The nurse is caring for the patient complaining of acute pain. The physician tells the nurse that the patient is not really in pain and orders a placebo instead. The nurse disagrees with this idea and tells the physician he will not administer a placebo,
even though he does not know whether the patient is experiencing pain or not. He suggests to the physician that they have an honest discussion with the patient rather than administering a placebo. This is an example of which element of ethical decision- making?
1. Utilitarianism
2. Virtue ethics
3. Paternalism
4. Rule-based ethics
Answer: 2
Explanation: There are many different guidelines for ethical decision making. Nurses often face threats to their personal and/or professional integrity and must choose to adhere (or not) to their own set of values. In this example, the nurse offered the physician an integrity-preserving compromise. Even though the nurse refused to carry out the order, he acknowledged the physician's opinion and sought to work with the individual patient. The nurse had already clarified his values and had identified the biggest stakeholder as the patient. He had also made it clear that in the moral hierarchy, his biggest duty was to the patient.
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