Introduction
An ethical dilemma can be a common occurrence during work as s nurse and often involves the taking of quick decisions in difficult situations. A recent situation in which I was involved in focused on a patient’s decision to remove his life support machine and die a peaceful death, something which was confirmed by his family. This clashed with my personal beliefs as I am against euthanasia and any form of assisted dying so together with my medical team I was faced with an ethical dilemma of whether to proceed with the patient’s request.
Discussion
The patient in question was suffering from a number of complicated illnesses which were not treatable and he could not survive long enough. He was also in great pain which was somewhat alleviated through morphine and other heavy drugs but he made several requests to his family and also to his doctors that he wished to cease his suffering.
After a discussion with his relatives with whom the patient had consulted when he was well, these gave their consent for the life support machines and other treatment to stop and/or be removed. Our medical team then entered into a discussion on the ethical implications of the case.
The ward consultant insisted that the patient’s wishes must be respected while another nurse including myself came up with the opposite view that removing life support was tantamount to euthanasia which is illegal in the country. Others agreed reluctantly with the consultant while one other doctor took our point of view. However after carefully reviewing the patient’s request and the repeated discussions with family, it was decided that the life support should be removed and treatment stopped. The patient died peacefully a few hours later with his family at his bedside.
Post decision effects
Obviously after the decision was taken, I had a good wrestle with my conscience. I asked myself if this was the right decision to be taken in the circumstances and although I felt that in my heart of hearts I was an accomplice to a morally deficient decision, this had been taken after much thought and consultation with peers and superiors. Perhaps I would have pressed for more time to assess the patient’s situation before pulling the plug, so to speak but it has to be said that this was rather hopeless, at least at this late stage.
Naturally this was a deep ethical dilemma which however resolved itself moderately successfully. The discussions with the family and their consent were both important factors to go ahead with the decision in the long run and although this went contrary to my beliefs and principles, at least one could argue that the patient’s wishes and that of his family were respected.
A strong moral stance has to be taken in such circumstances and at every stage discussion is a crucial and important part of the decision making process. Obviously one cannot consistently reach the right decision all the time but after compromises and adequate soul searching, this can be arrived at with compensatory balance on both sides of the equation.
References:
Davis, Fowler, Aroskar (2009); Ethical Dilemmas and Nursing Practice (5th Edition)
Prentice Hall Lo B (2007); Resolving Ethical Dilemmas: A Guide for Clinicians; Lippincott Williams & Wilkins
