The impact of people’s religious beliefs on their behavior can be listed among the factors that often cause ethical dilemmas in healthcare. The target of the given paper is to present and analyze the ethical dilemma related to the discussed factor. The paper describes the case of a teenager from a deeply religious family who made a suicide attempt that resulted in poisoning.
As for the specific clinical situation that is discussed within the frame of the assignment, it touches upon the way that religious beliefs of patients’ relatives can interfere with the process of treatment and outcomes for patients who need both nursing and psychological help. Working in a hospital, I have faced many situations that involved ethical dilemmas, but the case that I want to discuss in the paper refers to religious beliefs that can sometimes pose a threat to the psychological well-being of patients. The situation refers to the case of a teenager (a boy who is 14 years old) who tried to commit suicide by taking a large dose of drugs stolen from his aunt. Fortunately, the teenager’s life was saved as the specialists from our hospital managed to clean out the contents of his stomach before it was too late. After the surgical operation, the teenager agreed to discuss the motives of his actions with our specialists, and it was found out that he had communication problems with his peers.
His mother was informed about his stay at the hospital due to the intoxication, and she was told that his physical condition did not involve any threats for life. The teenager did not want us to disclose the information about his suicide attempt to his parents because all members of his family were deeply religious and they considered suicide as one of the worst sins. He wanted us to conceal the information about his suicide attempt and say that it was food intoxication, fearing that his parents will always hate him for that mistake. Nevertheless, we discussed the problem with his parents and encouraged them to support their son in this situation instead of blaming him. In common situations, healthcare providers should not discuss the religious beliefs of their patients and their relatives, but this case was extraordinary as the lack of discussion could cause additional suicide attempts.
Ethical Characteristics of the Dilemma
About the specific characteristics of the case, it needs to be said that the situation involved a communication problem based on the difference of religious views. First, the teenagers’ parents were shocked and their behavior was a bit inadequate as they started to pray and cry. Nevertheless, after the conversation related to the great role of the family in the rehabilitation of people with suicidal behavior, they agreed to avoid blaming their son (Ma, Batterham, Calear, & Han, 2016). Therefore, the situation presents a difficult communication problem.
There is a range of ethical principles that have to be respected by healthcare specialists, but it sometimes happens that these principles should be violated to create a safer environment for a patient and improve the outcomes of treatment. One of the most common ethical principles that nurses should use is the necessity to respect the opinions and religious beliefs of patients and people who visit them. Therefore, the decision to criticize one’s religious views is usually regarded as inappropriate for nursing professionals (Parahoo, 2014). Unfortunately, considering the psychological condition of the underage patient and the threat of new suicide attempts caused by blaming, it was necessary to talk to his parents and explain that their personal beliefs could be harmful to their son. In particular, his parents were encouraged to give pride of place to the feelings of their only son and support him instead of giving up on him and calling him a sinner.
Barriers to Ethical Practice
There are numerous barriers to ethical practice that can influence decision-making processes in healthcare. In the majority of cases, the barriers stem from the lack of knowledge concerning ethical standards and the fear of being criticized (Birle et al., 2016). As for the barriers to ethical practice associated with the discussed situation, it is important to state that the decision to discuss and even criticize religious beliefs which are usually considered inappropriate action for healthcare professionals was caused by real threats that existed for the patient. Therefore, the primary barrier to ethical practice pertinent to the case is the presence of limitations related to the code of ethics for healthcare professionals. According to the most common ethical rules that every healthcare specialist should work by, nurses should do their best to defend the dignity of their patients and minimize the influence of any factor that can pose a threat to their mental or physical condition. At the same time, criticizing other people’s personal beliefs has never been considered as an appropriate practice. As is clear from the case, the rule that healthcare specialists should respect the opinions and beliefs of patients and their families involves certain limitations. The latter is related to the fact that some beliefs may be detrimental to other people’s physical and psychological well-being. Another example of such limitation is several cases when people limit the access of their children to blood transfusion practices due to their religious beliefs.
To make the right conclusions and use the discussed experience during further practice, it can be extremely significant to identify the ethical theory that could be used in similar situations to produce the best possible patient outcomes. The theory that can be applied to justify the decision to criticize the religious beliefs of the patient’s relatives is utilitarianism. According to the discussed theory, the appropriateness of any action can be defined based on the consequences that it causes. The primary attention is paid to the notion of utility that denotes the usefulness of actions (Wagner & Dahnke, 2015).
The main principle related to the utilitarian ethical theory is the presence of right and wrong actions that are evaluated about the outcomes for different parties that they involve. An action is considered to be good if it involves positive effects for the majority of people and increases happiness. Therefore, the primary attention is paid not to the properties of action and methods but to the positive or negative effects that it produces. The given theory is suitable regarding the discussed clinical situation because it highlights the superiority of positive consequences for the majority of people involved in any situation.
In the discussed case, the primary problem is related to the fact that nursing specialists had to act as mediators between the patient and his religious parents to mitigate the threats for the former. Considering the psychological condition of patients with suicidal behavior, it was extremely important to reduce the impact of stress factors on the patient’s condition (Atwoli, Nock, Williams, & Stein, 2014). The decision to respect any religious beliefs and let the patient’s parents give pride of place to their assumptions concerning sins would not produce positive outcomes for any participant of the situation. Instead, it would be detrimental to the patient’s mental condition. At the same time, the decision to appeal to these people’s common sense and explain that they must support their son in any situation involved the maximum utility for the patient and his parents.
When the discussed dilemma occurred, I was shocked by the reaction of the teenager’s parents as everything that they were saying was focused on their religious assumptions and no attention was paid to the condition of their son. Considering that their behavior could be detrimental to the psychological condition of the patient, it was decided to lead a discussion concerning the key needs of people with suicidal behavior. Honestly, it was quite difficult to communicate with them as they were shocked and it could cause their inappropriate reaction. In the end, they agreed to visit a family therapist who could identify the reasons causing their son’s suicidal behavior. I do not think that I will have a different perspective if a similar situation occurs when I am working as an FNP. I will always try to make decisions maximizing the positive outcomes for my patients.
In the end, the discussed case involves a dilemma because religious beliefs present an extremely sensitive topic. As the analysis shows, the decision to criticize people’s beliefs and discuss them helped to reduce many threats for the patient. Also, the decision that was made does not contradict the utilitarian ethical theory.
Atwoli, L., Nock, M. K., Williams, D. R., & Stein, D. J. (2014). Association between parental psychopathology and suicidal behavior among adult offspring: Results from the cross-sectional South African Stress and Health survey. BMC Psychiatry, 14(1), 65.
Birle, D., Bonchis, E., Oakland, T., Opre, A., Crişan, D., & Jimerson, S. R. (2016). Examining the ethical knowledge and application ethics among school psychologists in Romania. Romanian Journal of School Psychology, 9(17), 7-24.
Ma, J., Batterham, P. J., Calear, A. L., & Han, J. (2016). A systematic review of the predictions of the interpersonal-psychological theory of suicidal behavior. Clinical Psychology Review, 46, 34-45.
Parahoo, K. (2014). Nursing research: Principles, process and issues (3d ed.). New York, NY: Palgrave Macmillan.
Wagner, J. M., & Dahnke, M. D. (2015). Nursing ethics and disaster triage: Applying utilitarian ethical theory. Journal of Emergency Nursing, 41(4), 300-306.