Guiding principles

Article Abstract:

Nurses faced with a patient refusing to take his or her medication face an ethical dilemma. If attempts at reassurance and explanation are unsuccessful, nurses need to examine the situation and the pros and cons of their possible actions. A checklist of 11 guidelines can help such situations, it advises nurses to identify the dilemma, moral values, the proposed decision, and the possible implications from the proposed decision.

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In their own best interest

Article Abstract:

Nurses treating elderly patients who refuse intervention face an ethical dilemma. Organic or cognitive problems can prevent the elderly from making decisions which are in their best interest. It is suggested that a patient's autonomy could be compromised in order to reduce pain; and also if the patient is jeopardising his her long-term autonomy with current autonomous decisions.

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A matter of life and death

Article Abstract:

A nurse describes her conflicting emotions when a consultant orders that a sick and handicapped child is not to be resuscitated despite the wishes of her foster mother. The nurse, who feels uneasy about upholding the decision but has no authority to reverse it, questions the consultant's right to play God and his reluctance to take into account the feelings of others.

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