Discussion: Ethical Dilemmas in Nursing


Ethical dilemmas in nursing are inevitable, considering that clinical duties may sometimes conflict in practice, which limits the protection of the patient’s interest and well-being. An ethical dilemma can arise from various scenarios, including understaffing situations where burnouts can occur, reducing the quality of service delivery and inadequate patient literacy, resulting in patients’ difficulty self-managing their disease (College of Nurses of Ontario, 2019). However, multiple principles, including the College Nurses of Ontario standards of practice, provide a blueprint for the codes of ethics for nurses.

Reflection of a Dilemma

I am a choleric person, meaning I can be dominant in a group due to the leadership influence associated with this personality. This factor made me experience various ethical dilemmas, including when the hospital’s administrator admitted a patient when the team had a busy surgical schedule. The patient priority list was long due to the many emergency cases, and the new patient’s case required urgent medical attention. The dilemma was if it was ethical for the surgeon to convince the patient that the surgical team was working on a tight schedule or to prepare the patient and operate on them within this tight schedule.

I knew that healthcare language might be complicated, but all patients have the right to know what is happening, especially when they have an emergency. Truthfulness was one of the ethical codes that played an integral part in this situation (Burkhardt et al., 2018). We had to disseminate this information in straightforward language so they could make the right decision. We had to talk to the patient alongside the family members about the current situation, the expected wait time, and the consequences of waiting for so long. Due to the long waiting time, the family decided to transfer this patient to another hospital. The hospital’s management was not amused by this decision, considering that the hospital lost a significant amount when the patient was transferred to another health institution.

The value of veracity is integral in nursing, as it enhances the patient-nurse relationship and decision-making. Autonomy is a moral theory that aligns with the principle of honesty since it gives the patient the power to decide the type of care they want and their preferred delivery style (Spicer et al., 2021). For instance, the principle of autonomy and veracity enables nurses to adhere to the patient’s requests or wishes, even if it does not align with what the majority wants (Spicer et al., 2021). For instance, a patient with a terminal illness may express their desire to discontinue treatment and be put on assisted suicide. This situation is one of the most controversial cases in this nursing field since this advance directive must adhere to fulfill the patient’s wishes. The value of autonomy, which is regarded for the patient’s wishes, helps maintain veracity, enabling the fulfillment of individualized care.

The CNO practice standard of autonomy presents various challenges when implemented as one theory. These challenges include delayed processes, poor healthcare service without professional counsel, and professional devaluation (College of Nurses of Ontario, 2019). Autonomy slows processes in nursing care, considering that some emergencies require a fast response, which can have detrimental health consequences when ignored. Patients may take a long time to reason out the best care service for their medical predicament, and this wasted time could lead to deterioration of health (College of Nurses of Ontario, 2019). For instance, the time spent by a patient thinking about whether or not to have dialysis may result in kidney failure. Nurses can avoid such situations if they make prompt decisions. This factor indicates that autonomy can also have detrimental consequences if the adverse effects are ignored.

Another problem with autonomy is that it could lead to poor health service delivery when medical prepositions are ignored. A patient who does not like injections may decide to take prescription drugs for a chronic infection and slow down recovery (College of Nurses of Ontario, 2019). At the same time, other alternatives like injections could stimulate better treatment. All these practices reduce the quality of care when nurses compromise to achieve autonomy.

Additionally, this theory could result in professional devaluation, sometimes hindering collaboration. When nurses are restricted from having the freedom to use their knowledge to provide care, they may suffer psychological harm from moral distress (Spicer et al., 2021). Nurses could sometimes become demotivated to suggest treatments considering that their prepositions may not be implemented, which results in poor quality service delivery. Demotivated nurses may not maximize their potential and creativity, which could hinder active engagement.

Various ethical principles are established to govern nursing practice and to help solve complex issues. The CNO’s standard of practice, including integrity, helps nurses maintain truthfulness in all cases to avoid compromising quality. However, some theories could hinder effective service delivery, including autonomy, when applied as one theory. The reason is that this causes medical processes to be delayed awaiting the patient’s directive. Another disadvantage is that autonomy could lead to poor healthcare service without professional counsel and professional devaluation. All these factors indicate that healthcare delivery is a complex system that must integrate various theories to surpass ethical dilemmas.


Burkhardt, M., Nathaniel, A. and Walton N. (2018). Ethics and issues in contemporary nursing. Toronto, Canada. Nelson Publication

College of Nurses of Ontario. (2019). Practice standard: Ethics. Web.

Spicer, J., Ahluwalia, S., & Shah, R. (2021). On challenges to respect for autonomous decision making in primary care. Clinical Ethics, 14777509211069908. Web.

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