Nurses are under an ethical obligation to contact directly with patients and other people in the hospital. Furthermore, while working with patients, nurses face difficult issues whereby they rely on the professional ethics that can assist them in finding appropriate solutions. Relying on the experience, a clinical specialist from the American Association of College Nursing, Marian Altman claims that nurses encounter ethical dilemmas daily in their working departments. However, nurses are under obligation to comply with professional ethics in their decisions that ensure solving various complicated issues. Accordingly, there are penalties such as legal charges for the nurses’ noncompliance with such ethical obligations (Reamer, 2018). Hence, being distressed by ethical dilemmas, the nurses become unable to act accordingly to their knowledge on performing correctly because of their attempts to prevent more serious problems in addition to the current one. As an ethical dilemma that is common to nurses, the issue of disclosing medical conditions requires addressing because of its possible negative impact on patients, nurses, and other people involved in the care process.
Description of the Dilemma
A nurse is under obligation to tell the patients and the patients’ families the truth about the patients’ health status and medication, according to the ethics stated by the American Nurses Association. Also, due to professional ethics, nurses are responsible for safeguarding the health and welfare of patients. Thus, every nurse ends up with a dilemma when there is a necessity to inform a patient about his or her critical condition that can affect his or her health, and thus life, negatively. As a result, the nurse becomes distressed since he or she has to perform an ethical responsibility in such a situation (Griffith & Tengnah, 2017). For example, in the case of a patient with a disease such as cancer that is at an advanced stage eventually leading to death, the nurse faces difficulties with telling such a patient the truth. If such patients receive the information concerning their life-threatening disease, they may end up committing suicide or making drastic decisions making the current situation even worse. Altman says that sometimes families request to keep information about the patients’ conditions secret from the patients; however, the nurse must consider the right of the patient to know the truth. Disclosing medical conditions becomes a great dilemma faced by the nurse because it can bring more harm than the intended positive outcome for the patient.
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Impact on Patients, Nursing Practice, and Research Process
The dilemma of disclosing medical conditions affects the patients, nurses, and the research process as well. In general, the impact on all parties may be positive or negative. Consequently, disclosing the vital information regarding their health may make the patients either weaker or stronger in terms of dealing with the disease. Sometimes, after becoming aware of their imminent death, the patients refuse to take medication and become arrogant. In some cases, the patients end up with being drug addicts or committing suicide. According to research made by medics in India, 54 patients (27 women and 27 men among them) in the care unit of oncology in Kasturba hospital have lost hope and suicidal thoughts as well (Grace, Innes, Patton, & Stockhausen, 2017). However, other patients, with very few of them-being told the truth, take it to their advantage and follow their medication closely in order to improve their health and thus save themselves from quick or early death. Other patients, unaware of the truth concerning their imminent death, end up worse because they continue living with the mistakes that negatively affect their health. On the contrary, many patients who come to know the bitter truth receive the chance to prevent them from causing further damage to their health due to the loss of hope.
Most nurses subjected to the presented dilemma result in being distressed. The nurses are in fear of facing legal charges, in case they dispute the patient’s right of knowing the truth. According to the ethical obligations, the nurse has to explain to the family as well as the patient the medical conditions. However, the nurse gets distressed due to his or her obligation to safeguard the welfare of the patient, despite the circumstances existed (Pozgar, 2018). Thus, some nurses may have the courage to tell the patient the truth; other cases require the nurse to avoid telling the patient about his or her condition, as advised by the family of such a patient. According to the American Nurses Association, a nurse should be loyal to the doctors, patients, and patients’ families. Consequently, the nurse is in a difficult situation on whether to defile the loyalty ethic and embrace the truthful ethic or otherwise embrace loyalty. The dilemma makes the nurse perceive his or her profession as considerable pressure because of considering it very hard due to his or her responsibility for the decision-making required. According to Altman, few nurses who are sufficiently strong will tell the bitter truth to the victims while the others who face difficulty in telling the truth are unable to do it since both are practicing their ethical obligations.
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The research process, on the other hand, can face difficulties as the result of inadequate information gathered. If particular research concerns a disease affecting a certain patient (S.Tong, W.Tong, & Low, 2018), there is the requirement to receive the permission for disclosing such information. If the patient or the patient’s family orders that the information remains secret, the research fails (Tong et al., 2018). The Canadian Nurses Association claims that all patients have a right to safeguard their information basing on the Health Information Privacy Statement. Research may have a purpose of promoting better health and health care; however, the confidentiality requirement prevents the research from being successful.
A research question arising from the dilemma is: How can nurses convince patients, their families, as well as every person affected, to opt for disclosing the patient’s medical information? However, when addressing such an ethical issue, a nurse has to recognize the situation leading to an ethical dilemma, formulate smaller parts that form the major dilemma to find out more information about the dilemma and the regulations on it, analyze the dilemma critically, and finally gain sufficient justification on the decision proposed. Information technology has an advantage in disclosing medical information dilemma because the computers allow storing correct and accurate data of the patients. If a research concerns a patient’s illness, the data stored by a computer can ensure finding out more about the illness or the research topic (Krautscheid, 2017); computers store messages from a long period of time permanently.
During their everyday activities in hospital, nurses have to deal with ethical dilemmas that lead to distress. The dilemmas should serve to provide conditions conducive to the nurses at work. The rules of law regarding the ethical professions should be flexible to enable the nurses to make the most appropriate decisions. Thus, the medical department should also employ guidance and counseling staff to provide advice and guidance to families and patients upon the ways to deal with the medical information given by nurses (Griffith & Tengnah, 2017). Ethical dilemmas can negatively impact the quality of services offered as health-wise in hospitals; therefore, they need the solutions as soon as possible.