Many nurses are placed in situations where their moral beliefs are in total or partial conflict with the policy of the facility that employs them. One such situation arose when a young woman received head trauma resulting in cessation of significant brain activity. She did not leave advance directives and her family’s religion prevented discontinuation of life support. All health care professionals involved agreed that there was no hope for recovery and did not want to be forced to attempt revival measures in the case of cardiac arrest. Meetings with the staff, religious consult, the family, and hospital counsel were nonproductive. Eventually, the patient was transferred to a long-term care facility.
An analysis of the factors according to Bandman and Bandman (2002) could not include the patient’s wishes as they had not been expressed prior to brain death. The ethical issue was the request of the family to continue any measures to keep her body functioning even though they would have to pay for expenses out-of-pocket. The moral conflict was between the family’s religious beliefs and the belief of medical personnel that any further measures were fruitless. The final resolution of taking the patient from the hospital into long-term care freed the staff from being forced to act against their beliefs while sustaining those of the family. Long-term care staff may have been better suited for acting in accordance with the family’s wishes until ultimate organ failure.
The issue was complicated due to the inability to appreciate the wishes of the patient, the influence of the people involved, and financial implications. Personal ethics may allow for conscious objection on the part of the nurse, but there are no specific guidelines for this action (Lachman, 2014).
References
Bandman, E. & Bandman, B. (2002). Nursing ethics through the life span. Upper Saddle River,
N.J.: Prentice Hall.
Lachman, V. (2014). Conscientious Objection in Nursing: Definition and Criteria for
Acceptance. Medsurg Nursing, 23(3), 196-198. Retrieved from
http://nursingworld.org/MainMenuCategories/EthicsStandards/Resources/Conscientious-
Objection-in-Nursing.pdf.
