PHI FPX 3200 Assessment 3: Applying Ethical Principles

Introduction

In the nursing profession, the transition from curative care to palliative care represents one of the most ethically challenging environments. Applying Ethical Principles in these moments is essential to preserve the dignity of the patient and the integrity of the healthcare system. This assessment analyzes a case where a terminally ill patient wishes to discontinue life-sustaining treatment, but the family—acting as legal proxies—demands that “everything be done.”

PHI FPX 3200 Assessment 3: The Core Ethical Dilemma

The primary conflict in this scenario involves a clash between Autonomy (the patient’s right to choose their path) and Beneficence (the family’s desire to act in what they perceive as the patient’s best interest). For the nurse, this creates “moral distress,” as they must advocate for the patient while maintaining a therapeutic relationship with the family.

Detailed Application of Bioethical Principles

1. Respect for Autonomy

Autonomy is the cornerstone of modern bioethics. When Applying Ethical Principles, the nurse must first determine if the patient has the “decisional capacity” to make their own choices. If the patient is competent and has expressed a clear desire to stop treatment, their autonomy typically overrides the wishes of the proxy. This is supported by the principle of self-determination.

2. Non-maleficence: Defining “Harm”

Non-maleficence is the duty to “do no harm.” In end-of-life care, harm can be interpreted in two ways: the harm of death versus the harm of prolonged, painful, and futile medical intervention. Applying Ethical Principles requires the nurse to argue that continuing aggressive treatment against a patient’s wishes may actually constitute a violation of non-maleficence by causing unnecessary suffering.

3. Beneficence and Quality of Life

Beneficence involves acting for the good of the patient. However, “the good” is subjective. While the family views the preservation of life as the ultimate good, the patient may view a “good death” with dignity as the superior outcome. The nurse’s role is to facilitate communication that aligns clinical actions with the patient’s personal values.

4. Justice and the Ethics of Futility

Justice refers to the fair allocation of resources. In cases of medical futility, Applying Ethical Principles involves considering whether it is “just” to utilize intensive care resources for a patient who has expressed a desire to stop, especially when those resources could benefit others with a higher chance of recovery.

Ethical Theory Synthesis: Deontology vs. Utilitarianism

To reach a “Distinguished” grade level, one must apply philosophical rigor:

• Deontology: A deontologist would argue that the nurse has an absolute duty to follow the patient’s autonomous wishes, regardless of the family’s emotional outcome. The “rule” of autonomy is universal.
• Utilitarianism: A utilitarian would weigh the collective happiness. While the patient finds peace, the family suffers a loss. However, most modern utilitarians argue that respecting individual rights leads to the greatest societal “utility” in the long run.

Interprofessional Collaboration and Resolution

When Applying Ethical Principles fails to resolve a conflict through bedside nursing alone, the nurse must engage with the Hospital Ethics Committee. These committees provide a neutral ground for interprofessional collaboration, involving physicians, social workers, and legal counsel to ensure that the patient’s “moral agency” is protected.

Conclusion and Recommendations

The application of ethical principles is a dynamic process. In the case analyzed, the patient’s autonomy must be the guiding light. My recommendation is to initiate a formal ethics consultation and facilitate a “family meeting” to align the proxy’s understanding with the patient’s documented or expressed wishes. By grounding our practice in the ANA Code of Ethics, we ensure that our advocacy remains professional, legal, and morally sound.