Ethical Dilemmas in Nursing: How to Navigate Tough Choices

September 07, 2023
Lewis Hill
Lewis Hill
Nursing Ethics
Lewis Hill is a distinguished researcher in the field of nursing ethics and holds a Ph.D. in Healthcare Ethics from the University of Toronto, Canada. With a wealth of experience, he has contributed to numerous groundbreaking studies in the realm of nursing ethics, shaping the ethical landscape of healthcare practices.

Nursing is a profession that demands not only technical skills but also a strong commitment to ethics and moral principles. Nurses are often confronted with complex and challenging situations that require them to make difficult decisions that may have far-reaching consequences for their patients, their families, and themselves. These ethical dilemmas in nursing can be emotionally taxing and morally perplexing. Moreover, it takes a lot of preparation to complete a nursing ethics assignment. Therefore, in this blog, we will explore some common ethical dilemmas in nursing and discuss strategies for navigating these tough choices.

The Ethical Framework in Nursing

Before delving into specific ethical dilemmas, it's essential to understand the ethical framework that guides nursing practice. Nursing ethics are built upon several key principles:

Navigating Ethical Dilemmas in Nursing
  1. Autonomy: Respecting the patient's right to make informed decisions about their care, even if those decisions differ from what the nurse believes is best.
  2. Beneficence: Acting in the best interests of the patient and providing care that promotes their well-being.
  3. Non-maleficence: Not harm. Nurses must strive to avoid causing harm to their patients, whether through actions or omissions.
  4. Justice: Treating all patients fairly and equally, without discrimination based on race, gender, age, or other factors.
  5. Veracity: Being truthful and honest with patients, providing accurate information about their condition and treatment options.

Common Ethical Dilemmas in Nursing

In the realm of nursing, ethical dilemmas are not uncommon occurrences. These perplexing situations often require healthcare professionals to navigate a delicate balance between their duty to provide optimal care and respecting the autonomy and choices of their patients. In this section, we will delve into some of the most prevalent ethical dilemmas that nurses encounter in their daily practice, shedding light on the complexities of these situations and the ethical principles that guide them.

  1. End-of-Life Care: Deciding when to withhold or withdraw life-sustaining treatment can be agonizing for nurses. Balancing the patient's autonomy and quality of life with the duty to not harm can create a profound ethical dilemma.
  2. Informed Consent: Ensuring that patients understand their treatment options and can make decisions is crucial. However, what happens when a patient cannot make decisions, and their family disagrees on the course of treatment?
  3. Resource Allocation: Nurses may be confronted with situations where there are not enough resources (beds, ventilators, medications) to treat all patients adequately. Deciding who gets what can raise ethical questions about justice and fairness.
  4. Confidentiality: Protecting patient confidentiality is paramount, but what if a patient discloses information that may harm themselves or others? Nurses must navigate the delicate balance between respecting confidentiality and ensuring patient safety.
  5. Patient Autonomy vs. Paternalism: Sometimes, nurses may disagree with a patient's treatment choices. Balancing a patient's right to autonomy with the duty to provide the best care can be challenging.

Strategies for Navigating Ethical Dilemmas

When nurses find themselves facing ethical dilemmas in the course of their caregiving, having a well-defined strategy is essential. In this section, we will explore a range of effective approaches and decision-making frameworks that nurses can employ to navigate these challenging situations with professionalism and compassion. By understanding and implementing these strategies, nurses can make ethically sound choices that align with their commitment to patient-centered care.

  1. Ethics Committees: Many healthcare institutions have ethics committees that can provide guidance and support when nurses encounter ethical dilemmas. These committees consist of experts in ethics, law, medicine, and nursing who can help navigate complex situations.
  2. Consultation: Seek input from colleagues and mentors. Discussing ethical dilemmas with peers can provide different perspectives and insights that can help inform your decision.
  3. Ethical Decision-Making Models: Utilize ethical decision-making models like the four-step process (identify the problem, develop potential solutions, evaluate the solutions, and implement the chosen solution) to systematically work through ethical dilemmas.
  4. Communication: Open and honest communication with patients and their families is crucial. Explain the ethical issues involved, listen to their concerns, and involve them in the decision-making process as much as possible.
  5. Self-Reflection: Take time for self-reflection. Consider your values, beliefs, and biases that may influence your decision-making. This self-awareness can help you make more objective and ethical choices.
  6. Continuing Education: Stay up-to-date with ethical guidelines and principles. Participate in ethics workshops and seminars to enhance your ethical decision-making skills.

Real-Life Ethical Dilemmas

Real-life ethical dilemmas in nursing often serve as poignant examples of the intricate moral choices healthcare professionals must make. These scenarios, drawn from the frontlines of healthcare, illustrate the complex interplay between ethical principles and practical decision-making. In this section, we will delve into several compelling real-life ethical dilemmas, exploring the nuances of each situation and the profound impact these decisions can have on patients, families, and caregivers. Let's explore a few real-life ethical dilemmas that nurses may face:

  1. Case 1: The Jehovah's Witness Patient: A patient refuses a blood transfusion due to religious beliefs, but the medical team believes it's necessary to save their life.
  2. Case 2: The Incompetent Patient: A patient with advanced dementia requires surgery, but they cannot provide informed consent, and their family members disagree on the decision.
  3. Case 3: Resource Allocation During a Pandemic: Hospitals are overwhelmed during a pandemic, and nurses must decide which patients receive ventilators when there aren't enough to go around.
  4. Case 4: Nurse Whistleblowing: A nurse witnesses a colleague making a serious medication error but is torn between reporting it and protecting their coworker.


Ethical dilemmas in nursing are inevitable, given the complex and sensitive nature of healthcare. Navigating these tough choices requires a solid understanding of ethical principles, effective communication, and a commitment to patient-centered care. While there may not always be a clear-cut answer, nurses can draw upon the ethical framework and the support of colleagues and ethics committees to make decisions that uphold the best interests of their patients and the profession of nursing itself. By continually striving to improve their ethical decision-making skills, nurses can ensure that they provide the highest quality of care while upholding the values and principles that underpin their practice.

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