Which situation should the newly licensed nurses identify as an ethical dilemma?

Which situation should the newly licensed nurses identify as an ethical dilemma?

• A. A nurse on a medical-surgical unit demonstrates signs of chemical impairment
• B. A nurse overhears another nurse telling an older adult client that if he doesn't stay in bed, she will have to apply restraints
• C. A family has conflicting feelings about the initiation of enteral tube feedings for their father, who is terminally ill
• D. A client who is terminally ill hesitates to name their partner on their durable power of attorney form

Answer: (C)

End-of-life decision making often presents ethical dilemmas when family members disagree about what care aligns with the patient’s values and wishes. In this scenario, the family’s conflicting feelings about starting enteral tube feeding for their terminally ill father require the nurse to navigate differing goals of care, quality of life concerns, and the patient’s previously expressed preferences or surrogate decisions. This sits at the heart of an ethical dilemma because it involves balancing beneficence (doing what might prolong life or improve nutrition) with nonmaleficence (avoiding burdens or harms that may not align with the patient’s wishes) and honoring autonomy when the patient’s own preferences may be unclear or superseded by family beliefs. The nurse’s role is to foster open communication, clarify goals, assess any advance directives, and involve appropriate support (such as ethics consultation or palliative care) to align care with what the patient would want. The other scenarios reflect safety, abuse, or straightforward autonomy issues rather than a conflict about the patient’s goals of care among family members.

End-of-life decision making often presents ethical dilemmas when family members disagree about what care aligns with the patient’s values and wishes. In this scenario, the family’s conflicting feelings about starting enteral tube feeding for their terminally ill father require the nurse to navigate differing goals of care, quality of life concerns, and the patient’s previously expressed preferences or surrogate decisions. This sits at the heart of an ethical dilemma because it involves balancing beneficence (doing what might prolong life or improve nutrition) with nonmaleficence (avoiding burdens or harms that may not align with the patient’s wishes) and honoring autonomy when the patient’s own preferences may be unclear or superseded by family beliefs. The nurse’s role is to foster open communication, clarify goals, assess any advance directives, and involve appropriate support (such as ethics consultation or palliative care) to align care with what the patient would want. The other scenarios reflect safety, abuse, or straightforward autonomy issues rather than a conflict about the patient’s goals of care among family members.