A nurse is caring for a patient near the end of life whose wishes regarding care are not known. The two sons disagreed with the two daughters about future medical plans for the patient during a recent family conference,

Question

and now the sons and daughters are not talking to one another. What action by the nurse would be best to help resolve this dilemma?

A.
Call the facility's ethics committee and request a formal consultation.
B.
Have social work coordinate another family meeting to discuss the issue.
C.
Meet with the sons and daughters separately to discuss their wishes.
D.
Request that the physician tell the family what is in the patient's best interests.

Answer 1

ANS: A
Ethical principles in health care are often in conflict, and it takes a skilled person to negotiate and mediate these situations. Ethics committees exist in most health-care facilities that are experienced in confronting these difficult situations. The best response would be for the nurse to request a consultation from the ethics committee. Another family meeting may not work, as the family already disagrees and tensions are high. The other options may be helpful, but are not as vital as a formal ethics committee consultation. Meeting privately with the sons and daughters might give the nurse some insight into their positions, but would not be as effective as utilizing the expertise on the committee. The physician should not decide what is in the patient's best interests, as this is paternalistic and violates the principle of autonomy.