Ethical Decision Analysis in Advanced Nursing

         Ethics in Nursing

  The main responsibilities of  a nurse is to promote health, to prevent disease and easing suffering in case of a disease. In his/her daily routine a nurse encounters many cases of life and death situations which require him/her to apply given set of ethical decision making standards to save the life of the patient. In addition to this role, they are expected to show total respect to the rights of the  patient, his/her family and the community at large. These rights are based on the patient’s culture, the right to life, the right of choice and the right to be treated with respect and dignity (“Top Ethical Issues in Nursing”).

                 Moral and Ethical Dilemmas

    According to Penticuff (2014), moral and ethical dilemmas occur when there is no clear right or wrong answer in a case involving conflict of values and goals. Most often, an important value is compromised causing emotional reactions. Two courses of action are involved and are totally opposite calling for the nurse involved to apply ethical decision making skills to protect the patient from any harm.

    In the case by Kaplan(2017),Karen the nurse need to make critical decisions in order  to save the life of the unborn kid from contacting HIV, to safeguard the confidentiality of her client who’s the unborn child’s father  and also to uphold the right to information to the Susan the wife. In this case the nurse encounters the following types of dilemmas;   

  1. Patient freedom versus Nurse control   

   In this case, Susan who is a primigravida mother refuses to undertake a routine HIV test claiming that they have been having a monogamous lifestyle with her husband without considering the harm this may cause to the unborn child. In as much as the nurse may want to help the unborn child, she can’t force the mother to undertake that test (Kaplan, 2017).

  • Truth telling versus Deception

    The nurse knows the right thing for Susan to do is to inform the husband of the unborn baby regardless of his standards on when they should get a child. Secondly, she would wish to disclose the HIV status of the husband to the wife so that she can get treatment as well as to protect the unborn child from getting infected. This would go along a long way to bleach the right to privacy of her clients and also cause detrimental results including divorce (Kaplan, 2017).

  • Pro-choice versus Pro-life

   This involves the nurse’s moral values and beliefs. She could have a strong respect for life and may choose not to forgo the child’s welfare for the parent’s satisfaction. She could also have a strong hatred for infidelity and may choose to inform Susan on the  husband’s  HIV status.(“Top Ethical Issues in Nursing”, 2017)

  • The minor dilemma

    The unborn child has the right to a healthy living without falling victim of the parent’s decisions. Regardless of the parents’ wish, it is the role of the nurse to uphold the best interest of the unborn child (“Top Ethical Issues in Nursing”, 2017).

Ethical Issues

   In this article, two ethical issues are prominent. First, is confidentiality; the information about a patient should be private and confidential as a way of showing respect. Releasing it may cause harm to the patient. HIPAA-Health Insurance Portability and Accountability Act provide a clear definition of what information can be released and to whom. Second, is consent; this is the permission required by a nurse to perform certain procedures on a patient. Susan refuses to have a HIV routine testing and the nurse cannot force her to have it. In California, a 12 year old can consent to a medical care and counseling on drug and alcohol abuse. (Greenwood,2017)

Ethical Decision Making

    Critical decisions ought to be undertaken in this case in order for the nurse to address this ethical dilemma .The first thing would be to evaluate the two conflicting issues and choose which one between them  is worth urgency morally. Secondly, the core principles of nursing ethics need to be considered. They include, respect for people, duty to do good, duty not to cause harm and fair allocation of justice. Lastly, the outcome of the decision ought to be critically considered. For example, upholding John’s confidentiality will lead to the untreated infection to the wife and consequent disease transmission to the unborn child which would otherwise be avoided. (Kaplan, 2017)


Fant,  c. (2012).  major ethical dilemmas in nursing. Retrieved from

GREENWOOD, B. (2017). Legal&Ethical Issues that Health Care Professionals facechron. Retrieved 3 March 2017, from

Kaplan, C. (2017). Ethical Retrieved 3 March 2017, from

Top Ethical Issues in Nursing. (2017). Loyola University New Orleans. Retrieved 3 March 2017, from

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