Is this an ethical dilemma or a moral dilemma?
In this dilemma, ethical and moral principles are closely linked. Nurses have a responsibility to follow a code of ethical conduct, which includes moral principles such as loyalty, beneficence, and respect for patients’ dignity and self-determination (Fowler, 2015, 4.2). Ethics oblige human beings to choose what is right above the expectations of what is strictly required (Fowler, 5.3). A moral dilemma arises when there is a conflict between the norms of value and obligation (Fowler, 6.1). In this case, from a moral standpoint, the nurse is torn between being appalled to force-feed a prisoner and falling under the pressure of authority exercised over her to conform to moral expectations in reinforcing public safety.
What ethical principles are in contention? How?
An ethical conflict arises in this situation regarding the ethic of care. Caregivers will find that their needs to care for themselves come in conflict with the care that they must give to others (Fowler, 2015, 2.2). The primacy of patients’ interests and their human dignity is in contention with nurses’ duties to self as others (Fowler, 5.1). Nurses owe moral duties not only to their patients but also to themselves.
Are there any virtues at risk? Whose? Why?
Virtue ethics for nurses have evolved greatly through time. Nurses have been expected to demonstrate virtues such as benevolence, kindness, competence, loyalty, etc. (Fowler, 2015, 5). The military leaders’ main priority and duty are to use the prisoner for the service to the government; the prisoners’ virtue here is his patriotic loyalty. The nurse puts her virtues in jeopardy by breaking the prisoner’s autonomy as opposed to her loyalty to her authority and country. Preservation of integrity requires sustaining the values that one cherishes both personal and professional (Fowler 5.4).
What justifies overriding an individual’s autonomy to make his own choices?
Nurses are obligated to treat their patients as autonomous agents. Some patients are unable to make their own decisions, some are not legally autonomous, but may be morally autonomous; the moral requirement is to respect the patients’ autonomy and protect those with diminished autonomy (Fowler, 2015, 3.2). The principles of beneficence and nonmaleficence obligate nurses to not inflict harm (Fowler, 6.2).
How does the Code guide the nurse in invoking conscientious objection?
The military nurse’s ethical objection to enteral feeding falls within the guidelines of the 2015 Code (Fowler, 2015, 8.4). Conscientious objection is a morally or religious-based refusal of assignment otherwise required by the authority or the law. Conscientious objection allows nurses to preserve their integrity in any situation in which they have moral objections to participating (Fowler, 5.4). Nurses have the right to defend themselves and their patients without fear of reprisal (Fowler, 1.1). A patient is a person of value and dignity, who deserves compassion without regarding personal or socioeconomic status they hold (M. D. M. Fowler, 2015, 01).
What lessons can be learned from this nurse’s dilemma?
Nurses face ethical dilemmas within healthcare quite often. The most difficult decisions are those between what is right and what is good. Each person must take responsibility and accountability for their actions and always act in the most human way possible.
References
Fowler, M. (2015). Guide to the Code of Ethics for Nurses. [Bookshelf Ambassadored]. Web.
Fowler, M. D. M. (2015). Guide to Nursing’s Social Policy Statement: Understanding the Profession from Social Contract to Social Covenant (First ed.). American Nurses Association.