Nursing is more than administering medications and monitoring vital signs—it is a profession grounded in compassion, advocacy, and ethical responsibility. Every day, nurses face complex situations that test their values and professional integrity. Ethical dilemmas are not only common but also critical to navigate, as the decisions made can significantly impact patient care and outcomes.
In this article, we’ll explore real-life case studies of ethical dilemmas in nursing, discuss the principles involved, and share strategies for making sound, patient-centered decisions.
Case Study 1: The Informed Consent Dilemma
Scenario:
A nurse is caring for a patient scheduled for surgery. Although the physician explains the risks and benefits, the patient appears hesitant and confused. Despite not fully understanding, the patient agrees to sign the consent form.
The Ethical Dilemma:
The nurse must decide whether to respect the patient’s autonomy to consent or intervene to ensure true informed consent is achieved.
Ethical Principles Involved:
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Autonomy: Patients have the right to make their own healthcare decisions.
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Beneficence: Acting in the best interest of the patient.
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Non-maleficence: Avoiding harm by ensuring patients are not misinformed.
Resolution:
The nurse should advocate for the patient by requesting the physician to revisit and clarify the explanation. This safeguards patient autonomy while ensuring the consent is truly informed.
???? Tip for NCLEX Prep: Questions about consent often test your ability to prioritize patient understanding over simply following instructions. Always advocate for patient clarity.
Case Study 2: Resource Allocation During a Crisis
Scenario:
In the midst of a severe flu outbreak, the hospital faces a shortage of ventilators. Nurses and physicians must determine which patients should receive treatment.
The Ethical Dilemma:
How do nurses balance fairness, survival probability, and clinical need when resources are scarce?
Ethical Principles Involved:
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Justice: Fair distribution of healthcare resources.
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Utilitarianism: Striving for the greatest benefit for the most patients.
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Professional Duty: Advocating for each patient under care.
Resolution:
Hospitals should create transparent, evidence-based criteria—developed with input from ethics committees and clinical teams—to guide decisions. Nurses play a critical role in applying these guidelines fairly and compassionately.
???? For Nursing Students: NCLEX prioritization questions often mirror this type of scenario. Focus on who has the best chance of survival and apply justice-based reasoning.
Case Study 3: Breach of Patient Confidentiality
Scenario:
A nurse overhears a colleague discussing a patient’s private health details in a public setting. Reporting the violation could protect the patient but may jeopardize the colleague’s career.
The Ethical Dilemma:
Should the nurse prioritize patient confidentiality or professional loyalty to a coworker?
Ethical Principles Involved:
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Confidentiality: Protecting sensitive patient information.
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Integrity: Upholding ethical and professional standards.
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Accountability: Addressing harmful behaviors within the profession.
Resolution:
The nurse should report the incident through the proper chain of command. While this may be uncomfortable, protecting patient privacy and maintaining trust in the healthcare system must take priority.
???? Real-World Application: HIPAA violations carry legal consequences. Nurses are not just ethically, but legally, obligated to protect patient information.
Why These Ethical Dilemmas Matter
Ethical dilemmas highlight the dual role of nurses as caregivers and patient advocates. They require critical thinking, emotional intelligence, and the ability to balance competing priorities. For nursing students and practicing nurses alike, learning to navigate these challenges strengthens professionalism and improves patient outcomes.
Key Takeaways:
✔ Always prioritize patient safety and rights.
✔ Apply ethical principles (autonomy, beneficence, justice, non-maleficence) consistently.
✔ Use hospital policies, ethics committees, and mentors as resources for decision-making.
✔ For NCLEX prep, practice applying these principles to real-world case studies.
Conclusion
Ethical dilemmas in nursing aren’t black and white—they exist in the gray areas of practice where values, responsibilities, and emotions intersect. By studying real-life cases and applying ethical principles, nurses can better prepare to handle these situations with professionalism and compassion.
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