Nurses face more and more ethical dilemmas during their practice nowadays, especially when they are taking care of the patient at end of life stage. The case study demonstrates an ethical dilemma when nursing staff are taking care of an end stage aggressive prostate cancer patient Mr Green who expressed the suicide thoughts to one of the nurses and ask that nurse keep secret for him in Brisbane, QLD, Australia.
Ethical dilemma identification
The ethical dilemma is identified as “if the nursing staff should tell other health care team members about patient's suicide attempt without patient's consent”.
To better solving this case and making the best moral decision, the ethical theory, the ethical principles and the Australian nurses' code of ethics values statement, the associated literature relative with this case are analyzed before the decision making.
Ethical decision making
After consider all of the above factors, in this case, the best ethical decision for the patient is that the nurse share the information of Mr Green's suicide attempt with other health care professionals.
In Mr Green's case, the nurse chose to share the information of Mr Green's suicide attempt with other health care professionals. The nursing team followed the self-harm and suicide protocol of the hospital strictly, they maintained the effective communication with Mr Green, identified the factors which cause patient's suicide attempt, provided the appropriate nursing intervention to deal will these risk factors and collaborated with other health care professionals to prefect the further care. The patient transferred to a palliative care service with no sign of suicide attempt and other self-harm behaviors and passed away peacefully 76 days after discharged with his relatives and pastors accompany.
Case Study Examples
Case studies exploring the following ethical and legal issues in clinical practice can be found on the UK Clinical Ethics Network website:
- Who should get an intensive care bed?
- A competent patient refuses treatment
- Breaching confidentiality to protect others.
Key legal and ethical issues are highlighted in the following short video clips provided on the Ministry of Ethics website.
- Police & RTA Consent (consent, incapacity)
- Non-Accidental Injury (Child protection, breach of confidentiality in public interest)
- HIV Part 1 (Informed consent, confidentiality and breach in public interest, duty of care)
- Blood transfusion (consent, confidentiality, incapacity)
- Needlestick Injury (consent, confidentiality, incapacity)
- 14 year old and contraception (consent, confidentiality)
- Dealing with authorities (confidentiality and breach of confidentiality).
These case studies have been designed for doctors, although the scenarios also have implications for advanced practitioners. You might want to discuss these clips with your colleagues. Please note that English law is mainly used in these videos, the law differs in Scotland in consent for children and young people and incapacity. There are also restrictions in the procedures that can be carried out by non-medically registered staff for people in police custody. This relates to what is admissable in court as evidence.