Ethical Dilemma

Nurses face dilemmas frequently while in the execution of their duty. They need to develop a proper framework for solving different ethical problems as they are common in the nursing field (Zahedi et al., 2013). In the case under analysis, there is a 41-year-old woman who has been suffering from cancer for a long time. However, she has decided to stop her treatment, which has led to a tough dilemma. The latter is whether I should support her decision, but it may have adverse health outcomes for the patient or should decline it and act in my interests as a nurse, but it may affect her right. There are different models which can be used to solve this dilemma, including ethical egoism, which involves the use of personal authority to decide in compliance with the doer’s own goals (Morrison, 2018). Primarily, the theoretical framework asserts that an act is moral if it supports one’s long-term interest. I support provisions of ethical egoism to decline the patient’s request because the model is essential as it helps people realize their goals even during hard times.

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Why I Have Chosen to Decline the Patient’s Request

It is my goal as a nurse to provide the best services to patients and ensure that they recover from their condition or make it manageable. The goal is well supported by egoism theory, which is the primary ethical framework used to defend my stand in this case (Morrison, 2018). In this regard, one should note that if I support the woman’s decision, then I can hardly achieve my primary goal since she can end up suffering, and it is not the best service I want to deliver. Therefore, as a nurse aiming to meet my objectives in the nursing career, it is only prudent for me to decline the request of the patient and ensure that she continues her therapy.

The patient has been developmentally delayed since birth. Thus, she can hardly make an informed decision. In this regard, one should note that the best person to give the most appropriate solution is me. As evident in the work by Acebedo-Urdiales, Medina-Noya, and Ferr?-Grau (2014), nurses have been mainly trained to handle complex situations while interacting with the patient. Thus, they have more relevant knowledge and skills to make informed decisions when compared to clients. Therefore, in this regard, it is only appropriate to advise the patient to continue her therapy since her choice is not well informed and has fatal consequences.

Considering that such consequences include death, it contradicts my long-term interest as a nurse. According to Rahman and Beattie (2008), there is always a need first to evaluate the effects of stopping treatment when such a request is made. If the results are fatal, then the move should not be taken. In this case, although treatment has gone on for a long time, it is still helpful as it suppresses cancer. Being guided by the provisions of the egoism theory and knowing that stopping cancer therapy for this patient has fatal consequences, it is not right to support her. Therefore, it is essential to decline her decision and urge her to continue treatment.

Nurses have the right to refuse to offer services that go against their ethical standards. According to Morrison (2018), in many areas, they have the right to perform only those directives that are in line with their moral beliefs. Such sentiments are also in compliance with the egoism theory as their primary purpose is to ensure that nurses stand on their ground to achieve their overall objective (Morrison, 2018). Thus, in this case, I have the right to decline the patient’s request and defend my stand. At the same time, considering the provisions of the egoism theory, my decision is ethical. Therefore, as a person determined to manage this patient’s condition, I have chosen to decline her decision.

Although in many countries, the patient has the right to make his or her own decision, nurses are urged to spend a lot of time on teaching the one what is right. One can find such sentiments in the work of Morrison (2018), who notes that nurses are obliged to give the best advice to clients. It would be unethical and unprofessional for me to avoid giving the patient correct information before supporting her decision. In line with this work, it would therefore only be ethical for me to help the patient understand the importance of continuing treatment.

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In this case, the provision of utilitarianism that an act is moral if its overall outcome is good for the greatest number of people coincides with my ethical egoism perspective. In this regard, to behave ethically, one should ensure that the total benefits of a particular decision outweigh its adverse effects (Morrison, 2018). In this case, stopping the treatment of this woman would most likely lead to her death as has been established before. On the other hand, continuing her medication ensures that the disease is suppressed and the patient continues living. It is in line with my primary goal as a nurse. Therefore, such a good action outweighs the wrong side, which is death. Hence, there is a need to reject this patient’s request.

Guided by the egoism model, courage is one of my chief virtues as a nurse. Over the years, I have realized that to achieve my overall goal in the profession, I have to embrace courage as it is the only way I can stand for what is right regardless of the consequences. As such, when nurses are faced with situations where making a particular decision is quite hard, they should evaluate available options and stand for the most appropriate (Morrison, 2018). In such an event, even when the patient disagrees, then the nurse will have his or her part done as a professional. Therefore, in this case, I will utilize this critical virtue to stand for what is right and appropriate, urging the woman to continue treatment.

One of the main arguments that can be put forward by those who support the patient in this case and are guided by the situational approach is that the move can satisfy her. However, the patient will be satisfied only at that moment when I agree to support her decision (Morrison, 2018). Afterward, she will end up in immense suffering as nothing will suppress cancer. As such, she will no longer be impressed by a person who has supported her to stop treatment. Therefore, it is essential to avoid such thinking and focus only on what will have positive consequences, advising the woman to continue therapy.

Another primary argument that can be given by those who support the woman decides that a nurse should work together with the patient and make decisions unanimously. However, clients are not always right. Since at times their choices are wrong, it is one of the primary reasons why they seek help from health professionals (Morrison, 2018). Therefore, as much as one would like to include the patient’s views in the treatment process, it is always important to evaluate the implications of such opinions and advise the patient accordingly. Thus, in this case, it would only be suitable to advise the client that her decision has significant negative consequences, and there is a need to drop it.

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Furthermore, those who support the woman’s decision may base their argument on the importance of respecting the patient’s rights. In this regard, it is important to note that someone’s liberty is not at all times should be ensured. At times, the right can be declined, particularly when it threatens someone’s life (Morrison, 2018). In this regard, the patient’s central argument is to stop her therapy as she has taken it for a long time without recovering. However, one should note that as much as she has not improved, treatment goes a long way in suppressing cancer, which has fatal consequences if not well controlled. Therefore, the patient’s right, in this case, can be declined, and it would be ethical to advise her on what is good.

Overall, my view is that benefit in any profession is achieved if the outcome is positive. In this regard, one should note that the primary goal of starting any task, including treatment, is to achieve excellent and beneficial results in the end. In this case, if I agree with the patient’s request, then the overall results will not be positive. Instead, they will be fatal. Therefore, guided by the provisions of ethical egoism, it is only right to decline the woman’s request and achieve positive results in the end, including fulfilling my goal as a nurse.


As stated at the beginning, based on the provisions of ethical egoism, I have chosen to reject the patient’s request in this case. The egoism theory asserts that an act is ethical if it supports someone’s primary goal. In this regard, my primary goal as a nurse is to offer the best services to patients and ensure that they recover from their condition or make it manageable. In this case, if I choose to support the patient’s decision, I will not be in a position to achieve my primary goal as the move has fatal consequences, including death. Therefore, as a determined nurse who observes ethics, I have chosen to decline the patient’s decision and instead urge her to continue therapy.

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