Nurses face ethical dilemmas
Nurses face a plethora of ethical dilemmas on a daily basis in their various responsibilities (Cerit & Dinç, 2013). These challenges present ethical quandaries that need ethical decision making in order to avoid bad consequences for the nurse, the patient, or other coworkers (Cerit & Dinç, 2013).
Taylor's "Simon's Normative Model"
Several models have been developed to aid with decision-making. One such model is Taylor's "Simon's Normative Model" (2013). This concept contends that the decision-making process is illogical. This approach divides decision making into three stages: intellect, design, and choice (Taylor, 2004). (2013). During the intelligence phase, the decision-maker must first identify the problem at hand through problem finding and formulation. In problem searching, the issue is compared to a standard to determine any differences whose evaluation determines the occurrence of the problem or not (Taylor, (2013). Problem evaluation alleviates the risks of solving a wrong problem. It entails searching for a similarity index between the problem at hand and an issue that had been resolved earlier. Formulation of different solution outlines for the same problem takes place in the design phase. Each alternative solution is evaluated for its negative and positive aspects. In the choice phase, the most suitable solution is sought for after comparing all available solutions. Quantitative and qualitative tools are used to discern the ideal solution (Taylor, (2013). Possible outcomes and scenarios are assessed when making choice of the best option. The selected option is executed followed by evaluation and documentation of the results. This model thus incorporates the steps of ethical decision making.
An example of an ethical dilemma
An example of an ethical dilemma is that of a 50year old patient who had aggressive prostate cancer at its end stage. He had been diagnosed with prostate cancer eight years ago but refused any surgical treatment instead resorting to other local treatment interventions. He did not follow up with the urologist ever since. During the current admission, he presented with anemia, lymphadenopathy and bone tenderness. After several diagnostic tests, it was discovered that cancer had metastasized to his bones, local lymph nodes besides invasion of the bladder and consequent left kidney obstruction. Further medical or surgical interventions were declared null as the tumor has spread extensively. Palliative care was instituted as chances were he had only 1-2months to live. The patient divulged to the team of medical providers that he had resigned to the actuality that he was going to die. On one occasion, he pulled aside one of the nurses and confided in her that he intended to commit suicide and that the nurse should keep it a secret. The nurse has two morally correct but incompatible options. She may have chosen to maintain the suicide intentions a secret, in which case, she would have respected the patient's right to make their decision. However, the decision could have resulted in the patient killing himself without any interventions from the health care team. Equally, she would have chosen to disclose the suicidal intentions to her colleagues who would have helped to monitor the patient and mitigate the risk of suicide. However, the patient's autonomy would have been violated. The ethical dilemma was whether the nurse should have disclosed about the patient's suicidal intents without his consent.
Importance of ethical decision making
Ethical decision making is thus paramount in ensuring professional excellence and the key provision of quality health care services. Decision making should be advised by the steps of ethical decision-making outlines in the models.
References
Cerit, B., & Dinç, L. (2013). Ethical decision-making and professional behavior among nurses: a correlational study. Nursing Ethics, 20(2), 200-212.
Taylor, D. W. (2013). Decision-making and problem-solving. Handbook of organizations, 48-86.
