A physician orders a nurse to give a patient a placebo instead of her scheduled opiate medication because he doesn't believe that the patient is really experiencing pain. The nurse refuses to do so but tells the physician he is happy to talk with the
patient about her pain and whether they could try decreasing the dosage of her pain medication. This is an example of which element of ethical decision making?
1. Values clarification
2. Stakeholder identification
3. Moral hierarchy exploration
4. Integrity-preserving compromise
Answer: 4
Explanation: There are many different guidelines for ethical decision making, although no one 'right' way. Nurses often receive 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 he 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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