This case poses a challenging moral dilemma about when tragic news should be relayed to a patient. Amira Mullins is the featured patient, as she is in critical condition, is in desperate need of emergency surgery, and is questioning the state of her loved ones. The dilemma involves the issue of non-maleficence, beneficence, and autonomy. In this case, I argue that non-maleficence and beneficence temporarily outweigh autonomy. Maintaining a relationship based on trust between nurses and patients should be paramount while also promoting the health of the patient. In this instance, the concept of promoting the patient’s wellbeing and the concept of remaining honest and forthcoming are at odds. The moral dilemma is whether the nurses should immediately inform Amira of her partner’s death or wait and inform Amira when she is in a more stable condition. I argue that the nurses should wait to inform Amira of her partner’s death.

Beauchamp and Childress define nonmaleficence as “a norm of avoiding the causation of harm” (13). In this instance, Amira needs surgery in order to survive and prevent the risk of further harm. Immediately informing Amira that her partner died when she is in such a fragile state is not practicing nonmaleficence. It is never a good time to hear about the loss of a loved one, but hearing such news places further stress on Amira’s body, possibly pushes back surgery, and promotes risk of additional harm. Beneficence is defined as “a group of norms pertaining to relieving, lessening, or preventing harm and providing benefits and balancing benefits against risks and costs” (Beauchamp & Childress 13). The nurses in this case should emphasize the fact that her daughter Samantha is okay and stress that it is important for her to try and remain calm. Telling Amira that her partner died can only result in more harm.

While Amira has a right to know about her partner’s condition, the timing of such knowledge could be detrimental. It is in Amira’s best interest for the nurses to focus on Amira’s wellbeing and postpone adding additional stress. There is the possibility that Amira could die during surgery without knowing about her partner’s death, but the nurses need to do all they can to lessen the psychological strain on the body. Waiting until Amira has recovered from surgery, is stable, and in a calmer environment is the only way to ensure that Amira can physically withstand news of the death of her partner. An emergency room setting is never ideal to notify a family of the death of a loved one. The fact that the patient is in and out of consciousness also prompts whether she is stable or competent enough to be interviewed by the police. The patient’s physical wellbeing in this instance overrides all else.

This case brings the moral obligations and responsibilities of nurses into consideration. The relationship between nurses and patients is often based on trust, but it can be challenging to make sure the patient’s physical wellbeing is always at the forefront. One study conducted in Sweden by Cronqvist, Theorell, Burns, and Lützén (2004) interviewed intensive care nurses. This study contrasts the tendency to “care for” versus the tendency to “care about” patients. Cronqvist et al. found that it can be challenging to balance “moral obligations and work responsibilities” (73). This furthers the notion that nurses may feel inclined to maintain a trustworthy relationship, as indicated by their profession’s code of ethics, while also weighing the moral implications of their actions.

Works Cited:

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York:

Oxford UP, 2009. Print.

Cronqvist, A., Theorell, T., Burns, T., & Lützén, K. (2004). “Caring about—Caring for: Moral

obligations and work responsibilities in intensive care nursing”. Nursing Ethics, 11(1),

63-76.