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Current Issues in Nursing

Review (briefly) and identify the selected article

This case study examines an oncologist’s legal and ethical issues in relation to a critical event involving a patient with end-stage liver cancer (Lachman, 2016). The oncologist recommended a biopsy of the bone marrow. He wanted to see what was going on with her, even though it was of no advantage. None of the treatment was going to change. Both the patient and the nurse next to him were visibly upset as the bone marrow biopsy was performed. This is an opportunity for every doctor to gain first-hand knowledge of what it’s like to treat patients in a standardized hospital with a rigid hierarchy. Following my case study, I have reflected on what I have learned about nurses’ moral distress.

The KEY ethical principle(s) involved in the article

The foundation of ethical guidelines is based on four ethical principles. Paramedics face a wide range of ethical dilemmas, and the standards don’t cover all of them. By examining the ethical standards, the guidelines often assist in sorting out the concerns raised by a particular situation. In bioethics, the principles of autonomy, beneficence, non-maleficence, and obligation are commonly used. Examining the conflict between these ideals might help people better understand the challenges at hand. The bioethics model is analyzed using these principles and theories to develop a comprehensive ethical decision-making framework in this case study.

Autonomy– this is a patient’s right to think and act as they see fit a decision about his care. The patient has access to all the information they need to make informed decisions about their health care. Autonomy refers to the concept of self-reliance and the right to make one’s own decisions. This essence enables people to take control of their lives and treat others with respect.

Beneficence – Health care personnel have a duty to offer patients adequate and need-based treatment to improve their well-being. The essence of doing well is establishing a relationship of care and trust with the sufferer. Empathy is an essential part of good deeds, as it allows us to understand and sympathize with those in need.

No maleficence – Doctors and nurses have to avoid or reduce harm to the client, avoid or minimize harm. It is the responsibility of health care personnel to provide environments in which paramedics can deliver the patient with consistently high-quality and safe care while adhering to established standards. Using this case study, it is clear that the oncologist’s actions could have resulted in the patient’s death (Lachman, 2016).

Justice – Health care providers are responsible for treating patients unbiased and truthfully. Paramedics must help those in need. The patient’s condition can be improved by assisting the injured and ailing. The doctor in this circumstance should have provided the patient with the proper treatment and not merely fulfilled his curiosity.

Apply and integrate your perspectives on the ethical challenge

Ethical decision-making models provide several valuable tools and additional advantages for making informed decisions. It should be highlighted that there are no factual solutions, but only well-reasoned ones. It aids in shedding outdated mental habits. As a result of this predicament, the oncologist lacks the expertise to determine which drug the patient should be given. Because of this, it is thought of as a decision-making challenge. Promoting a client’s well-being implies making it easier for them to maintain their health and well-being and preventing or eradicating any harm that might come their way. Sometimes it’s hard to know what’s best for a given situation. To arrive at the appropriate course of action, it is vital to first distinguish between the nurse’s and the client’s perspectives on what is good. It might be tough to weigh a therapy option’s possible benefits and risks. Nurses must begin with the patient’s perspective in mind.

Ethical values such as delivering safe, competent, and ethical treatment are at the heart of this scenario’s first ethical consideration. It is the nurse’s responsibility to highlight the issue of dangerous, non-compassionate, unethical, or incompetent practice or conditions that interfere with the capacity of nurses to provide safe, compassionate, and component treatment. Professional norms and rules supporting ethical practice must be followed by nurses, who CNA classifies as self-regulatory professionals who adhere to code of ethics principles and obligations (McAninch, 2016). In their role as paramedics, the nurse and oncologist were responsible for providing adequate medical care to the patient, providing the correct information about the patient’s condition, and ensuring the patient’s safety.

Nurses are tasked with asking oncologists whether the treatment decisions they are making for their patients are beneficial. The oncologist decided to provide the patient with incorrect information and to document all of the patient’s physiological data. In the care of paramedics, the patient had a right to receive proper medical care, be protected from danger and environmental hazards, and be provided with accurate information. As a result, inevitably, doctors and nurses won’t always agree and get along. Here, it’s clear that the nurse was only there to see the oncologist perform a bone marrow biopsy, and she didn’t check in on whether or not it was beneficial to the patient.

How nurses might address the challenge

Moral resilience – Self-care can be achieved through cultivating a strong moral compass. A sense of self-worth and control help nurses responds positively to their distress as nurses. From that vantage point, nurses can lead without feeling inadequate, weak, or oblivious to the needs of others. Mindfulness is an excellent way to cultivate moral resilience (McAninch, 2016). When nurses have moral resilience, they can better discover meaning and healthily respond to ethical dilemmas.

Self-stewardship – Caring for one’s well-being is an integral part of self-stewardship. This type of assistance and intervention helps care providers to discuss and interpret their ethical or personal dilemmas in a safe, professional setting. If a facility consistently violates patient rights or requires nurses to severely and frequently compromise standards of practice or personal morality, nurses should not be hired there. A unionized workplace provides them with the opportunity to seek assistance. Unions and other forms of union activism may help accomplish bringing about the desired change. Ideally, any agreement made through such action would be in accordance with the profession’s standards of practice, provincial and federal legislation that govern nursing practice, and the Codes of Ethics for the profession.

Structural support – Individuals at all levels in an organization must be aware of how moral distress affects nurses and prevent it. When nurses’ mental health is discounted or ignored, it has long- and short-term effects on the healthcare system. Nurses are often shy about talking about their thoughts, but now is the perfect opportunity to change that. There will be increased physical scarring as a result. As they strive to recover a sense of “normalcy,” nurses also require assistance and training (Čartolovni et al., 2021). It is the responsibility of healthcare institutions to address the requirements of both patients and employees.


Čartolovni, A., Stolt, M., Scott, P. A., & Suhonen, R. (2021). Moral injury in healthcare professionals: A scoping review and discussion. Nursing Ethics28(5), 590-602.

Lachman, V. D. (2016). Moral resilience: managing and preventing moral distress and moral residue. Medsurg Nursing25(2), 121-125.

McAninch, A. (2016). Moral distress, moral injury, and moral luck. The American Journal of Bioethics16(12), 29-31.


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