Ethical Dilemma in Health Care

Table of Contents

Introduction

The development of codes of ethics resulted in certain competence expected from health care professionals in medical practice and research. An advanced nursing practitioner should be aware of ethical dilemmas that might occur on an everyday basis or in the process of conducting a study during which research demands might conflict with the rights of participants. Polit and Beck (2016) note that an international ethics code is required by some nurse ethicists for nursing studies, but most of the countries have their own codes established by medical professionals or the government. The purpose of this paper is to identify and describe an ethical dilemma topic, compose a research question related to it, and formulate a position on this dilemma discussing the advantages and disadvantages that technology might have on it.

Selection and Description of Ethical Dilemma

Health care practice provides a great number of real-life cases with certain moral issues, which can be utilized for discussion and reflection in order to get solutions or answers. Each case involves not only health care professionals such as physicians and nurses but also the patient’s family and social workers who also participate in solving the ethical dilemma. Some researchers state that the expertise to solve ethical dilemmas requires an understanding of dialogue, Socratic epistemology, and practical rationality (Stolper, Molewijk, & Widdershoven, 2016). In some cases, nurses witness trauma and suffering that their patients have to go through which leads to compassion fatigue. In this case, a nurse is stressed due to the firsthand experiences of pain and suffering of both patients and family members. Compassion fatigue is one of the many ethical issues that a nurse may face, and it can threaten ethical practice in the nursing profession as explored in this paper.

Ethical Dilemma Description and Impact

In the course of their work, nurses may have firsthand experience of the nature and intensity of suffering that patients and their family members go through, which may lead to compassion fatigue. According to Pembroke (2015), compassion fatigue is a “state of significant depletion or exhaustion of the nurse’s store of compassion, resulting from repeated activation over time of empathic and sympathetic responses to pain and distress in patients and in loved ones” (p. 120). Cumulatively, a nurse suffering from this kind of fatigue will be drained physically, mentally, and spiritually, thus affecting the effectiveness of executing one’s duties according to the set codes of ethics. Bao and Taliaferro (2015) argue that a nurse suffering from compassion fatigue will perform inadequately and score poorly in providing holistic care. The common characteristics of this condition include irritability, anger, dissatisfaction with work, lack of sympathy and empathy, impaired ability to make critical decisions concerning the care, and the development of posttraumatic stress disorders (PSTD) in prolonged cases (Lachman, 2016). As such, a nurse may not follow the set code of ethics that demands one to be compassionate, empathetic, sympathetic and make the right decisions even under difficult circumstances.

This form of ethical dilemma places patients at risk as nurses suffering from compassion fatigue may make mistakes with serious repercussions. For instance, Lachman (2016) highlights a case of a nurse who made medication errors and led to two deaths within one week. Additionally, patients will be impacted negatively because they may not experience the compassion and empathetic care that they should receive according to nursing ethics. Similarly, compassion fatigue affects the nursing practice negatively as nurses suffering from this problem may not observe the governing principles that dictate how individuals should function within the profession.

The research process on studying the effects of compassion fatigue on the nursing practice and the associated ethical issues may require an interview with nurses who have experienced the condition. However, such caregivers may not be willing to share their stories openly due to the guilt associated with some of the repercussions like errors leading to the death of patients. Ultimately, research on this subject may be hindered due to the lack of critical information from people suffering from compassion fatigue.

A Research Question

Compassion fatigue affects the way nurses carry out their duties, thus influencing the nursing profession negatively. Therefore, a research question may focus on highlighting the different strategies that nurses can use to deal with this problem in the workplace. This way, the outcomes of the research may be useful in addressing some of the ethical issues that nurses have to deal with in the course of their work. The research question, in this case, will be framed as follows: – What strategies can nurses use in dealing with compassion fatigue in the workplace?

Formulation of Dilemma Position

Given the nature of the work environment that nurses operate in, they will inevitably be exposed to traumatic cases, which may trigger compassion fatigue. Therefore, nurses should undergo training on coping strategies as a way of ensuring professionalism in the execution of their duties. One of the effective coping strategies is the principle of equal regard where nurses are expected to love and care for patients the way they do to themselves (Pembroke, 2015). This way, a nurse will not feel emotionally and spiritually drained. The fifth provision of the American Nursing Association (2015) states that the “nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth” (p. 19). Secondly, nurses can employ the principle of equanimity whereby in the process of extending compassion to others, one is not emotionally overwhelmed (Pembroke, 2015). This aspect will create a balance in the way nurses respond to traumatic cases while observing professionalism. In the workplace, the management should create an environment where nurses can derive satisfaction from their work without external stressors like unstable leadership. The culture of caring in the workplace should also be cultivated to ensure that nurses get the necessary support while executing their duties.

The Advantages and Disadvantages of Technology

Nurses can use technology as a strategy for coping with compassion disorder. The Internet has useful resources like meditation strategies that can be employed to clear one’s mind. Additionally, nurses can join online support groups where individuals share their experiences as a coping mechanism. On the other hand, nurses suffering from compassion fatigue may misuse social media due to associated symptoms like anger and irritability. Therefore, one may end up sharing patients’ information through social media as a way of venting, which is a negative coping mechanism.

Conclusion

Compassion fatigue creates an ethical dilemma in the nursing practice, as nurses are required to deal with traumatic cases while observing the set code of ethics. However, with the right coping strategies, both at the personal and organizational level, nurses can strike balance while executing their duties. The research question related to this ethical issue should focus on ways that nurses can use to cope with compassion fatigue. Additionally, technology should be used with caution to deal with this problem.

References

American Nurses Association. (2015). Code of ethics for nurses with interpretative statements. Silver Spring, MD: ANA.

Bao, S., & Taliaferro, D. (2015). Compassion fatigue and psychological capital in nurses working in acute care settings. International Journal for Human Caring, 19(2), 35-40.

Lachman, V. (2016). Compassion fatigue as a threat to ethical practice: Identification, personal and workplace prevention/management strategies. Ethics, Law and Policy, 25(4), 275-278.

Pembroke, N. (2015). Contributions from Christian ethics and Buddhist philosophy to the management of compassion fatigue in nurses. Nursing and Health Sciences, 18(1), 120-124.

Polit, D. F., & Beck, C. T. (2016). Resource manual for nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Stolper, M., Molewijk, B., & Widdershoven, G. (2016). Bioethics education in clinical settings: Theory and practice of the dilemma method of moral case deliberation. BMC Medical Ethics, 17(1), 45-55.

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