How Nurses and physicians face ethical dilemmas — the Croatian experience

Abstract

The aim of this study was to assess nurses' and physicians' ethical dilemmas in clinical practice. Nurses and physicians of the Clinical Hospital Centre Rijeka were surveyed (N=364). A questionnaire was used to identify recent ethical dilemma, primary ethical issue in the situation, satisfaction with the resolution, perceived usefulness of help, and usage of clinical ethics consultations in practice. Recent ethical dilemmas include professional conduct for nurses (8%), and near-the-end-of-life decisions for physicians (27%). The main ethical issue is limiting life-sustaining therapy (nurses 15%, physicians 24%) and euthanasia and physician-assisted suicide (nurses 16%, physicians 9%). The types of help available are similar for nurses and physicians: obtaining complete information about the patient (37% vs. 50%) and clarifying ethical issues (31% vs. 39%). Nurses and physicians experience similar ethical dilemmas in clinical practice. The usage of clinical ethics consultations is low. It is recommended that the individual and team consultations should be introduced in Croatian clinical ethics consultations services.

Ethical Dilemmas of End of Life Care in Intensive Care Unit : A Literature Review

“…The arranged research by Erdil & Korkmaz (2009) also, shows that the ethical problem arise in critical unit like physical maltreatment (10%), psychological maltreatment (34%), ignoring patient privacy (37%), discrimination (5%), and relationship (3%). Moreover, another research shows that the most experienced ethical dilemmas by nurse personally is related to the near the end-of-life decision 11%, justice 7%, professional relation 6%; and the most arising ethical issue on related situation is limiting life sustaining therapy (nurse 15%, doctor 24%) and euthanasia by doctor 28% (Sorta-Bilajac, Baždarić, Žagrović, et al, 2011). The study of Erdil & Korkmaz (2009) describes that the infringed ethical principles is autonomy (30%), respect for an individual's privacy and intimacy (22%), Non Maleficence (16%), Beneficence (17%), Justice (15%).…”

“…Moreover, based on the research an ethical dilemmas situation arise because behavior and attitude of nurse or doctor before implements the comprehensive ethical principle in their service given (Falcó-Pegueroles, Lluch-Canut, Roldan-Merino, Goberna-Tricas, & Guàrdia-Olmos, 2015). The implementation of ethical principle closely correlated to the situation of ethical dilemmas, that it is almost exist in clinical practice area, occurred when the healthcare staff faced with critical thinking situation in decision making of experienced case (Sorta-Bilajac, Baždarić, Brkljačić Žagrović, et al, 2011). The undergone effect of nurse is ethical dilemmas that will bring any impediments in implement their action that contravene to the moral beliefs (Ferrell et al, 2010).…”

Simulations in nursing practice: toward authentic leadership

“…Nurses work in teams at the forefront of healthcare, and that means they must deal with numerous ethical dilemmas. However, they often lack the power to solve these ethical dilemmas (Sorta-Bilajac et al 2011). For that reason, it is important to identify the benefits of team-based simulations from an ethical perspective.…”

Euthanasia and physician-assisted suicide

“…Studies have also been conducted in the United States, 17 where some states allow PAS under certain, legally regulated conditions, and in countries where no legislation on euthanasia or PAS exists, such as Croatia, 18 Finland 19 and Poland. 20 The empirical literature on the subject reveals a lack of consensus among nurses on euthanasia in general and their involvement in the process in particular.…”