All human beings have the right to practice any religion they so choose. Patients have rights regarding any and all care or treatments they receive while hospitalized. The ethical dilemma comes into play when as in this scenario, a viable human being is unable to make decisions regarding their care due to illness or injury and must rely on someone else to make those choices for them.
Obviously this young man 26 years of age thought he had his whole life ahead of him. He was living that life as though the choices he would make that evening, to refrain from wearing a seat belt while speeding down a road he had probably driven thousands of times, would make no difference. Unfortunately his situation changed in the blink of an eye. He was engaged to be married, he had plans and dreams not unlike you and I do, and then by a twist of fate he is reduced to an unconscious being reliant on others to sustain his life or make decisions that would alter it forever.Unresponsive to the world and those in it whom he loves, he now cannot tell us what he desires.
Understandably his mother and the woman he is engaged to be married to love and want what is best for him. As his nurse you are faced with a very tough decision when the result of lab tests reveal he needs a blood transfusion. Through conflict at his bedside between his mother and girlfriend, you are made aware the patient has been raised as a Jehovah’s Witness. Jehovah’s Witnesses believe that God wants them to abstain from blood, They believe if they try to save their life (by means of blood transfusions) they will lose it, and if they lose their life for Jesus (by not receiving a transfusion), this will enable them to have eternal life in God’s kingdom (“Blood Transfusions,” 2016). “They see it as a test of sorts from Jesus, if they give up their life for him, He will give them life eternal in return” (“Blood Transfusions,” 2016).
As a nurse my duty lies with ensuring the well being of the patient entrusted to my care. The first thing I would do in this situation is protect the patient from harm. I would insist the controversy be taken elsewhere suggest and escort both parties from the room. Establishment of a private area for further discussion away from the patient’s hearing. He may be unable to respond, but he can still hear what is said in his room.
Everyone has the freedom to believe what they want, if however they become incapacitated and have no written directives on file regarding what to do in cases of emergency, nurses need to know and should act following the “Code of Ethics for Nurses.” The code is set forth by the American Nurses Association, and the number one provision in that code is to “practice with compassion and respect for dignity, worth, and uniqueness of every individual” (“Code of Ethics,” 2016). The ethical principle of human value comes into play. The patient has a right to be valued. The family and his wife-to-be both have insight into what they think the patient would want in this situation. The decision that will effect the life of this human being cannot be determined unequivocally by his family alone.
“There are standards of care for all medical interventions that have been set by professional organizations, based on best available evidence” (“Ethical Dilemmas,” 2016). Every situation brings with it unique circumstances, and the need to be evaluated by everyone who has the patient’s best interest in mind. Focusing on the patient’s beliefs and principles and acting upon what the patient would want is a much better way to come to a decision and will lessen the animosity between the patient’s loved ones (“Ethical Dilemmas,” 2016). All members of the health care team should work together to decide what the best decision is when ethical concerns arise (“Ethical Dilemmas,” 2016). Defining the values and moral positions of the patient, family, and health care team members helps in making decisions for quality patient care (“Ethical Dilemmas,” 2016). I would also want to have a member of the ethics committee from the facility in which I work to consult with family and other health care team members to ensure the best decision is made and the patient is not harmed in any way. It is my responsibility to identify and respond to matters of moral principle regarding patients under my care, but collaboration with someone well versed in ethical issues is needed to ensure dignity and respect is provided to the patient and their family.
“An inherent privilege of nursing practice – and one of its greatest challenges – is that every nurse is brought close to the most profound aspects of life – birth, suffering, and death – to grief, pain, and joy. It takes courage to be a nurse” (Cowen & Moorhead, 2011).
Blood transfusions. (2016). The Jehovahs Witnesses. Retrieved from http://thejehovahswitnesses.org/blood-transfusions.php
Code of Ethics for nurses. (2016). American Nurses Association. Retrieved fromhttp://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses
Cowen, P. S., & Moorhead, S. (2011). Current issues in nursing. (8th ed.). St. Louis, MO: Mosby.
What do I do now? Ethical dilemmas in nursing and health care. (2013). Indiana State Nurses Association, 39(2), 5-12. Retrieved fromhttp://connection.ebscohost.com/c/articles/85651572/what-do-do-now-ethical-dilemmas-nursing-health-care
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