Top 4 Nursing Ethics Problems Faced By Oncology Nurses
By Sarah Stasik, Contributor
All RNs face nursing ethical dilemmas from time to time, but for some oncology nurses, ethics problems can be a daily challenge. This is especially true when treating advanced cancers or when patients approach end of life, but oncology nurses can face difficult ethics questions with any patient.
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4 nursing ethics dilemmas oncology nurses may face
The costs of treatment, disagreements over what's best for a family member and balancing quality of life with its length are some common nursing ethics concerns in oncology. Take some time to move beyond developing clinical cancer care skills and consider these four common oncology nurse ethical issues.
1. Costs that are prohibitive for the patient
Cancer care is expensive. In fact, it accounts for around 5 percent of all healthcare spending and often requires the use of exorbitantly priced medications. Even with insurance, patients can pay $12,000 per year or more in out-of-pocket expenses for cancer drugs that cost a total of up to $400,000 annually per patient.
Oncology nurses and other clinicians in the niche must draw on their code of ethics when deciding how to approach care when these types of costs are at play. This is especially true when it comes to evaluating the value provided against the cost or helping the patient do so.
2. Medical treatment that extends life without considering its quality
Oncology nurses who treat patients with advanced cancer deal daily with people who are dealing with a range of mental and physical side effects, including potentially severe pain and side effects from treatment that drastically diminish quality of life. And yet, hope of a cure or remission is often injected within this situation.
One area that requires RNs to draw heavily on their nursing code of ethics is understanding when an extension of life may not be the right option. While the patient and/or their family must make the final decision, oncology professionals must know when to present palliative care as the recommended course of action.
3. Disparities in the wishes of patient and family
Modern medical ethics and even the updated nurses code of ethics calls for the patient to be the primary driver behind treatment decisions. In the past, preference might have been given to the family in what type of care was provided to a cancer patient, especially if the patient is incapacitated. Today, though, even without a documented advance directive, patients must be able to rely on nurses to advocate for any choices they verbalized to clinical staff. For oncology nurses, that may mean going against the family's wishes.
4. Caring for patients who make risky decisions
Cancer patients, understandably, want to find any possible treatment for their conditions. In some cases, they may seek alternative therapies or decline certain recommendations from their doctors. Some patients may not want care at all. Whatever the choice of the patient, nurses and doctors have to make ethical decisions that balance medical resources, treatment protocols and the patient's wishes —even if the person presents for treatment or help after making a decision they were informed might not be the most ideal choice.
Ultimately, oncology nurse ethics can be difficult to navigate. But RNs in this specialty must work to apply the nursing code of ethics in every decision to protect their careers, employers and patients.