Role of Ethical Dilemmas in Nursing


This paper highlights the legal and ethical implications of a nursing situation; these entail ethical dilemmas that have been ranked as priority measures in the nursing professional standards. Nursing professional standards include concerned discussions of legal and ethical problems like obligatory reporting and duty of care, regulations, and laws (Ali & Hasan, 2021). Mostly, ethical dilemmas happen when a certain problem exists between professional principles. Making decisions in favor of one’s principle mostly gets into violating the other, and this exists in scenarios where a particular situation fully involves an argument between two contradictory values.

The case discussed is that of Caterina Montalto, who happened to be a patient at the Arcare Hampstead and was found dead in a water fountain while her face looked down. The issue was not adequately reported to Coroner Heather on May 31, 2011. The main agenda of this article is mainly to get to adequately examine the real magnitude of ethical dilemmas. The dilemmas focused on topics like autonomous decision making, care rationing in unsuccessful therapies and the significance of advance directives that nurses face. Ethical dilemmas have ever been a great challenge and a live source of tension.

Ethical Dilemma, Including Standards, Codes, and Laws

Effective lifecare decisions are always crucial because they govern how a particular group conducts itself. These decisions are always set to the fact that they have the potential to boost human life, with the close support of medical technology, or the decision to accept the natural dying process of a person (Ninomiya, 2014). When an individual is ready to die, their lifetime responsibility is over; this includes settling family issues and making peace with the inevitable. The problem serves as one of the priority concerns in the nursing profession that need to be solved urgently. The standards of ethical conduct portrayed in the Montalto case fully reflected the nursing ethical principles governing care in health facilities’ regulations (Feeg et al., 2021). Codes and laws are mainly put in place to effectively enhance the protection of all patients’ rights as very confidential and signing of the informed consent. Setting laws helps nurses advocate for professional accountability as part of their work. Therefore, a violation of these laws should mean serious legal consequences for these nurses which may even lead to revocation of their medical licenses in serious cases.

Relevant Facts of the Stuation

The study was carried out in the U.S., where healthcare professionals must fully respect their patient’s autonomy (Hognestad Haaland et al., 2021). Healthcare providers failed to consider their operational limitations and perform their responsibilities as mandated. Some nurses did not stick to effective communication between the patient and family members. This is a measure that should address the patient’s care goals and treatment modalities fully. Proper communication with the patient also helps to determine the response to medication and to measure progress over time. Ethical decision-making in nursing has to be a deliberate process whereby a nurse’s perspective is required to identify, plan, implement, and evaluate any alternative action (Jørgensen & Kollerup, 2021). The study identified that most nursing ethical issues usually relate to the quality of life of critically ill patients. It’s clear that, at times, the treatment offered by the healthcare providers does not fully benefit the patient but acts as a burden instead.

Caterina Montalto, an older woman who lived at the Arcare Hampstead elderly care nursing home, is found dead in a water fountain. The Coroner, Heather Spooner, clarifies that Montalto was a dementia patient characterized by roaming. Because the fountain was relatively closer to the nursing home and easily accessible to the dementia unit, Mrs. Caterina slipped and fell. Montalto’s death was not reported initially to Heather as it was supposed, but according to Margaret Spooner, Mr. Heather oversaw the inquiry into her death. Thorough investigations were then carried out by the police, who used a compact closed-circuit CCTV camera. The camera was directed towards the courtyard and the police collected the incident footage which further proved it incredibly instructive.

Values at Stake

It is the responsibility of a nurse to be able to weigh how to help the life of their patients best, but it must be stated that the existence of these responsibilities should not be a form of getting to waste of resources (Khachaturian et al., 2010). Wasted resources are a clear indication of more troubles in the future than get to benefit the patient through prolonging medically ineffective therapies. The fact that most ethics do not give a clear-cut answer but only bring in place the guidelines of possible behavior regarding the use of advance directives in the modern generation, most individuals are seen to be in a better position of managing any legal difficulties that may come in as a result of their decisions. Management of ethical considerations around end–of–life care has always been part of the difficulties healthcare providers get to undergo.

Legal aspects such as the lack of provider notification in the court of law may be a reason for punishment. It must be clear that proper documentation of the patient’s condition; includes the date, time, and person notified. It is the responsibility of senior healthcare leaders to deal with the current ethical quandaries by enforcing procedures. Healthcare providers should be at the forefront of educating patients on decision-making. If possible, hospitals should have a legal team that attends to such matters and questions nurses who do not adhere to the laid-down guidelines.

Options and Justification

The chronological order of events could easily be monitored effectively, not just a 50- minute timeline of each event. It happened that Mrs. Caterina Montalto slipped through the pool and ended herself in the pool. At times, caring for and isolating people with dementia in a home environment becomes more challenging. As a result, ethical dilemmas of how effective a person may be is dependent on balancing that autonomy with their safety and well-being. They can freely express their personal preferences and make desirable choices (Ninomiya, 2014). Autonomy in dementia care over time has been very challenging. It becomes difficult to explain how those living with dementia at home are perceived to be at risk for problems, especially falls, fire hazards, drugs, and socially isolated (Barasteh et al., 2021). Most of these risks are at the forefront in threatening their levels of autonomy.

Strategies to Prevent Reoccurrence

Research studies have proven that dementia can easily be prevented by taking part in physical exercises. This would improve the level of cognition in older adults, thus bringing it usually. Because the vascular disease can easily cause dementia, ameliorating predisposing conditions for vascular deformities like diabetes, dyslipidemia and hypertension must be discouraged (Samman, 2021). Simple healthy habits such as eating a balanced diet, regular exercising, reduced smoking and alcohol intake and regular social involvement help to reduce the chances of developing dementia. Regular medical check-ups are also encouraged for early detection of any such problems. Eliminating the existing relationship between antihypertensive treatment measures and the risks for dementia must be done to curb further issues.

Personal Reflection

Patients need to be fed with trustworthy information on any possibilities for case-specific therapy solutions and accurate prognosis. Through this, most patients may be willing to write down a living will. It will be easier for their families to make appropriate decisions in events where patients become incapacitated (Mok et al., 2017). Thus, inherent in nursing is mainly concerned with dignity, respect for life, and consideration of human rights must be unrestricted by sex, politics, race, or nationality (Mallette, 2021). As part of their ethical obligations, nurses must be honest, open, and truthful. To prove any signs of malpractice or negligence in a court of law, elements like injury, causation, foreseeability, and breach of duty owed to the patient must be well stated and understood.


Studies identified that antihypertensive treatment and risks for the occurrence of dementia might be a clear indication of reduced cognitive decline and vascular dementia form. It has been a great challenge to people in the modern lifestyle, and as a result, several preventive strategies have been examined to manage the occurrence of this problem. People should consider the elimination factors and develop appropriate approaches to cub the situation.


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