Ethical issues in nursing contain all the tough decisions the healthcare profession faces each day in caring for society. Some are rooted in time and will never change, while others are brought about by new changes in technology. These are the most prevalent issues nurses face.  

Top 10 Most Prevalent Ethical Issues In Nursing

Nursing is a field where you are forced to make tough decisions at a moment’s notice. Some days may go smoothly, but others can be trying. This is one of the main reasons that careers in nursing fluctuate and new job opportunities open consistently. Many nurses struggle with the stressful work life. However, nurses support each other through these ethical obligations.

Life and death decisions are tough on everyone, whether you’re the patient, a loved one, or a healthcare provider. In nursing school, students study ethical issues in nursing in order to hold down the fundamental integrity of the field and provide the best care to patients and their communities. Not every nurse, or person, approaches choices in the same way. And in some scenarios, there is no right or wrong answer.

What Constitutes an Ethical Issue?

This noble field may face hard choices at unexpected times in all departments and facilities. It is unavoidable, but the ethical dilemmas nurses face can change with time. Ethical issues can concern technological advancements, such as keeping people alive longer. Advancements have been made to help people live longer, but not always better lives.

Nurses want to help people, ease their suffering, and restore them to health. Ethical issues spring up when it’s hard to say what is the right thing to do.

The Nursing Code of Ethics

Created to help nurses weave through some of the ethical issues they face in their work, the nursing code of ethics was developed by the American Nurses Association (ANA). The ANA continues to create policies and reports that address issues in ethics and human rights at the national and state level as well as internationally.

“The Code,” as it is called in the nursing field, is a tool nurses use to make these tough decisions – both now and in the future. The Code is updated regularly to reflect changes in the healthcare setting, and it delves into the foundational values of nursing that don’t change. For example, it always aligns nurses with providing respectful and humane care by:

  • Providing ethical values, duties, and obligations of those in the profession
  • Serving as the nursing industry’s nonnegotiable ethical standard
  • Expressing an understanding and vital commitment to people everywhere

This ethical code is extremely important in today’s healthcare system. It reiterated the values and ethical commitments nurses make by choosing this profession, lays down the boundaries of duty andt loyalty to patients, and delves into duties nurses face beyond average encounters with patients.

Each nurse enters into this social contract and agrees to follow the Code, promising to provide safe, high-quality health care for everyone and anyone who needs help. This promise binds nurses together in their mission, no matter what challenges the modern healthcare system throws their way now or in the future.

10 Most Common Ethical Issues in Nursing

Dealing with ethical issues will always be a factor in the field of nursing. The career is full of tough decisions and caring for other people. While the industry has changed in recent years due to modern healthcare, some ethical issues remain the same. Here are the 10 most common ethical issues in nursing today.

Obtaining Informed Consent

Before a medical procedure takes place, it is the nurse’s responsibility to obtain informed consent. Every patient has a right to know the risks and benefits involved with a procedure in order to make an informed decision as to proceeding or denying treatment. It’s the nurse’s job to make sure each patient understands this and maintains the right of the patient to make this decision.

Problems come up with a patient is incapacitated or is not able to make the decisions that need to be made. Families typically take over and speak on the patient’s behalf (which can lead to other ethical dilemmas), but not everyone has a caretaker looking out for their best interests.

Other times, families and patients feel more comfortable asking nurses what the doctor meant because they can speak to them in plain language. How much the nurse conveys in this scenario is also an ethical issue, as some nurses may not be ready to partake in this discussion.

Telling the Truth

Another dilemma nurses face is when to tell the truth. Nurses share the status of a patient’s condition with family members and explain what treatments or medications can be used to help, but sometimes family members don’t want the patient to know themselves. Patients trust nurses to do what’s best for them, and they have a right to know the details, but not all situations are so black and white.

Other issues concern how much people really want to know, and how well they can face harsh realities. Does a patient really want to know they may die at any moment, or will this only further complicate their condition? Nurses need to make that call.

Patient Confidentiality

Patients trust nurses and other healthcare providers to take care of them, but also to keep their medical information safe.

Healthcare professionals should never disclose sensitive information on a patient’s health or history, and patient confidentiality says they cannot talk about your medical issues with anyone who is not involved. Unless a patient deems a family member in-the-know, a health care provider cannot offer this information up.

Nurses need to respect patient autonomy, even when questioned by law enforcement officials.

Disclosing Medical Conditions

Sometimes families or doctors prefer not to tell a patient about their medical diagnosis, and some people don’t want to know the harsh reality of their mortality.

Along the lines of telling the truth, nurses face ethical dilemmas in disclosing medical conditions. They need to respect the privacy of the patient and consider their right to know about their own condition without broadcasting the information to the world, but they also need to remain faithful to their colleagues.

Work Environment

The healthcare industry is known for its stressful work environment, where professionals work extremely long shifts that sometimes span weeks at a time before they get a day off. The work keeps them constantly busy, which doesn’t allow much time to take care of yourself.

Many nurses are overworked, hospitals are understaffed, and the pay is not always the greatest. Prioritizing needs and families can add stress to an already stressful work setting.

There are also issues with workplace bullying in nursing. The hierarchy structure in many healthcare workplaces is criticized for not encouraging discussions and collaboration. Healthcare can be competitive, but nurses need to work as a team along with doctors.

Lines can also blur between patients and co-workers. Since nurses spend all their time in their work setting, they can form personal relationships with the people near them. Technology and social media today can further blur the line between personal and professional behavior.

Incompetence Among Peers

Another issue in healthcare are when another healthcare member shows incompetence. You may feel the need to report them out of necessity to keep patients safe, but when staffing is already low, many people stay silent. Do you protect the staff member from losing their job or a patient from malpractice? Competing obligations can require creative solutions you may not have considered.

End-of-life Decision-making

Technology has extended the life of the population, but not the quality. Nurses need to decide when technological interventions should be used and when hospice is best. Patients want to reserve dignity, some even have set plans for their end-of-life care that should be respected.

If death is harder for you, Five Wishes offers a guide to aid in these discussions.

Genetic Testing

Genetic testing technology is new, and the healthcare workforce will eventually catch up to tackle these issues.  Bioethics bring concerns of the enormous implications we could be causing whereas issues with genetic testing surround the availability of benefits to those with money.

Some nurses may have also graduated before genomics and genetic testing was common, or patients may try an online genetic profile that put healthcare providers in awkward positions.

Conflicts of Interest

Sometimes more than one ethical issue brings up a conflict of interest where you need to decide whether to back up your co-workers (doctors and other nurses on your team) or your patient.

Physician-Assisted Suicide

Nurses and doctors may be asked by terminally ill patients to end their life. If the quality of life isn’t good and the patient is on their deathbed, they may choose to end it all. Sometimes patients don’t have the availability or means to carry out the task and search for help. But when you’ve made an oath to care for people, how can you kill them? Is it more humane to keep them living until the end or follow their wishes? Issues are not always easy.

Other Nursing Ethics Concerns

Cultural diversity can play a role in caring for people of various backgrounds, values, and traditions. One person’s ritual may not be deemed acceptable by another’s religious views, and nurses need to balance the needs of everyone in their care.

How to Deal With Ethical Issues

Ethical issues in nursing can be tough, but they’re not going anywhere. If you need help with an ethical dilemma, the Hastings Center and the ANA have several helpful resources for nursing. Education and collaboration with other nurses may help you make hard decisions.

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