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Nurses adhere to certain ethical principles when caring for patients. These principles include beneficence which is doing no harm to the patient, maleficence which is doing harm to a patient for positive outcome, justice in allocating care based on need not status and patient autonomy which is respecting the patients right to make health decisions. Conflict with these principles results in an ethical dilemma.
Unsafe Patient to Nurse Ratio
The nurse has an ethical duty to keep her patients safe. An ethical dilemma happens when a nurse finds herself in a situation where she has too many patients and cannot provide adequate care for all of them on her own.
Inappropriate Medication Orders
Giving wrong medication doseages or medication for the wrong illness is unsafe for patients and may lead to death. Nurses can find themselves in an ethical dilemma when they have to challenge a medication order written by a physician.
Nurses often have to call on physicians in situations beyond their scope of practice such as medical emergencies. The nurse finds herself in an ethical dilemma if the physician does not respond and her patient's condition goes from bad to worse.
Nurses float from department to department in the course of their career. When a nurse finds herself in an unfamiliar department and is asked to provide care she is inadequately trained for, she may have to refuse to provide care to avoid making the patient unsafe.
Life Threatening Patient Decisions
Patients sometimes make decisions that are unsafe, such as refusing treatment for a baby, medication or life saving procedures. The nurse finds herself in an ethical dilemma because not giving the needed treatment goes against beneficence and giving it ignores patient autonomy.
- •"Lippincott Manual of Nursing Practice"; Sandra M. Nettina ANP-BC.; 2009