Ethical dilemma

The management provided was not providing any much relief to his condition. On the third week of his care, the patient became more and more discouraged and felt that he would not recover from the illness. The interdisciplinary care team had opted to counsel the patient for palliative care as they felt his condition was no longer sustainable. Mr. Lee during the routine care in the ward confided in one nurse that he was contemplating suicide and asked her not to share the information with anyone else. Lee hence retained the right to make all decisions that pertained to his health and care provided to him. The health decisions taken by Mr. Lee about his care are detrimental to his health as they impede the very essence of care delivery.

His actions are also of impact to his loved ones and significant others as his loss will affect them psychologically. End-of-life decisions affect all the parties involved in the care of the patient, the decisions to end his life are also of impact to the caregivers (nurses) who as per the ANA code of practice have the responsibility to prevent any harm to the patients under their care (Gurney et al. The patient's desire to end his life contravenes the nurse's perspective that is bound within the desire to provide a peaceful death for the patient. The nurse provides palliative care to manage the end-of-life needs of the patient while the patient prefers ending his own life. In so doing, the patient's preferred outcomes contradict the nurse's preferred outcomes.

If the nurse adheres to the provision of confidentiality and allows the patient to commit suicide, she will be liable for negligence for not acting as per the standard of practice and the policies established within the hospital for the care of suicidal patients. The nurse will also have contravened the ethical code of practice which calls for nurses’ primary responsibility to be the patients’ and to act within their ability to prevent any harm to the patient. Acting on the Choice The best choice in this case study would be to share the information with the other patient caregivers and the interdisciplinary team members as well as the patient's family and initiate support against suicide. This decision would be the most appropriate as it ensures that the healthcare providers acted in the patient’s best interests to prevent harm as per the nursing code of ethical practice and as per the ethical provisions of beneficence.

The decision to prevent suicide is also within the ethical provisions which allow for the breach of the patient’s confidentiality if such information when shared would avert obvious danger to the patient or contribute to better outcomes of their care. The risk-benefits of the decision to intervene are higher compared to a decision not to intervene in the case allowing for the patient to commit suicide. Although providing the patient with the option to sign an advance directive is a good option, at the time of identification of a suicidal patient, the most immediate act of priority is to mitigate any risks that would lead to suicide hence the need to share the information and institute measures to prevent suicide in the case scenario.