An Ethical Dilemma
Ethical decision-making is inherent in the nursing, and medical practice. Ethics is considered a critical scrutiny of moral thought and practice (Campbell et al 1997). Whereas `dilemma' is a situation in which one is faced with a choice of two or more equally unfavourable alternatives (Microsoft 1997). So medical ethics is defined as moral guidelines for doctors and nurses governing good professional conduct (Softkey 1996). The basic aims are considered to be doing good, avoiding harm, preserving the patient's autonomy, telling the truth, and pursuing justice. Ethics, morals, dilemmas, deontology and utilitarianism are the focus considered and discussed throughout this ethical account. Seedhouse (1988) discusses the slogan `Work for health is a moral endeavour'. He interprets this as a question, `is work for health a moral dilemma?' if this is the correct way of looking at this slogan then the following account can be interpreted as an issue of `moral dilemma' for all the health workers concerned...
During practice placement a 76 year old, terminally ill lady (in-operable cancerous bladder) was discovered to have an acute ischaemic leg. There were no pulses from the femoral down. The Senior House Officer contacted her Consultant. After much consideration the consultant decided to let nature take its course. This decision was not taken lightly. The patient had a past history of bleeding problems so anticoagulants could not be prescribed and due to her present condition, pneumonia; she would probably not survive an anaesthetic. Therefore in light of this decision the consultant placed a `Do Not Resuscitate' (DNR) order on her notes. At no point was the patient included in the conversation taking place nor did they explain the problem that was causing such an issue. The focus of this ethical dilemma is veracity (truth telling), should the diagnosis and prognosis have been explained to the patient?
By letting nature take it course would...