While implementing crisis intervention strategies to work with terminally ill patients, nurses and physicians can face a lot of ethical, moral, and legal dilemmas. One of the most problematic situations in this case is the patient’s plan to commit suicide. On the one hand, the terminally ill patient can suffer from the unbearable pain and discuss the death as the only chance to avoid being a burden for the relatives. On the other hand, a nurse should address the patient’s concerns from the point of morality, but act according to the principles of the ethical code and legal norms. While implementing the crisis intervention steps for the patient planning to commit suicide, a nurse faces such ethical dilemmas as the necessity to prevent the client’s death addressing his or her interests; such moral dilemmas as the necessity to respond to the interests of the patient and relatives as well as general moral norms; and such legal dilemmas as the necessity to follow specific regulations and the confidentiality principle.
The patient’s plan to commit suicide is often a challenge for the medical staff because of the variety of ethical issues and dilemmas. The main ethical task of a nurse who knows about the patient’s plans to commit suicide is to prevent the realization of the client’s intentions. At this stage, it is necessary to find the answer for such a dilemma as a necessity to follow the Hippocratic Oath and the principles of beneficence and non-maleficence while providing the effective solution to the patient’s problem (Patel & Jakopac, 2011, p. 112). While focusing on relieving the patient’s sufferings, a nurse should follow the norms reflected in the ethical code strictly. The proposed crisis intervention should work to reduce the patient’s sufferings and stabilize the psychological state.
The next group of dilemmas is associated with the sphere of morality. On the one hand, terminally ill patients have the right to openly discuss their situation and plan the ways to relieve the sufferings. On the other hand, terminally ill patients have no moral right to commit suicide because of the fear to become a burden for the relatives. A nurse should focus on finding the ways to regulate the case while addressing the interests of the patient, the hopes of the relatives, and the other widely acceptable moral norms (Wywialowski, 2004, p. 54). The development of the effective crisis intervention for a terminally ill patient can become a real moral challenge for a nurse whose task is to save the life of the patient and work to create the positive atmosphere.
Legal dilemmas are also faced by a nurse whose terminally ill client is planning to commit suicide. The first issue is in the necessity to realize the effective control over the patient’s actions to prevent the suicide. This problem is associated with the nurses’ task to prevent situations when patients can pose a danger to themselves (James, Gilliland, & James, 2012, p. 97). The next issue is the necessity to follow the principle of confidentiality. Developing the crisis intervention oriented to preventing the patient from committing suicide, a nurse may not inform the patient’s relatives about the problem without the patient’s consent.
Ethical, moral, and legal dilemmas associated with the crisis intervention for the terminally ill patients planning to commit suicide are faced by nurses regularly in their practice. The discussed dilemmas require finding effective solutions to the provocative questions. In this case, the task of a proficient nurse is to focus on following the code of ethics and moral and legal norms in order to resolve the problem effectively.
References
James, R., Gilliland, B., & James, L. (2012). Crisis intervention strategies. New York, NY: Cengage Learning.
Patel, S., & Jakopac, K. (2011). Manual of psychiatric nursing skills. New York, NY: Jones & Bartlett Publishers.
Wywialowski, E. (2004). Managing client care. New York, NY: Elsevier Health Sciences.