Yes, this is an ethical dilemma in many different ways. First, the doctor wrote a DNR order on a patient without the families consent. I understand that the doctor wants to honor what he thinks the patient’s wishes are, but legally he has no grounds to write the order without the families consent. Secondly, the doctor tells the nurse not to inform the family of the written DNR order. Depending on if the nurse kept this information to herself or not would be another factor in this ethical dilemma.
The nurse needs to make sure the family makes the best decision for their loved one. As a future nurse, I would never want my fidelity to be questioned. We have to make sure to uphold the patient, and the families wishes during this difficult time. The family is wanting to try to make sure everything is done to help their mother. I would want to make sure the family understood exactly what a DNR order is.
I would also want to make sure to answer any questions and give the family time to process this difficult information. This is a decision that the family will have to live with for the rest of their lives. This in itself is a heavy burden to carry. That is why the nursing staff needs to take the time to make sure the family makes the best decision and fully understands the decision they are making for their loved one. According to Plakovic (2016), the benefit of the patient having a longer life can cloud the families judgement to make the best decision about quality of life (Plakovic 2016).
The family also needs to understand that this decision needs to be a family discussion, and a unified decision. I would also want to make sure that the family understands that care will not be compromised if they choose a DNR for their loved one. According to Barlow (2014), “It limits only the provider’s actions to resuscitate a patient who’s pulseless or not breathing; it doesn’t restrict other clinically indicated care” (Barlow 2014). After time has passed for the family to come to a decision, answer any questions the family may have, and fully understand this decision, then the doctor can finalize it with official paperwork.