A nurse is a member of an ethics committee. The committee has ...

[tsand2]

A nurse is a member of an ethics committee. The committee has been asked to help make a decision regarding end-of-life care for an unresponsive patient who has no advanced directives or next of kin.
 
  The nurse asks the committee to meet with the patient's friends to learn more about his life. This action corresponds with which guideline from the DILEMMA mnemonic?
  1. Moral hierarchy
  2. Make decisions
  3. Describe the conflict
  4. Learn background information

Question 2

A physician orders a nurse to give a patient a placebo instead of her scheduled opiate medication because he doesn't believe that the patient is really experiencing pain. The nurse refuses to do so but tells the physician he is happy to talk with the
 
  patient about her pain and whether they could try decreasing the dosage of her pain medication. This is an example of which element of ethical decision making?
  1. Values clarification
  2. Stakeholder identification
  3. Moral hierarchy exploration
  4. Integrity-preserving compromise

[canderson530]

Answer to Question 1

Answer: 4
Explanation: By learning more about the individual's background from his friends, it may be possible to learn how the patient might view issues surrounding end-of-life care. Additional background information may also include evidence-based information regarding the particular diagnosis of the patient. Moral hierarchy, making a decision, and describing the conflict are not the elements described by this scenario.

Answer to Question 2

Answer: 4
Explanation: There are many different guidelines for ethical decision making, although no one 'right' way. Nurses often receive threats to their personal and/or professional integrity and must choose to adhere (or not) to their own set of values. In this example, the nurse offered the physician an integrity-preserving compromise. Even though he refused to carry out the order, he acknowledged the physician's opinion and sought to work with the individual patient. The nurse had already clarified his values and had identified the biggest stakeholder as the patient. He had also made it clear that in the moral hierarchy, his biggest duty was to the patient.