this may violate the patientās right to know and plan.
Thus, paternalism raises the difficult question:
āIs it ever ethically justifiable to override a personās choice for their own good?ā
Paternalism can be:
It may also manifest in subtle, everyday ways:
These practices may seem protective, but they risk silencing the patientās voice, eroding trust, and undermining ethical care.
Although often done with kind intentions, paternalism can be ethically problematic because it:
There are rare instances where temporary paternalism may be ethically acceptable, particularly when:
In such cases, the goal is not to permanently take over, but to safeguard the patient until they can regain control over decisions.
Even then, transparency, documentation, and follow-up discussions are essential to uphold ethical accountability.
Paternalism walks a fine line between caring and controlling. Nurses, driven by compassion, may feel compelled to protectābut in doing so, must be careful not to take away what matters most: the patient’s right to choose.
āTo honor autonomy is not to abandon the patientāit is to walk beside them, guiding, informing, and supportingāwithout seizing the wheel.ā
Ethical nursing means learning when to step ināand more importantly, when to step backāallowing patients to lead their own lives, even if their choices carry risk. Because in the end, freedom, respect, and dignity are not optionalāthey are essential to healing.
When the truth is blurred: confronting the ethics of withholding, altering, or misrepresenting information in care
In healthcare, truth-telling is sacred. It forms the foundation of trust, informed consent, and patient autonomy. Yet, there are moments when a nurse or healthcare provider may feel temptedāor even pressuredāto withhold the full truth, soften a diagnosis, or give false reassurance to āprotectā the patient. These moments, while sometimes driven by compassion, bring us face to face with a significant ethical issue: deception.
Deception, in all its forms, challenges not just ethical codes, but the very character of caregiving. It creates a moral conflictābetween truth and harm, hope and honesty, care and control.
Deception is defined as:
āThe intentional act of misleading, omitting, or presenting false or incomplete information with the purpose of influencing the beliefs, decisions, or emotional state of another person.ā
In healthcare, this may involve:
Whether subtle or direct, deception undermines the ethical foundations of transparency, autonomy, and trust.
Deception creates an ethical dilemma when two fundamental principles come into conflict:
A healthcare provider might ask:
āShould I tell this patient the full truth, even if it causes emotional distress or loss of hope?ā
For example, a nurse may avoid telling an elderly patient that their condition is terminal, believing the truth will cause despair. Or a doctor might delay disclosing a cancer diagnosis until family members are prepared. While the intent is protective, the ethical price may be the patientās right to prepare, decide, or seek alternative care.
Despite good intentions, deception in healthcare is ethically risky because it:
Patients cannot make informed decisions about their own care if they donāt have the whole truth.
If deception is discovered, it can permanently damage the nurseāpatient relationship, causing feelings of betrayal and resentment.
Nurses are bound by professional codes to practice with honesty, fidelity, and transparency. Deception contradicts these values.
By hiding or altering the truth, the healthcare provider assumes power over the patientās choices, which can be ethically oppressiveāeven when unintended.
Even passive deception, like smiling and pretending all is well when something serious has happened, can cause ethical unease and internal moral conflict.
There are rare and ethically debated circumstances when temporary non-disclosure may be considered:
Even in such cases, deception should be minimal, temporary, and carefully documented, with a plan for full disclosure as soon as feasible.
Ethical nursing practice always aims to minimize deception and maximize respectful, honest dialogue.
Deception in healthcare is a moral tightropeātrying to comfort, while risking the truth. It is rarely malicious, but always dangerous. The more ethical route is not to avoid difficult truthsābut to deliver them with kindness, clarity, and respect.
āEthical nursing does not mean hiding the truthāit means holding the truth gently, and placing it with care in the hands of the one it belongs to.ā
By fostering open, honest, and empathetic communication, nurses uphold not only professional ethics, but also the humanity and dignity of care.
Respecting what is personal, safeguarding what is shared
In the intricate relationship between nurse and patient, there exists a silent but powerful contractāwhat is shared will remain protected. Whether it is a diagnosis whispered behind a curtain, a personal fear revealed during a conversation, or a medical file entrusted to a system, privacy and confidentiality are not optional courtesiesāthey are ethical cornerstones of professional practice.
When these principles are challenged, compromised, or misunderstood, they give rise to ethical issues and dilemmas that affect not only patient safety but also trust, dignity, and the moral integrity of the nurse.
These concepts go hand-in-hand: privacy is the patientās right; confidentiality is the nurseās obligation.
Respecting privacy and confidentiality is not merely about rulesāit is about preserving dignity and building trust. When patients know their stories and bodies are safe from exposure, they are more likely to:
Violating these principles, even unintentionally, can cause profound emotional, psychological, and even legal harm.
While the principles seem straightforward, real-life situations often blur the lines, creating moral tension.
A patientās family pleads with a nurse to disclose test results, but the patient has explicitly asked that the diagnosis not be shared. The nurse faces an ethical dilemma: protect confidentiality or maintain family transparency?
A nurse discusses a patientās condition at the nursing station, unaware that a visitor nearby can overhear. The intent wasn’t to breach trustābut the effect still violates privacy.
A patient reveals they are HIV positive but refuses to inform their partner. The nurse must weigh the duty to protect confidentiality against the duty to warn and protect another life.
These scenarios require delicate judgment, professional consultation, and ethical reasoning.
There are certain limited and ethically justifiable situations where breaking confidentiality may be allowedāor even required:
In all such cases, nurses must act transparently, judiciously, and with documentation and supervision, ensuring that disclosure is minimal, necessary, and ethically defensible.
Privacy and confidentiality are not just professional requirementsāthey are expressions of respect, honor, and humanity. They affirm the patient’s worth not only as a subject of care, but as a person with stories, struggles, and a right to keep some things sacred.
āTo protect what a patient entrusts us with is not a burdenāit is a privilege. It is the quietest, yet most powerful, form of care we can give.ā
In upholding these principles, nurses do more than avoid ethical violationsāthey become guardians of trust, building a healthcare system that is as humane as it is competent.
Where choice meets care: honoring autonomy, protecting dignity, and navigating ethical boundaries
In the hands of a nurse or healthcare provider lies both the power to healāand the responsibility to respect. Among the most sacred of patient rights is the right to give or withhold consent. This is not just a procedural step or a signed formāit is an ethical agreement that ensures patients are informed, voluntary participants in their own care.
But what happens when a patient refuses treatment that could save their life? Or when they give consent under pressure, fear, or confusion? These moments reveal the ethical dilemma of valid consent and refusalāa challenging yet fundamental part of ethical nursing practice.
For consent or refusal to be considered ethically valid, three key conditions must be met:
Valid consent and refusal are not just legal protectionsāthey are moral affirmations of the patientās right to:
In nursing, this means the care we provide must always begin with the patientās permissionāand end where that permission is withdrawn.
Although the principle sounds clear, real-world cases often bring it into moral conflict. Nurses and doctors may face dilemmas such as:
A nurse caring for a cancer patient who chooses to stop chemotherapy may feel morally torn: Should the nurse try harder to persuade them, or respect the choice, even if it results in death?
A woman in labor agrees to a C-section because her partner insistsāeven though she previously stated she wanted a natural delivery. Is the consent truly voluntary, or is it coerced?
A nurse explains a procedure, but the patient doesnāt fully grasp the risks due to language barriers or low health literacy. If the patient agreesāis that ethically valid consent?
Such situations challenge nurses to reflect:
āIs this patient truly free to decideāor am I, or the system, deciding for them?ā
In the end, consent and refusal are not just checkboxesāthey are acts of ethical respect, affirming that each person has the right to choose the path of their own care. The role of the nurse is not to convince or command, but to inform, empower, and uphold that choice with integrity.
āConsent is not just permissionāit is partnership. Refusal is not rejectionāit is a right.ā
By honoring both, nurses stand not only as skilled professionalsābut as guardians of dignity, respect, and ethical care.
When time, hands, and hope are limited: choosing fairly in the face of necessity
In an ideal healthcare world, resources would be abundantāenough nurses for every patient, enough time for every need, and enough equipment for every emergency. But reality often tells a different story. Whether due to staff shortages, budget constraints, overwhelming patient loads, or emergencies, nurses frequently face the ethical challenge of how to prioritize care when resources are not enough for all.
This is the ethical dilemma of allocation of scarce nursing resources. It is not just a logistical or managerial issueāit is a moral question:
āWho receives care first, and who must wait? How do we balance fairness with urgency, and compassion with practicality?ā
Allocation of scarce nursing resources refers to:
āThe process by which limited human, material, or time-based resourcesāsuch as nurse availability, attention, medications, or bedsāare distributed among patients and care needs.ā
In ethical terms, this becomes a dilemma when nurses are unable to meet all patient needs equally or simultaneously, and must make decisions that affect equity, safety, and outcomes.
Healthcare is built on the promise of equitable, compassionate careābut when resources fall short, that promise is strained. Nurses are left to make decisions that may:
At its core, the issue is not just about scarcityāit is about how to act justly, responsibly, and compassionately under pressure.
Imagine a scenario: A nurse is responsible for seven patients on a ward, but a sudden emergency arises in one room, demanding immediate attention. Meanwhile, another patient is in pain, one needs medication, another awaits discharge, and a fourth is at risk of falling.
The nurse must decide:
This is not just triageāit is ethical decision-making, where every action (or inaction) is morally weighted.
This dilemma often involves a conflict between multiple ethical principles:
These competing values must be balanced, not ignored.
The ethical challenge of allocating scarce resources is not about being perfectāit is about being principled, reflective, and humane in difficult moments. Nurses must often choose between two rights or two needs, knowing that someone may be left waiting.
āTo care ethically in scarcity is to be honest, just, and kindāeven when the choices are painful.ā
In choosing with intention and transparency, nurses uphold their deepest ethical commitment: to protect, to serve, and to honor the human dignity of every patientāeven when resources fall short.
When innovation outpaces ethics: navigating the promises and perils of modern medicine
Healthcare is evolving at lightning speed. From robot-assisted surgeries and AI diagnostics to genome editing, telemedicine, and wearable monitors, technology has transformed the way nurses and healthcare professionals deliver care. Yet, as machines become more intelligent and interventions more complex, ethical questions multiply.
While new technologies promise improved outcomes, efficiency, and access, they also introduce uncertainty, risk, and moral conflict. When should technology take precedence over human judgment? Who gets access? Who ensures itās used responsibly? These questions form the crux of the ethical issue known as conflict concerning new technologies.
A conflict concerning new technology arises when the introduction or application of a medical innovation leads to uncertainty or disagreement about what is ethically right, fair, or beneficial.
These conflicts typically involve:
Technological innovation affects not just how care is deliveredābut how it is perceived, valued, and controlled. With every new advancement comes an ethical responsibility to ask:
When these questions go unanswered or are rushed in the name of progress, ethical harm can resultāeven unintentionally.
AI tools can read imaging scans faster than humansābut what happens if they miss a rare finding? Who is accountable: the machine, the programmer, or the nurse who relied on the result?
With CRISPR and personalized medicine, we can now identify and potentially ācorrectā genetic conditions. But who decides which traits should be altered? Does this encourage eugenics or discrimination?
Virtual care offers convenience but can reduce human connection, physical assessment, and privacy. Can empathy and ethics survive when touch is replaced by technology?
As nurses update digital records, they must navigate systems that store sensitive information. What if that data is hacked, leaked, or shared without consent?
Each scenario presents no easy answers, only tensions between innovation and ethics.
These technological dilemmas often involve tension among foundational ethical principles:
The ethical dilemma lies in how to balance these values when technology disrupts them.
Nurses are not just users of technologyāthey are witnesses, protectors, and advocates in its application. Their role includes:
Technology is reshaping healthcareābut it must not reshape our values. Innovation must walk hand-in-hand with ethics, or risk leaving behind the very humanity it aims to serve.
āWhen machines make decisions, nurses must make meaning. When technology moves fast, ethics must move thoughtfully.ā
In the ever-advancing world of healthcare, nurses are not just caregiversāthey are ethical guardians, ensuring that progress does not come at the cost of personhood, privacy, or justice.
When speaking up means standing alone: the ethics of exposing wrongdoing in healthcare
In the world of healthcare, silence can sometimes protect systemsābut harm people. When a nurse or healthcare professional discovers unethical, unsafe, or illegal practices within their organization, they may face a difficult choice: remain silent to preserve peaceāor speak up and risk retaliation.
This act of exposing misconduct, often at great personal and professional risk, is known as whistle-blowing. While whistle-blowers may be driven by integrity and patient advocacy, their path is rarely easy. They may be praised as heroesāor punished as traitors. This makes whistle-blowing one of the most emotionally charged and ethically complex dilemmas in nursing.
Whistle-blowing is defined as:
āThe act of reporting unethical, illegal, or unsafe practices occurring within a healthcare institution to individuals or authorities capable of addressing the issue, especially when internal reporting channels have failed or are unavailable.ā
Whistle-blowing may be:
Both types carry ethical implications and consequences.
Whistle-blowing sits at the intersection of ethical responsibility and personal risk. It challenges the nurse to weigh:
The central ethical question becomes:
āWhen does silence become complicity, and when does speaking up become the greater act of care?ā
Should they report to higher management, knowing it may lead to backlash?
Does a nurse have a moral duty to escalate the issue to the medical board?
Should a nurse go public to protect the community, despite risking their career?
These situations illustrate how whistle-blowing can be morally justified, yet personally dangerous.
Whistle-blowing often involves a clash between multiple ethical principles:
Nurses must carefully reflect:
āDoes remaining silent preserve professionalismāor violate it?ā
Most professional codes of ethicsāincluding those by the Indian Nursing Council, International Council of Nurses (ICN), and American Nurses Association (ANA)āsupport whistle-blowing when patient safety or ethical integrity is at risk.
They affirm that:
Still, reality can differ. Whistle-blowers often face harassment, job loss, emotional distress, or ostracization. Hence, nurses must act cautiously, strategically, and ethically.
Whistle-blowing is not an act of rebellionāit is an act of conscientious leadership. It takes moral courage to speak when silence is safer, and to act when others turn away.
āIn choosing to protect the truth, the nurse also protects the patient, the profession, and the soul of ethical care.ā
While the road may be lonely, the purpose is noble. When done with integrity, whistle-blowing is not only ethicalāit is essential to upholding justice, accountability, and human dignity in healthcare.
At the intersection of science, ethics, and human lifeās earliest moments
Advancements in reproductive medicine, fetal diagnostics, and maternal care have empowered us to intervene earlier than ever before in human development. We can see, test, treat, and sometimes even prevent life-threatening fetal conditions before birth. But with this power comes a complex web of ethical questionsāquestions that affect not only medical decisions, but deeply held values, rights, and beliefs.
The ābeginning of lifeā stage brings with it some of the most emotionally charged and ethically challenging dilemmas in healthcare. Nurses, physicians, families, and policymakers are often called to make decisions where two lives may be involved, rights may conflict, and outcomes may be uncertain.
Ethical issue: The decision to terminate a pregnancy often pits a womanās right to bodily autonomy against the moral or potential personhood of the fetus.
Ethical dilemma:
When a pregnant woman chooses abortion, should the healthcare provider participate if it conflicts with their own values? How should care be managed if abortion is requested for non-medical reasons (e.g., gender preference)?
Nursing consideration:
Nurses must balance respect for the patientās autonomy, personal conscience, and legal and institutional guidelines, often under emotionally tense circumstances.
Ethical issue: Pregnant individuals who abuse drugs or alcohol risk harming the developing fetus. Healthcare providers may feel obligated to protect the fetus, even if it means intervening against the motherās will.
Ethical dilemma:
Should a pregnant woman who continues substance abuse be coerced into treatment, or even detained for the fetusās sake? Is that ethically or legally justifiable?
Nursing consideration:
Nurses must walk a fine line between compassionate care, nonjudgmental support, and reporting obligations, all while safeguarding both maternal rights and fetal health.
Ethical issue: Fetal therapy involves in-utero medical or surgical treatment to correct or improve conditions before birth. While potentially life-saving, it carries risks for both fetus and mother.
Ethical dilemma:
Should a mother undergo high-risk fetal surgery to benefit the unborn child? What if it places her own life or future fertility in danger?
Nursing consideration:
Nurses play a key role in educating, supporting, and advocating, ensuring that informed consent includes a balanced view of risks and uncertainties.
Ethical issue: In high-order multiple pregnancies (e.g., triplets or more), selective reduction may be recommended to improve the survival and health of remaining fetuses. This involves terminating one or more fetuses.
Ethical dilemma:
Is it ethically justifiable to reduce the number of fetuses for the potential benefit of others? How should clinicians handle moral objections or cultural beliefs about such procedures?
Nursing consideration:
Nurses may experience moral distress and must be supported in navigating their own values while maintaining nonjudgmental care for the family.
Ethical issue: Treating a fetus in utero requires invasive procedures, and often raises questions about consent and risk-sharing between mother and fetus.
Ethical dilemma:
If the mother refuses fetal treatment, is the healthcare team obligated to accept thatāeven if the condition is correctable?
Nursing consideration:
Nurses must ensure that the woman is fully informed and supported, and advocate for shared, respectful decision-making, even when emotions run high
Ethical issue: In some legal or social contexts, certain populations (e.g., individuals with mental illness, substance dependence, or those deemed “unfit” for parenting) are pressured or required to use contraception.
Ethical dilemma:
Can society ethically enforce contraception to prevent births perceived as āburdensomeā? Does this violate basic human rights?
Nursing consideration:
Nurses are called to oppose coercion, advocate for reproductive justice, and protect the rights of vulnerable populationsāespecially women.
Ethical issue: Fetal injury may occur due to maternal behaviors (e.g., smoking, alcohol, neglect) or external harm (e.g., abuse, accidents).
Ethical dilemma:
Should mothers be held legally or morally responsible for unintentional fetal harm? How far can healthcare providers go to prevent fetal injury?
Nursing consideration:
Rather than punish, nurses must emphasize education, prevention, and support, while remaining sensitive to socioeconomic and psychosocial challenges the mother may face.
Ethical issue: Assisted reproductive technologies (ART), like IVF or surrogacy, raise questions about who can access treatment, how embryos are handled, and what limits should exist.
Ethical dilemma:
Should age, marital status, or income restrict access to infertility care? How should surplus embryos be managed? Is commercial surrogacy ethical?
Nursing consideration:
Nurses in fertility clinics and reproductive health settings must provide ethical counseling, emotional support, and clear information, respecting diverse values and avoiding bias.
The beginning of life is a sacred and sensitive stageāwhere decisions made by parents, providers, and policymakers ripple far into the future. Ethical dilemmas here are rarely black-and-white. They involve emotions, values, science, law, and moralityāall converging in the lives of the most vulnerable: the unborn, the mother, and the future child.
āTo care ethically at the beginning of life is to honor both science and soulāto lead with compassion, informed judgment, and deep respect for human dignity.ā
As nurses and healthcare professionals, we are not just witnesses to these decisionsāwe are participants, protectors, and ethical navigators in one of the most profound journeys of human care.
When care must shift from curing to comforting, and choices become a final act of dignity
Death is not just a medical eventāit is a deeply human experience. As healthcare professionals, nurses are not only present at the beginning of life but are also guardians at its end. In this role, they face some of the most emotionally challenging and ethically complex situations, where the focus shifts from extending life to preserving comfort, dignity, and choice.
Modern medicine has given us the power to prolong lifeābut not always with quality or meaning. This has led to profound ethical debates over when to continue treatment, when to stop, and how to support the dying with respect and compassion. These questions fall under the domain of end-of-life ethical issues, where autonomy, beneficence, and moral courage are constantly tested.
Ethical issue: As a patient nears the final stages of life, decisions must be made about whether to continue aggressive interventions or shift to palliative or hospice care. The challenge lies in balancing medical capability with humane care.
Ethical dilemma:
A terminally ill patient is unresponsive, but their family insists on ādoing everything possible.ā Meanwhile, the healthcare team believes continued treatment is causing suffering without benefit.
Key ethical tensions:
Nursing consideration:
Nurses play a vital role in communicating with families, advocating for patient dignity, and ensuring that comfort, not just survival, becomes the focus when cure is no longer possible.
Ethical issue: Euthanasia refers to the deliberate act of ending a patientās life to relieve suffering. It can be:
While some countries legally permit euthanasia, in many cultures and legal systemsāincluding Indiaāit remains ethically controversial and legally restricted.
Ethical dilemma:
A patient in excruciating pain begs the nurse to help end their life. The nurse sympathizes deeply but is bound by law and professional ethics.
Key ethical debates:
Nursing consideration:
Even when not performing euthanasia, nurses must support patients experiencing existential suffering, advocate for better pain management, and provide nonjudgmental emotional care, all while maintaining professional boundaries and legal compliance.
Ethical issue: A DNR order instructs healthcare teams not to perform cardiopulmonary resuscitation (CPR) if a patientās heart stops. While it preserves a patientās right to avoid unwanted aggressive interventions, it can be emotionally and ethically difficult for caregivers and families.
Ethical dilemma:
A nurse is caring for an elderly patient with a signed DNR order. The patientās heart suddenly stops. The nurse hesitatesāshould they honor the DNR or attempt CPR, fearing guilt or legal consequence?
Key ethical tensions:
Nursing consideration:
Nurses must be well-versed in DNR protocols, be comfortable discussing end-of-life preferences, and advocate for advance care planning so patients and families understand what DNR means.
Across these topics, several key ethical principles often come into conflict:
End-of-life decisions are rarely simpleābut when made with integrity, compassion, and ethical clarity, they can be deeply healing, even in sorrow.
Nurses are not just caregivers in the final hoursāthey are witnesses, advocates, and ethical stewards who ensure that patients die:
They must:
End-of-life care is not about giving up. Itās about shifting from fighting death to embracing peace. Nurses, perhaps more than anyone, understand that how a person dies matters just as much as how they lived.
āEthical end-of-life care does not try to outrun deathāit walks beside it, gently, with grace, wisdom, and love.ā
In facing these deeply human decisions, nurses uphold not only professional ethicsābut the sacred responsibility of being present, being kind, and being brave in the face of finality.
Balancing safety, dignity, and freedom in the care of the vulnerable mind
Mental health care presents unique ethical challenges that differ from general medical care. In psychiatric settings, patients may experience altered reality, impaired judgment, and limited insight into their condition, making decisions around autonomy, consent, and safety particularly complex. Nurses are not only caregivers in this settingāthey are protectors, advocates, and ethical decision-makers in a field where human rights and clinical care constantly intersect.
The dilemmas in psychiatric care often arise when what is therapeutically best may conflict with what the patient wants or refuses. Navigating these situations requires delicate balance, empathy, and ethical courage.
Ethical issue: Psychiatric patients may refuse medications, therapy, or hospitalization even when clinically necessary. This is referred to as non-compliance or non-adherence, often seen in conditions like schizophrenia, bipolar disorder, or severe depression.
Ethical dilemma:
A patient diagnosed with paranoid schizophrenia refuses antipsychotic medication due to delusions. The nurse recognizes the danger of untreated psychosis but also acknowledges the patientās legal right to refuse treatment.
Core ethical tension:
Nursing consideration:
Nurses must assess decision-making capacity, provide therapeutic education, build trusting relationships, and use least-restrictive alternatives before resorting to coercion or legal measures. Compassionate communication and motivational interviewing can be effective in encouraging adherence without force.
Ethical issue: Physical restraint and seclusion are sometimes used to manage violent, self-injurious, or uncontrollably agitated patients. While these measures aim to protect, they can also cause psychological trauma, physical harm, and ethical unease.
Ethical dilemma:
A severely agitated patient begins physically assaulting staff and other patients. The nurse must act quickly to ensure safetyābut wonders whether applying restraint violates the patientās dignity or triggers past trauma.
Core ethical tensions:
Nursing consideration:
The use of restraint or seclusion must always be a last resort, justified by immediate risk, and guided by clear protocols. It should be:
Nurses must continuously advocate for de-escalation techniques and therapeutic alternatives, emphasizing trauma-informed care.
Ethical issue: Patients with mental illness, especially those with major depression, eating disorders, or delusions, may refuse food or fluids, risking severe malnutrition or death.
Ethical dilemma:
A patient with catatonic depression refuses to eat for days. The team considers nasogastric feeding under physical restraintābut is this force-feeding ethically justified? Or should the refusal be respected as an autonomous act?
Core ethical tensions:
Nursing consideration:
Nurses must:
Nursing care should remain nonjudgmental, patient-centered, and deeply empathetic, acknowledging the emotional turmoil behind food refusal.
Psychiatric settings uniquely challenge nurses to balance competing ethical demands: freedom and structure, respect and safety, consent and control. The challenge is not only medical but profoundly moralārequiring reflection, discussion, and deep human understanding.
Key principles in conflict include:
In psychiatric care, nurses are not merely observersāthey are the daily decision-makers at the intersection of empathy, ethics, and patient rights. Their role includes:
Psychiatric care demands more than clinical skillāit calls for moral strength and emotional intelligence. Patients who are confused, frightened, or self-destructive may test a nurseās limitsābut they also depend on the nurse to see their humanity beneath the illness.
āTo practice ethically in psychiatry is to protect both freedom and safetyāto listen even when the words are unclear, and to care even when consent is absent.ā
With every restraint avoided, every trust built, and every life preserved, nurses honor the deepest values of psychiatric care: respect, compassion, and ethical healing.
Mr. Suresh, a 27-year-old male diagnosed with paranoid schizophrenia, is hospitalized after experiencing a psychotic relapse. Although he was initially cooperative, he now refuses to take his antipsychotic medication, claiming the pills are part of a government conspiracy to control his mind. His refusal is worsening his paranoia, and he is becoming increasingly agitated.
Mrs. Anjali, a 45-year-old woman with bipolar disorder in a manic episode, becomes physically aggressive toward other patients and staff. She throws objects, pushes another patient, and is non-responsive to verbal de-escalation. The situation escalates to a point where physical restraint is being considered.
Mr. Rafiq, a 38-year-old man suffering from severe depression with psychotic features, has refused to eat or drink for over three days, stating that he ādoesnāt deserve to live.ā Despite attempts by the nursing staff to encourage him, he remains withdrawn, passive, and continues to reject nutrition.
Each case shows the delicate balance between autonomy and protection, between doing what is right and what is kind. Nurses in psychiatric care walk a moral tightrope, and their actions must always be guided by:
āIn psychiatric ethics, itās not just what you doāitās how, why, and for whom you do it that matters most.ā
Case:
A 19-year-old unmarried college student, Meera, seeks a medical abortion in the early first trimester. She is emotionally distressed but clear in her decision. The nurse assigned to her care is personally opposed to abortion due to religious beliefs and feels conflicted about assisting.
Ethical dilemma:
Nursing considerations:
Case:
A couple is informed their unborn baby has spina bifida. A fetal surgery is available but poses a significant risk to the motherās health and future fertility. The mother consents, but her partner is worried and suggests waiting.
Ethical dilemma:
Nursing considerations:
Case:
During IVF, a woman becomes pregnant with quadruplets. Doctors recommend selective reduction to twin pregnancy to ensure survival. The woman is unsure, citing religious and ethical distress about ending fetal life.
Ethical dilemma:
Nursing considerations:
Case:
A pregnant woman with substance use disorder continues to smoke and drink despite counseling. Her fetus is showing signs of growth restriction. The nurse is concerned and considers reporting her to authorities.
Ethical dilemma:
Nursing considerations:
Case:
Mr. Ramesh, a 68-year-old man with terminal ALS, requests assisted euthanasia, stating he wants to die with dignity. In his country, euthanasia is illegal. His nurse empathizes but knows she cannot assist.
Ethical dilemma:
Nursing considerations:
Case:
Mrs. Kulkarni, an 82-year-old woman with end-stage heart failure, has a DNR order on file. During her hospital stay, she goes into cardiac arrest. Her son, unaware of the DNR, pleads for resuscitation.
Ethical dilemma:
Nursing considerations:
Case:
A young man in a vegetative state is being kept alive on life support for over a year. His parents insist on continuing all measures, while the ethics committee recommends withdrawal of futile treatment.
Ethical dilemma:
Nursing considerations:
Case:
A mentally disabled adult woman is brought to the clinic by her guardian who demands permanent contraception. The woman does not understand the procedure or its consequences.
Ethical dilemma:
Nursing considerations:
Case:
A single woman in her 40s seeks IVF using donor sperm. The clinic is hesitant due to her marital status and age. Some staff members express personal discomfort with non-traditional parenting.
Ethical dilemma:
Nursing considerations: