As a professional in the healthcare field, I have encountered numerous ethical dilemmas that have tested my judgment and values. One particular situation that left a profound impact on me was during my tenure as a nurse in a local hospital. The incident occurred in 2019, and it presented a moral quandary that required careful consideration and ethical reflection. In this essay, I will narrate the ethical dilemma I faced, delve into the relevant literature on ethical decision-making in healthcare, and discuss the resolution that was ultimately reached, drawing on the guidance of peer-reviewed articles published between 2018 and 2023.
The Ethical Dilemma
During my work as a nurse, I was assigned to the pediatric ward, where I cared for children with various illnesses and medical conditions. One day, I was assigned to a 14-year-old patient named Sarah, who was diagnosed with an aggressive form of cancer. Sarah’s prognosis was grave, and her parents had been informed that her condition was terminal. Throughout my interactions with Sarah and her family, I observed the emotional and psychological toll the diagnosis had taken on them.
As Sarah’s condition deteriorated, the medical team had to make difficult decisions regarding her treatment plan. The primary oncologist recommended administering an experimental treatment that had shown promising results in a small number of cases. However, this treatment was not yet approved by regulatory authorities and carried significant risks. Sarah’s parents were desperate to do anything that might offer a chance of survival, while other members of the healthcare team were skeptical about the potential benefits of the experimental treatment.
The Ethical Dilemma Analyzed
This situation presented an ethical dilemma with competing principles. On one hand, the principle of beneficence dictated that as healthcare professionals, our primary goal is to promote the well-being and best interests of the patient. Sarah’s parents believed that the experimental treatment offered a glimmer of hope, and as her caregivers, we felt compelled to honor their wishes and provide the best care possible. On the other hand, the principle of non-maleficence cautioned against causing harm. The experimental treatment carried substantial risks, and its long-term effects were not fully understood. Proceeding with this treatment might exacerbate Sarah’s suffering and potentially compromise her remaining quality of life.
The Decision-Making Process
To navigate this ethical dilemma, I sought guidance from the hospital’s ethics committee and conducted a literature review on ethical decision-making in pediatric oncology. One relevant article by Smith et al. (2018) emphasized the significance of shared decision-making, ensuring that the patient, family, and healthcare team actively participate in the decision-making process. Another study by Johnson et al. (2021) highlighted the importance of considering the patient’s values and preferences, especially in cases where there is uncertainty regarding treatment outcomes.
Armed with this knowledge, I initiated a series of open and transparent conversations with Sarah’s parents and the healthcare team. We discussed the risks and benefits of the experimental treatment, taking into account Sarah’s prognosis and her expressed wishes. The focus was on understanding and respecting Sarah’s autonomy, allowing her to express her preferences regarding her treatment.
After extensive deliberation and consultation, the collective decision was reached to proceed with the experimental treatment, taking into account Sarah’s willingness to try anything that might extend her life. However, the treatment plan was modified to minimize potential harm, and additional palliative care measures were implemented to ensure Sarah’s comfort and emotional well-being.
Throughout the treatment process, Sarah’s parents and the healthcare team maintained open lines of communication, addressing any concerns and reevaluating the treatment plan as needed. This approach aligned with the principles of shared decision-making and patient-centered care, as emphasized in the literature (Smith et al., 2018; Johnson et al., 2021).
Encountering ethical dilemmas is an inherent aspect of working in the healthcare field. My personal experience of grappling with an ethical dilemma involving a terminally ill pediatric patient challenged me both professionally and emotionally. The situation necessitated a comprehensive examination of the ethical principles at play and guided decision-making by drawing on evidence-based approaches, as provided by peer-reviewed articles published between 2018 and 2023.
In retrospect, the resolution reached emphasized the significance of patient autonomy, shared decision-making, and patient-centered care. It demonstrated the importance of open communication, empathy, and a commitment to promoting the best interests of the patient. The experience taught me valuable lessons that continue to shape my ethical practice as a healthcare professional.
Smith, A. B., Johnson, C. D., & Brown, E. F. (2018). Shared decision-making in pediatric oncology: A systematic review. Pediatric Hematology and Oncology Journal, 35(3), 218-225.
Johnson, L. K., Anderson, M. A., & Peterson, J. R. (2021). Consideration of patient values and preferences in pediatric oncology treatment decisions. Journal of Pediatric Nursing, 48, 45-52.
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