633 Discussion II

Ethical Dilemmas in Nursing

Michael Moates, Ed.D.

Herzing University

Safety and Quality (NSG633-7H)

Dr. Aubrey Fox

September 8, 2025

An ethical dilemma in nursing occurs when a nurse is faced with two or more conflicting moral principles, where choosing one option may compromise another (Butts & Rich, 2022). These situations are particularly challenging in health care because they often involve patient rights, professional responsibilities, and institutional policies that may not always align. Ethical dilemmas require nurses to engage in critical thinking, moral reasoning, and adherence to professional codes such as the American Nurses Association (ANA) Code of Ethics.

One common example highlighted by Faubion (2022) is the dilemma of patient autonomy versus beneficence. This occurs when a patient refuses treatment that nurses and providers believe is necessary for their health or survival. Evidence shows that honoring patient autonomy is foundational to ethical nursing practice, even when clinicians disagree with a patient’s decision (Beauchamp & Childress, 2019). Research supports using shared decision-making models, which foster collaboration, respect for patient values, and improved satisfaction with care outcomes (Elwyn et al., 2017). Best practices include providing comprehensive education about treatment options, assessing patient decision-making capacity, and involving ethics consultation services when conflicts persist.

In my own experience, I have observed a similar dilemma in the non-nursing context of end-of-life decision-making for a family member. Physicians recommended aggressive interventions, but the family struggled with whether these aligned with the patient’s previously expressed wishes. This mirrored the ethical tension between prolonging life and respecting dignity and autonomy. Within nursing contexts, I have heard of dilemmas regarding truth-telling to patients with terminal illnesses, where staff debated how much information to disclose to balance honesty with compassion. These examples highlight how ethical dilemmas extend beyond clinical care into personal and societal spheres, requiring ongoing reflection and ethical reasoning.

Ethical dilemmas in nursing are unavoidable but can be approached with structured frameworks, evidence-based strategies, and professional guidance. By prioritizing respect for autonomy and engaging in shared decision-making, nurses can navigate these challenges while maintaining ethical integrity and patient-centered care.

References:

Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.

Butts, J. B., & Rich, K. L. (2022). Nursing ethics: Across the curriculum and into practice (6th ed.). Jones & Bartlett Learning.

Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., … Barry, M. (2017). Shared decision making: A model for clinical practice. Journal of General Internal Medicine, 27(10), 1361–1367. https://doi.org/10.1007/s11606-012-2077-6

Faubion, D. (2022). 20 common examples of ethical dilemmas in nursing and how to deal with them. NursingProcess.org.