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Ethical Dilemmas in Nursing: Four Scenarios

Scenario 1: Incompetence among Peers

Step 1: After reading all Required Reading Assignments, choose one of the following topics (scenarios) for your post (remember this is not a political discussion).

Scenario 1:  Incompetence among Peers

The nurse caring for clients to which she was assigned finds significant differences in the assessment findings from the preceding nurse in both assessment and documentation. This has been true for the past month when this nurse has assumed responsibility for Nurse B’s clients. She is concerned about the findings, the threat to patient safety, and the need to protect and support staff.

a.  What are the ethical principles of concern in this situation?

b.  What actions would you take to address this scenario? Support your decision based on theory and ethical standard.

c.  Relate this to a real-world experience.

Scenario 2:  Informed Consent

The nurse has just witnessed the physician obtain consent from a client for a new procedure. The nurse, who has worked in this specialty area for a long time and is considered to have expertise in the area, noted that there were disclosures about the procedure that the doctor did not make. In addition, the client has a diagnosed mental deficit and the family was not present for the discussion. The family has asked the nurse to explain what was said since the patient told the family he signed the form but “I didn’t really know what he was talking about.”  

a.  What are the ethical principles of concern in this situation?

b.  What actions would you take to address this scenario? Support your decision based on theory and ethical standard.

c.  Relate this to a real-world experience.

Scenario 3:  Failure to Disclose a Medical Condition

The nurse is caring for a client who had been surrounded by “caring family” who have requested that the physician and staff not share with the client that he is dying. It is estimated that he has less than 1-2 months to live. The nurse has reviewed the client’s chart and diagnoses and knows this to be a fact. The patient has said to the nurse that he “suspects that something is really wrong, and I have this feeling that I may not live much longer.” Does the nurse honor the request of the family or honor the patient’s right to know?

a.  What are the ethical principles of concern in this situation?

b.  What actions would you take to address this scenario? Support your decision based on theory and ethical standard.

c.  Relate this to a real-world experience.

Scenario 4:  Bioethical Issue:  Down’s syndrome CRISPR/Cas9 Genetic Treatment (Eliminating Genetic Disease through the Manipulation of DNA)

The nurse is working in an OB prenatal center in a major teaching center. She meets the Joneses, who have been told that they have a 50% chance of having a child that is severely affected by Down’s Syndrome. They have been given the choice of abortion or trying a new technique being used in early pregnancy in which the doctor attempts to effect a change in the embryos early in development.  The Joneses are attempting to decide what to do. They ask what you, the nurse, would do?  

a.  What are the ethical principles of concern in this situation?

b.  What actions would you take to address this scenario?  Support your decision based on theory and ethical standard.

c.  Relate this to a real-world experience.

Step 2:  Write a 150-word summary of your response to one of the four scenarios, including information that responds to the questions. You must cite, in APA format, at least two references within the summary and include these in an APA reference list. You must also include a title page that includes your name and student ID, course number and name, date, and title of the assignment indicating which of the two topics you chose.

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