Nursing Ethics and Palliative Care: Collaboration and Leadership
This paper examines the ethical dimensions nurses encounter when palliative care protocols are undefined or absent within healthcare facilities. Drawing on scholarly sources, it argues that hospitals and hospice centers bear a responsibility to establish clear, evidence-based palliative care frameworks rather than leaving such decisions to nurses alone. The paper explores the concept of positive deviance as described by Jodie Gary, the risks of both under-regulation and rigid control, and the importance of interprofessional collaboration grounded in high moral conviction and low bias. It concludes that consistent, patient-centered procedures are essential for achieving the best possible outcomes for terminally ill patients and their families.
- Introduction: Identifies leadership gaps in palliative care protocols
- Ethical Challenges in Palliative Care: Examines pain management, silos, and nurse decision-making
- Positive Deviance and the Absence of Leadership: Gary's concept of nurse autonomy as constructive deviance
- Collaboration, Flexibility, and Patient-Centered Care: Balancing procedure, flexibility, and stakeholder priorities
- Interprofessional Ethics and Shared Goals: Ewashen on contested ethics and shared professional goals
- Conclusion: Calls for evidence-based, patient-centered palliative protocols
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- The paper grounds its argument in concrete examples — such as the cancer patient and the emergency room versus hospice nurse distinction — making abstract ethical concepts accessible and relatable.
- It balances critique (faulting hospitals for failing to establish protocols) with nuance, acknowledging that overly rigid controls can be just as harmful as no controls at all.
- The use of multiple scholarly sources, including Gary (2014) and Ewashen et al. (2013), strengthens the ethical analysis and demonstrates engagement with current nursing literature.
Key academic technique demonstrated
The paper effectively employs source integration with direct quotation and paraphrase to support its claims. Rather than simply summarizing sources, the author synthesizes them into a coherent argument about leadership voids in palliative care, using Gary's concept of positive deviance to reframe nurse autonomy as a constructive rather than problematic phenomenon.
Structure breakdown
The paper follows a traditional academic essay structure: an introduction identifying the problem, an analytical body divided across four thematic concerns (ethical challenges, leadership absence, collaborative ethics, and interprofessional goals), and a conclusion that restates the core argument. Each body section builds on the previous one, moving from problem identification to proposed frameworks for resolution.
Introduction
While most hospitals appear to be well-run and most situations are planned for in advance — including what nurses should and should not do, and why — this is not always the case. One example is the scenario in which palliative care is probably or definitely called for, yet no defined or clear protocol exists for when the palliative path should be initiated or what criteria should guide that decision. Patients facing such situations are typically terminal or at least cannot be effectively treated for their condition. An easily recognizable example is a cancer patient whose disease has progressed beyond what medicine can address. When leadership is absent with respect to palliative care protocols, it falls to nurses to collaborate, work together, and initiate the proper level of care when no one else will step up.
References
Engel, J., & Prentice, D. (2013). The ethics of inter-professional collaboration. Nursing Ethics, 20(4), 426–435. http://dx.doi.org/10.1177/0969733012468466
Ewashen, C., McInnis-Perry, G., & Murphy, N. (2013). Inter-professional collaboration-in-practice: The contested place of ethics. Nursing Ethics, 20(3), 325–335. http://dx.doi.org/10.1177/0969733012462048
Gary, J. (2014). The Wicked Question Answered. Dimensions of Critical Care Nursing, 33(3), 142–150.
Lennon-Dearing, R., Lowry, L., Ross, C., & Dyer, A. (2009). An interprofessional course in bioethics: Training for real-world dilemmas. Journal of Interprofessional Care, 1–12. http://dx.doi.org/10.1080/13561820902921621
Working Together Toward a Common Goal: A Grounded Theory of Nurse-Physician Collaboration. (2015). MEDSURG Nursing, 24(5), 356–362.
Create your account
Always verify citation format against your institution’s current style guide requirements.