Identify And Discuss A Spiritual, Moral, Or Ethical Dilemma

Identify and discuss a spiritual/moral/ethical dilemma that this patient is experiencing

A 19-year-old female patient presents with a positive pregnancy test after experiencing a week of nausea and vomiting. She admits to being sexually active with no contraception and has not disclosed her pregnancy to her parents or her Christian mentor due to fear of their disapproval. She feels overwhelmed, tearful, and uncertain about her options, especially after her boyfriend, who is not Christian, expresses a desire for her to consider abortion. The patient herself holds strong Christian beliefs that life begins at conception, which conflict with her current situation and her boyfriend’s request. This scenario presents a profound spiritual, moral, and ethical dilemma for the nurse practitioner (NP), as she balances her professional responsibilities, her personal moral beliefs, and her obligation to provide patient-centered, culturally sensitive care.

Paper For Above instruction

The scenario described involves a complex moral and spiritual dilemma that challenges the nurse practitioner's (NP) personal beliefs and professional standards. The core of this dilemma revolves around conflicting values: the patient’s Christian faith that life begins at conception and the potential decision to pursue an abortion, influenced by her boyfriend's wishes. This situation prompts the healthcare provider to navigate ethical principles, spiritual sensitivities, and legal considerations while respecting patient autonomy and promoting nonmaleficence.

Understanding the Ethical and Moral Dilemma

At the heart of this case is the moral tension between the NP’s personal beliefs about the sanctity of life and her professional obligation to support patient autonomy. The patient's Christian values oppose abortion, viewing it as morally wrong, based on the belief that life begins at conception (Pearly, 2020). Conversely, her boyfriend’s perspective represents a pro-choice stance, emphasizing reproductive rights and autonomy. The NP must reconcile her moral rejection of abortion with her duty to respect the patient’s autonomy and provide unbiased information about pregnancy options, which include continuing the pregnancy, adoption, or termination.

This conflict is compounded by the patient's fear of familial and social repercussions, including potential devastation from her parents and her boyfriend regardless of her decision. Such fears influence her capacity to make an informed and autonomous choice free from coercion. Furthermore, the patient's age and dependence on her healthcare provider for guidance heighten the importance of ethical sensitivity and respect for her values.

The ethical principles involved include beneficence—acting in the patient's best interest by providing comprehensive information; nonmaleficence—avoiding harm through judgmental attitudes or moral imposition; autonomy—supporting her right to make informed choices; and justice—ensuring equitable access to information and services regardless of personal or moral beliefs (Beauchamp & Childress, 2019). The situation challenges the NP to uphold these principles while navigating her personal moral stance.

Spiritual and Moral Dimensions in Nursing Practice

Shelly and Miller (2006) articulate six principles of spiritual interventions: listening, presence, prayer, healing, forgiveness, and hope. Applying these principles can guide the NP toward compassionate, holistic care. Firstly, active listening and presence allow the NP to honor the patient's emotional and spiritual experiences without judgment. Respecting her faith and feelings, the NP can create a safe space for dialogue.

Secondly, the principle of forgiveness and hope emphasizes nonjudgmental support and guiding the patient toward hope, regardless of her decision. The principle of prayer, while respecting the patient’s faith, can serve as a spiritual tool, offering comfort if the patient seeks spiritual support herself. The NP's own Christian beliefs, while personal, should be kept separate from her professional conduct, honoring the patient's values and choices.

Furthermore, the NP should consider spiritual interventions that affirm the patient's intrinsic worth, such as discussing her faith's teachings about God's love and acceptance, which can provide comfort irrespective of her decision. This approach aligns with the principle of spiritual care that supports healing and emotional well-being (Doka, 2019).

Approach to Care in Light of Ethical Standards and Faith

Per the American Nurses Association (ANA) Code of Ethics (2015), nurses are expected to respect patient autonomy and provide care without discrimination while maintaining personal integrity. The NP must embody cultural humility, acknowledging her own beliefs and ensuring her personal values do not impede delivering unbiased, respectful care.

Given her Christian faith, the NP should openly acknowledge her beliefs but clearly state her commitment to support all patients’ rights and choices. She should provide comprehensive, evidence-based information on all pregnancy options, including continuing the pregnancy, adoption, and abortion procedures, emphasizing informed consent (Holden et al., 2021).

The NP can explore spiritual interventions aligned with the patient's faith to assist her during this difficult time. This may include connecting her with her Christian mentor or spiritual counselor, as she initially intended. Respecting her autonomy, the NP can help her weigh her options in the context of her values and beliefs, supporting her emotional health and decision-making process.

The professional boundaries should be maintained by ensuring that personal moral judgments do not influence the information and support provided. The focus should be on empowering the patient to make decisions consistent with her faith, values, and circumstances. The NP should also recognize the importance of self-awareness and manage her own moral discomfort, seeking supervision or peer support if needed.

In conclusion, navigating this ethical dilemma requires balancing respect for the patient’s autonomy and faith with the nurse’s own moral and spiritual integrity. Applying principles of spiritual nursing interventions, maintaining ethical standards, and fostering open, compassionate communication are essential components for providing holistic care (Doka, 2019). This approach affirms the patient’s dignity and supports her in making an empowered decision aligned with her values.

References

• Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
• Doka, K. J. (2019). Spirituality and end-of-life care: Principles and practices. Routledge.
• Holden, D., Ostwald, S., & Pion, S. (2021). Ethical decision-making in nursing practice. Nursing Ethics, 28(1), 21-30.
• American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. ANA Publishing.
• Pearly, S. (2020). Ethical considerations in early pregnancy counseling. Journal of Nursing Ethics, 27(4), 876-884.
• Shelly, G. B., & Miller, W. R. (2006). Faith, hope, and love: Principles of spiritual support. In Teaching and Learning in Nursing (5th ed.). Lippincott Williams & Wilkins.
• Landeghew, B., & Smith, P. (2018). Spirituality in health care. Journal of Contemporary Nursing, 34(3), 235-241.
• Giske, G. G., & Lausund, W. (2022). Ethics in nursing practice. Sage Publications.
• Walsh, J. M., & Bracken, B. M. (2017). Spirituality and mental health: Implications for practice. Journal of Mental Health Counseling, 39(2), 138-152.
• Ross, L. E. (2019). Moral distress and mental health: An exploration in nursing. Nursing Ethics, 26(3), 1034-1044.