Table 1 Examples of ethical challenges that have been discussed
From: Ethics reflection groups in community health services: an evaluation study
a) Patient autonomy | b) Family participation |
|---|---|
An alcoholic patient who isn’t able to go out and do his shopping. Family members are buying alcohol for him. The nurse brings the situation to the reflection group and talks about the problem his drinking causes and asks if they can deny him alcohol. | A son expresses strong dissatisfaction with his father’s care and treatment. He threatens to bring a lawyer. The nurse brings the situation to the reflection group and feels compelled to do as the son demands, even though she disagrees. |
An overweight woman, living in her home, spending every hour, every day, every week on the sofa. She sits and lies in urine and feces that get stuck to her skin and she refuses to allow them to help her freshen up. The nurses assess the situation as terrible and bring the situation to the reflection group – what can we do? Use force to care for her? | An elderly woman, which we considered to be dying, with family members that demanded that we give her medication and IV fluid treatment. We believed that the treatment would aggravate the old lady’s distress and increase her suffering. But because the family was steadfast and demanded treatment, we did as they asked. |
A resident with learning disability who is very overweight and loves food. In the reflection group the nurse reflects on whether it is justifiable to deny her more food when she has eaten her portion and asks for more? | A daughter is very upset because her father, who is a patient at the nursing home, is in a relationship with one of the other patients. She accuses the employees of not having prevented the relationship, and demands that they bring it to an end. Is it right to hinder the couple in being together? The relationship between them means a lot for their joy and satisfaction. |