Background Information
A 48-year-old man with a history of alcohol abuse had just undergone surgery, and I provided him with postoperative care, including pain management. However, the patient refused medications because of his religious beliefs. He stated that he was a sinner, and he believed that God wanted him to suffer to redeem his sins. As a Christian, I believe that God wants the good for all of his children, and, even if a person commits sins, he can atone for them by leading a virtuous life rather than suffering. In addition, as a nurse, I believe that I must relieve the pain that my patients experience because pain causes them to have unnecessary physical and emotional suffering. Therefore, I was faced with an ethical dilemma of whether I should administrate pain medication against the patient’s will.
Pain Management
Pain is common in clinical practice, and nurses have an ethical obligation to relieve it to alleviate patients’ suffering. My patient had moderate to severe pain, which could prolong his recovery and significantly reduce his quality of life if left untreated. Table 1 presents my ethical decision-making process, aiming at reconciling the patient’s values, my values, and professional standards.
Table 1. Ethical decision-making process.
Based on the above analysis, I see that the principle of autonomy conflicts with the other three principles. My priority will be to avoid harm and do the best I can for the patient’s well-being.
Final Decision
As a nurse, I am obliged to do no harm to the patients and contribute to their well-being. In the given case, my values coincide with professional standards but do not align with the patient’s beliefs. Therefore, my duty will be to provide the patient with information about the consequences of his choice to refuse pain medications. I will also appreciate the patient’s religious beliefs and encourage him to see God’s will in a different light to help him see that he is not obliged to suffer. If he remains firm in his decision after being well-informed about the consequences, I will explain that I will have to administrate medications against his will. This is because the principles of nonmaleficence and beneficence prevail in this situation since, without medications, the patient’s recovery will be delayed, causing him harm.
References
Gregory, D., Raymond, C., Patrick, L., & Stephen, T. (2018). Perspectives on the art and science of Canadian nursing (2nd ed.). Wolters Kluwer.
Keatings, M., & Adams, P. (2019). Ethical and legal issues in Canadian nursing. Elsevier Health Sciences.