Jalani, Shermina A
Nursing Roles and Responsibilities
Ethical Decision Making Process
Situation: Mrs. L, a 67- year old woman, is hospitalized with multiple fractures and lacerations
caused by an automobile accident. Her husband, who was killed in the accident, was taken to the
same hospital. Mrs. l, who had been driving the automobile, constantly questions her primary
nurse about her husband. The surgeon has told the nurse not to tell Mrs. L about the death of her
husband; however the surgeon does not give the nurse any reason for these instructions. The nurse
expresses concern to the charge nurse, who says the surgeon’s orders must be followed-that the
surgeon will decide when Mrs. L should be told. However, the nurse is not comfortable with this
and wonders what should be done.
• Come up with your ethical decision.
Step 1: Identifying and setting up the Ethical Problem
• The ethical problem is whether the nurse should follow the surgeon’s order not to tell Mrs.
L about her husband's death, or if the nurse should inform Mrs. L about her husband's death
despite the surgeon's orders.
Step 2: What are the relevant facts?
• Mrs. L is hospitalized with multiple fractures and lacerations caused by an automobile
accident. Her husband was killed in the accident and also taken to the same hospital. Mrs.
L constantly questions her primary nurse about her husband. The surgeon has told the nurse
not to tell Mrs. L about her husband's death, but no reason was given for these instructions.
Step 3: Who are the Stakeholders?
• The stakeholders in this case are Mrs. L, her deceased husband, the nurse, the surgeon, and
the hospital.
Step 4: What are the relevant options?
1. The nurse follows the surgeon's order not to tell Mrs. L about her husband's death.
2. The nurse tells Mrs. L about her husband's death despite the surgeon's orders.
Jalani, Shermina A
3. The nurse seeks clarification from the surgeon regarding their orders and the reason for
them.
• Option 1 may prevent Mrs. L from experiencing immediate emotional harm, but it may
cause her greater harm in the long run when she finds out later. Option 2 may cause
immediate emotional harm to Mrs. L, but it allows her to grieve and begin the process of
moving on. Option 3 seeks to clarify the surgeon's orders and may lead to a better
understanding of the situation and a more informed decision.
• The affected parties have a right to know the truth about their loved ones' condition and
status. Option 2 respects Mrs. L's right to know about her husband's death.
• Option 2 advances the common good by promoting honesty and transparency.
• Option 2 allows the nurse to act with compassion and empathy, which are virtues valued
in healthcare.
• Option 2 treats Mrs. L and her deceased husband the same, by respecting their right to
know the truth about their situation.
Step 5: Determine the most appropriate action
• Based on the evaluation of the available options, the most appropriate action is for the nurse
to tell Mrs. L about her husband's death despite the surgeon's orders. This option respects
Mrs. L's right to know the truth, promotes honesty and transparency, and allows the nurse
to act with compassion and empathy. The nurse should approach Mrs. L with sensitivity
and provide emotional support during this difficult time. The nurse should also seek
clarification from the surgeon regarding their orders and the reason for them, to ensure that
all parties involved are informed and on the same page.