In medical facilities across the country, nurses face ethical dilemmas that challenge their training and personal morality everyday. As with many cases of ethics, there is rarely a perfect solution to a problem. Decisions may be reached on the basis that a procedure will be beneficial or causes no harm, yet matters are hardly black and white.
There are many issues of ethics that nurses may encounter, though one that is continually pressing is the question of whether nurses should treat family members, or even themselves for that matter.
When the nurse becomes the patient, the line between one’s role as a professional and as a recipient of care blurs inevitably. Similarly, when the patient is a friend, loved one, or family member, an objective interpretation of the situation can be even more convoluted.
Identifying Ethical Dilemmas
The dilemma all starts with consideration of the patient and provider roles, and the responsibility that comes along with this relationship. As a nurse, you are obligated to operate within the scope of practice given your education and license. When difficult decisions arise that require keen medical knowledge, how easily can you separate your personal and professional view of the situation? How easy should this be in the first place?
Because it’s almost impossible not to be a parent, child, or spouse before being a nurse, understanding the nuances of the Nursing Code of Ethics is a logical first step to securing your moral framework as a professional.
By understanding some of the main moral difficulties that arise when considering the treatment of friends or family, it can be easier to discern when and when not to practice.
Provision 1.2 Relationships with Patients
Establishing a trusting and understanding relationship with each patient is a key factor in providing the right care for the situation. Whether it’s regarding culture, value systems, religion, or someone’s lifestyle, nurses are to remain impartial in order to avoid conflict.
It’s easy to see how pairing this moral standard with knowledge of a family member or friend’s background could present difficulties should you find yourself as their nurse.
Provision 2.2 Conflict of Interest for Nurses
Nurses are constantly striving to promote a patient’s best interests while preserving the professional integrity of themselves and other interprofessional decision-makers.
It’s not uncommon for conflicts to arise from competing loyalties in the workplace – coupled with the expectations of patients, their families, physicians, colleagues, and their overarching healthcare organizations, nurses can find themselves in some pretty complex dilemmas.
Finding an objective way to interpret your role within this network of potential conflicts can serve to elucidate the lines between one’s professional and personal functions.
Provision 3.1 Privacy and Confidentiality
Generally speaking, the effort to provide proper health care does not warrant unwanted or unnecessary intrusion into a person’s life. For family members or friends, this confidentiality may already be breached. This provision makes it clear that nurses are in questionable moral territory when dealing with familiar/familial patients.
Provision 4.1 Authority, Accountability, and Responsibility
In dealing with the moral issue of treating friends or family members, an evergreen consideration is that nurses bear the primary responsibility for the care their patients and clients receive. As a professional, you are accountable for your own practice, meaning that any ethical missteps or violations are entirely ascribed to one’s own personhood.
Ethical Dilemmas Beyond the Facility
Although it may be less likely to find yourself caring for a friend or family member at your actual place of employment, that doesn’t mean these ethical dilemmas stop at a healthcare facility’s door.
This isn’t to say that you shouldn’t treat your child’s scraped knees, bumps or bruises, but more or less it’s deciding when to hand the duties over to another impartial professional – something difficult for parents of any profession to do.
When it comes to treating adult family members or spouses who need medical assistance after being discharged from a hospital setting, the situation can be difficult to navigate. As always, it’s recommended that you provide care within your education and licensing. Things like changing dressings and helping loved ones follow orders given are generally permissible. However, when it comes to medications there can be some ethical complications if you are not fully authorized to be handling these matters.
Regardless of your expertise, it still may be best to delegate the responsibility of caring for a friend or family member to an outside professional. Even if it’s one of the hardest decisions to make, avoiding further legal, ethical and moral violations can at least render the entire situation as being handled properly.