Nurses constantly experience ethical dilemmas and legal issues during the course of their profession. These experiences are very challenging as they compel nurses to make immediate ethical and legal choices based on the interest of patients, relatives or physicians. Under certain circumstances, nurses find themselves in great dilemma in trying to balance legal and ethical issues regarding certain medical procedures.
Though there are codes of ethics and legal responsibilities that nurses must adhere to, the needs of patients are very complex in that, they may result into ethical and legal conflicts. “In decision-making, the nurses’ choices and actions should reflect best clinical practice, be the right things to do morally, and be within the legal scope of policies, procedures, and practice acts” (Guido, 2009, p. 12). Hence, ethical and legal issues bind nurses in their profession. This essay analyses ethical and legal aspects of two case studies in nursing.
The first case study is an ethical issue, which falls under dilemma of autonomy. According to Smith, “…dilemma of autonomy occurs when individuals other than the patient must determine, or attempt to determine, what’s best for the patient” (2005, p. 75). Nursing ethics demands that the patient act autonomously in making informed choices about medication or other health related issues.
In this situation, the patient had the right to deny further chemotherapy; may be because the medications were not effective or the patient had lost hope of recovering. At least, these were indications of the patient’s dissatisfaction with chemotherapy and it was ethically right for the boy to decline any further chemotherapy administration.
In contrast to the patient’s interest, the physician, the nurse and the parents acted in beneficence. In this case, dilemma of beneficence ensued as the physician, patient and family differed on the issue of medication. “Dilemmas of beneficence occur when health care providers, the patient, and/or family members disagree about what course of action is in the patient’s best interest” (Leddy & Pepper, 1993, p. 54).
The action of beneficence is an ethical aspect that requires nurses to act in the interest of the patient. Prescription of new medication by the physician with the consent of parents and compliance of the nurse to administer medication, though done against the interests of the patient, highlighted an ethical act of beneficence.
The second case study has both ethical and legal aspects regarding nursing profession. In this case, the nurse failed to act in ‘nonmaleficence’ in order to protect the patient against harm by injecting antidepressants to every new resident, but instead follow physician’s instructions blindly.
The nurse also acted contrary to the ethical concept of veracity by lying to the patients on the kind of medication prescribed to them. The ethical principle of veracity “requires the health care provider to tell the truth and not intentionally deceive or mislead clients,” (Guido, 2009, p. 21). The nurse acted unethically by failing to comply with the two ethical principles viz. nonmaleficence and veracity.
The legal aspect of the second case is that, the nurse failed to comply with the legal responsibility of administering medication. Edwards argues that, “…nurses should always observe five rights when administering medication to the patients, that is right medicine, to the right patient, in the right dose, through the right route, and at the right time” (2007, p. 9).
In this case, the nurse made medication errors by giving every patient antidepressant, which was wrong medication to the wrong patients. The nurse is therefore liable to lawsuit due to medication errors.