A situation of ethical dilemma that you have experienced as a psych nurse

by | Apr 1, 2025 | Essays

 

 

Describe a situation of ethical dilemma that you have experienced as a psych nurse and how it was resolved. (Saunders, 2014)

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


This question has been answered

God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

Hypothetical Ethical Dilemma:

Imagine I am a psych nurse working in an outpatient community mental health clinic. One of my long-term clients is Sarah, a 26-year-old woman diagnosed with schizoaffective disorder. She has been relatively stable on her current medication regimen for over a year, attending regular appointments, and actively participating in group therapy.

During one of our individual sessions, Sarah confides in me that she has recently stopped taking her antipsychotic medication. She states that she feels “much clearer” without it, although she acknowledges experiencing some mild increase in racing thoughts and feeling slightly more anxious. She insists she can manage these symptoms on her own through mindfulness exercises and journaling, which she has learned in therapy.

Hypothetical Ethical Dilemma:

Imagine I am a psych nurse working in an outpatient community mental health clinic. One of my long-term clients is Sarah, a 26-year-old woman diagnosed with schizoaffective disorder. She has been relatively stable on her current medication regimen for over a year, attending regular appointments, and actively participating in group therapy.

During one of our individual sessions, Sarah confides in me that she has recently stopped taking her antipsychotic medication. She states that she feels “much clearer” without it, although she acknowledges experiencing some mild increase in racing thoughts and feeling slightly more anxious. She insists she can manage these symptoms on her own through mindfulness exercises and journaling, which she has learned in therapy.

Sarah explicitly asks me not to disclose this information to her parents, who are very involved in her care and have a tendency to become overly worried and controlling. She fears that if they know she has stopped her medication, they will pressure her to resume it immediately and potentially undermine the progress she feels she is making in her recovery.

This situation presents an ethical dilemma rooted in the conflict between several core ethical principles (as discussed in Saunders, 2014 and general nursing ethics):

  • Autonomy: Sarah, as an adult, has the right to make decisions about her own treatment, including the right to refuse medication, provided she has the capacity to understand the risks and benefits of her decision.
  • Beneficence: I have a duty to act in Sarah’s best interest and to promote her well-being. Stopping antipsychotic medication for schizoaffective disorder carries a significant risk of relapse, which could negatively impact her functioning, relationships, and overall quality of life.
  • Nonmaleficence: I have a duty to prevent harm. If Sarah experiences a relapse due to stopping her medication, this could cause significant harm to herself and potentially others.
  • Veracity: I have a duty to be truthful and honest with Sarah, as well as with other members of her treatment team and, potentially, her family, while respecting appropriate boundaries.
  • Fidelity: I have a duty to be loyal to Sarah and to honor our therapeutic relationship, including respecting her request for confidentiality.

Resolution of the Ethical Dilemma:

Following an ethical decision-making framework, which might involve steps similar to those outlined below (drawing upon Saunders, 2014 and general ethical principles), I would approach this situation as follows:

  1. Gather Additional Information and Assess Sarah’s Capacity: I would engage in a more in-depth conversation with Sarah to understand her reasons for stopping the medication. I would assess her current mental state, her understanding of her diagnosis, the potential risks and benefits of discontinuing medication, and her ability to articulate a rationale for her decision. This assessment would be crucial in determining her capacity to make an informed decision.

  2. Review Relevant Policies and Legal Guidelines: I would consult the clinic’s policies on patient confidentiality and the legal guidelines in my jurisdiction regarding the rights of adult patients with mental illness, including their right to refuse treatment.

  3. Consult with Colleagues and the Treatment Team: I would discuss the situation (without revealing Sarah’s name initially if necessary to maintain confidentiality during the consultation phase) with my supervisor and other members of Sarah’s treatment team, such as the psychiatrist. This interdisciplinary perspective would provide valuable insights and help identify potential risks and alternative approaches.

  4. Discuss the Dilemma with Sarah: I would have an open and honest conversation with Sarah, acknowledging her autonomy and her feelings about the medication. I would gently explore her understanding of the potential consequences of stopping her medication, including the risk of relapse. I would also explain the limits of confidentiality, particularly if her decision poses a significant risk of harm to herself or others (although based on the initial information, she doesn’t seem to be in immediate crisis).

  5. Explore Alternatives and Collaborative Solutions: Instead of directly disclosing to her parents against her wishes, I would work collaboratively with Sarah to explore alternative solutions. This might include:

    • Developing a detailed relapse prevention plan that includes early warning signs and coping strategies.
    • Increasing the frequency of our individual therapy sessions to closely monitor her mental state.
    • Encouraging her to openly discuss her feelings and concerns about the medication with her parents in a safe and supported environment, perhaps with me present as a facilitator.
    • Exploring alternative medication options or dosages with the psychiatrist that might address her concerns about feeling “unclear.”

  6. Balance Confidentiality with the Duty to Prevent Harm: If, despite our collaborative efforts, Sarah’s symptoms begin to worsen significantly, or if her decision to stop medication puts her at imminent risk of harm (to herself or others, although this is not indicated initially), the ethical principle of nonmaleficence and the duty to protect would likely override her request for absolute confidentiality. In such a situation, I would need to consider involving her parents or other relevant supports, even against her explicit wishes, while explaining my rationale to her clearly and compassionately. This decision would be made in consultation with the treatment team and in accordance with legal and ethical guidelines.

  7. Document Thoroughly: Throughout the entire process, I would meticulously document all assessments, discussions, consultations, and decisions made, along with the rationale for those decisions.

Outcome (Hypothetical):

In this hypothetical scenario, through open communication and collaborative problem-solving, Sarah might agree to a compromise. Perhaps she would consent to a trial period of closer monitoring with increased therapy sessions, while also agreeing to discuss her concerns about the medication with her parents in a facilitated setting. If her symptoms remained stable or improved with non-pharmacological interventions, her autonomy would be respected. However, if her symptoms began to deteriorate, we would have a pre-established plan for reintroducing medication and involving necessary supports, hopefully with Sarah’s understanding and cooperation.

This situation highlights the complexities of ethical decision-making in psychiatric nursing, where balancing patient autonomy with the duty to promote well-being and prevent harm often requires careful assessment, thoughtful deliberation, collaboration, and open communication. The resolution is rarely black and white and often involves finding the least restrictive and most ethically justifiable course of action in a given situation.

This question has been answered.

Get Answer