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Legal/Ethical Dilemma in Nursing

Introduction

In recent years, nursing professionals are increasingly facing legal/ethical dilemmas on a daily basis irrespective of the area or domain of their practice in healthcare environments. The decisions that these professionals take in the provision of care to patients must take into consideration laws and ethical standards. Consequently, in order to make suitable and fitting decisions, nursing professionals are obliged to demonstrate an all-inclusive comprehension of how legal standards, ethics, and nursing interface (Yakov, Shilo, & Shor, 2010). This paper expounds on an issue involving a pro-choice versus pro-life legal/ethical dilemma.

Situation and Resolution

The scenario revolved around a 21-year old woman who wanted to procure an abortion in a catholic-sponsored health institution. Previous CT scans of the pregnancy had revealed that the baby would be born with a severe head deformity due to some drugs that the woman was advised to take during her fourth month of pregnancy. The woman was in her seventh month of pregnancy, implying that the unborn baby could live if born prematurely. The legal/ethical dilemma for the nursing professional revolved around guaranteeing that the patient’s rights were respected versus preserving the sanctity of life as elaborated in the Nurse Practice Act for the specific state as well as the American Nursing Association (ANA) code of ethics. Additionally, being a catholic-funded healthcare institution, the law was very clear that no abortion was to be procured for whatever reasons unless the life of either the mother or the unborn baby was at risk.

The woman had a right of choice to seek help in the termination of pregnancy as most states in the United States give legal power and authority to the person for what goes on in his or her body. Indeed, available literature demonstrates that “protecting patients’ rights is part of the professional ethics of health care workers” (Yakov et al., 2010, p. 501). Yet, even if known ethical principles demand nurses to respect the decision making of the patient (autonomy) and also to bring about good for the patient (beneficence), the professionals are nevertheless obliged to follow the law or face penalties including termination of employment and license cancellation (Holm & Severinsson, 2014). Components of the ANA code of ethics are clear that nursing professionals should do all what is in their reach to protect and preserve lives, including those of unborn babies (Loon, Vries, van der Weijden, Elwyn, & Widdershoven, 2014). This precisely illuminates the legal/ethical dilemma for the nursing professional who was requested by the patient to assist in terminating the pregnancy.

Available literature demonstrates that “nurses must balance their decisions based on what evidence-based practices dictates, what the law mandates, and what the ethical dilemma calls for” (Loon et al., 2014, p. 541). Drawing from this exposition, the legal/ethical dilemma was resolved by using effective communication skills and conflict resolution strategies to demonstrate to the patient that evidence-based practices have shown that children born with such defects have a high chance of survival. The patient was made to understand that it was for the best interests of her health and consciousness that the pregnancy was carried to term. Overall, the request to assist in procuring the abortion was turned down as the nursing professional was well aware of the fact that violating components of the ANA code of ethics as well as parts of the Nurse Practice Act could result in employment and licensure penalties. As already mentioned, the ethical principles involved in the scenario included beneficence and autonomy.

Channels Used

Effective communication is critical in resolving legal/ethical dilemmas as well as in ensuring adherence and satisfaction with care (O’Hagan et al., 2014). In the case scenario, listening skills and the employment of positive emotions were used to ensure effective communication between the nursing professional and the patient. These skills enabled the establishment of rapport- and relationship-building in the communication process, which in turn facilitated a quick understanding of the issues that revolved around the legal/ethical dilemma.

Interest-based conflict resolution strategy was used to resolve the dilemma. Available literature demonstrates that “interest-based conflict resolution is designed to help people develop win-win solutions using creative and collaborative strategies to satisfy their mutual needs and interests, rather than competing with one another” (Barsky, 2010, p. 164-165). Interprofessional collaboration was done between relevant stakeholders (nursing professional, counselors, and physician) to ensure that the legal/ethical dilemma was resolved from a multi-departmental perspective. Lastly, clear expectations were set to ensure that team members (nursing professional, counselors, physician and patient) developed a constancy of purpose and foresight in the resolution of the legal/ethical dilemma.

Conclusion

This paper has illuminated an issue involving a pro-choice versus pro-life legal/ethical dilemma. From the discussion, it is evident that nursing professionals encounter legal/ethical dilemmas on a daily basis and hence must develop effective strategies for use in resolving the issues and avoiding costly litigation or loss of employment. It is also evident that these professionals must be guided by professional codes of ethical conduct in resolving the dilemmas. Of critical importance is the evaluation of evidence-based practices in ensuring that the decisions reached by parties guarantee the safety of the patient and at the same time shield nurses from employment and licensure penalties.

References

Barsky, A. (2010). A conflict resolution approach to teaching ethical decision making: Bridging conflicting values. Journal of Jewish Communal Service, 85(2/3), 164-169.

Holm, A.L., & Severinsson, E. (2014). Reflections on the ethical dilemmas involved in promoting self-management. Nursing Ethics, 21(4), 402-413.

Loon, M.S.K., Vries, A.D., van der Weijden, T., Elwyn, G., & Widdershoven, G.A.M. (2014). Ethical issues in cardiovascular risk management: Patients’ need nurses’ support. Nursing Ethics, 21(5), 540-553.

O’Hagan, S., Manias, E., Elder, C., Pill, J., Woodward, K.R., McNamara, T…McColl, G. (2014). What counts as effective communication in nursing? Evidence from nurse educators’ and clinicians’ feedback on nurse interactions with simulated patients. Journal of Advanced Nursing, 70(6), 1344-1355.

Yakov, G., Shilo, Y., & Shor, T. (2010). Nurses’ perceptions of ethical issues related to patients’ rights law. Nursing Ethics, 17(4), 501-510.