Ethics in Nursing What Current Ethical Issue

Ethics in Nursing

What current ethical issue related to nursing or access to care did you choose to describe?

Therapeutic lying is my subject of choice -- whether or not nurses/care providers cross their ethical boundaries when they lie to patients about their health conditions, or when they withhold information that they perceive as unfavorable and which they believe would be detrimental to the patient's recovery process. A nurse has an ethical and legal duty to be honest with their patient and at the same time look out for their well-being -- so how should one act when these two elements appear to be in conflict?

What are the relevant laws, regulations or policy related to this issue?

The law recognizes the nurse-patient relationship as a fiduciary relationship. Under fiduciary law, the fiduciary (the nurse in this case) is expected to act in the best interests of the agent at all times. This includes being truthful, honest, and committed to the agent and the relationship at all times. The dilemma arises in situations where truthful disclosure is likely to compromise the very interest of the person the fiduciary seeks to protect.

What ethical principles are at issue here?

The paternity, nonmaleficence, and fidelity principles are at play in this regard. The first two appear to be in support of therapeutic lying as they require providers to refrain from engaging in actions likely to cause their patients distress and anguish. The fidelity principle, however, faults the idea of lying, requiring providers to always be truthful and honest with their patients, regardless of the circumstances.

Propose a Resolution to this Issue

The issue could be resolved within the framework of deontological ethics, which is based on the premise that a wrong action does not become right, just because it yields a positive outcome. In this regard, nurses ought not to lie with the aim of pleasing a patient; rather, the truth should be told at all times, simply because that is the right thing to do.

How is the proposed solution supported by ethics?

The proposed solution is supported by the 4th provision of the Code of Nursing Ethics, which requires nurses to always ensure that their actions and behavior are in congruence with the moral principles of self-determination and worth of patients, respect for dignity, and fidelity, which calls for utmost fairness, truthfulness, and dedication, regardless of the circumstances.