Ethical dilemmas are more frequent in health care, primarily because of the remarkable advances in medicine and technology. Health practitioners are now able to diagnose and treat illnesses that were lethal a decade ago. The growing understanding of human genetics has also created new and unique dilemmas. Concerns about patient choice, quality of life, and access to health care are also becoming more frequent and complex. As a result, health care professionals face an increasing number of issues for ethical decision-making.
Some research suggests that nurses do not always have a clear understanding of their role in ethical concerns. They may not know how ethical decisions are made and may feel powerless when faced with ethical dilemmas (Zink, & Titus 1996). Decision makers of healthcare practices find themselves in ethical dilemmas when they must choose between courses of action that are based on different moral frameworks, varying organizational philosophies, or conflicting duties or moral principles (Darr, 1997). Although in some cases reasonable people can be strongly committed to different courses of action, in most ethical dilemmas the various players can reach consensus despite cultural or religious differences (Darr, 1997). Decisions of this nature are most times painful and much contemplation is required. Differing ethical theories do not necessarily conflict, and people following diverse philosophies may reach the same conclusions via different reasoning (Darr, 1997). People have opinions and these opinions are what give people a way to express themselves. If people did not have differences of opinions about particular situation, there would be no ethical dilemma (Ecker, 1996). More and more people have recognized the importance of bioethics in health care settings. Ethics committees are an important resource for patients and providers in all healthcare settings, including home health, long-term care, psychiatric facilities, clinics, and hospitals (Beauchamp & Childress, 1994). Ethics committees focus on education, policy development, and clinical consultation on ethical issues. They review decisions and develop policies and procedures about important issues such as informed consent and limitation of treatment.
Nurses and Decisions about Ethical Dilemmas
Ethical decisions are inherent in the daily practice of nurses and other healthcare practitioners and are critical to the care being delivered to patients. Several notable studies have been conducted in recent years about nurses and ethical practice. For example, a study done by the American Nurses Association found that 79 percent of those responding said they faced ethical issues daily or weekly (Zink, & Titus, 1997). A high percentage of nurses said they faced ethical dilemmas “frequently.” Other studies document areas in which nursing needs to strengthen its role in ethical practice. One study revealed that nurses have a relatively low level of ethical sensitivity to issues other than patient autonomy. The study found that approximately twenty-five (25 %) percent of a sample of nurses failed to define or defined incorrectly the term ethical dilemma. Of those who did define it correctly, only forty (40%) percent used a conceptual definition (Oddi, Cassidy, & Fisher, 1995). Others defined ethical dilemmas in specific …