Advanced Practice Nursing Decisions that Cause Moral Distress (End of Life)

Question Description

Case Study Ethical Legal Dilemma Advanced Practice Nursing

Course outcomes addressed in this Assignment:

MN506-1: Apply theoretical frameworks and concepts to ethical dilemmas in the advanced practice role.

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PC 2.3: Demonstrate integrity through the application of relevant codes of conduct and social responsibility within one’s profession.


1.Create an ethical legal decision-making dilemma involving an advanced practice nurse in the field of education. Apply relevant codes of conduct that apply to the practice of nursing and your chosen field.

2.Include one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts.

3.Construct a decision that demonstrates integrity and that would prevent violation of the ethical principle and prevent the law from being violated.

4.Describe the legal principles and laws that apply to the ethical dilemma.

5.Support the legal issues with prior legal cases or state or federal statutes.

6.Analyze the differences between ethical and legal reasoning and apply an ethical-legal reasoning model in the case study to create a basis for a solution to the ethical-legal dilemma.

7.List three recommendations that will resolve advanced practice nurses’ moral distress in the dilemma you have presented.

8.Based on the issue you presented and the rules of the law, apply the laws to your case and come up with a conclusion.


•This is a fact-based Assignment that will not include your opinion.

•This will require research and support for what is written.

•The Assignment should be in your words after reading the scholarly and fact-based publications and have proper citations. There should be no quotations. The professor wants to hear your voice as a masters trained nurse.


In the Unit 2 topic 1 Discussion, you will choose an ethical-legal dilemma that would cause the advanced practice nurse moral distress. You will write the introductory paragraphs for the Unit 4 Assignment in the Unit 2 topic 1 Discussion Board and post it for your peers to comment on.

You will continue working on the topic you have chosen and submit the paper using the most recent version of APA format. The paper should have a minimum of seven citations and some of these should be case law or applicable statutes. The Kaplan Library has Westlaw Campus Research database where you can find case laws that relate to your topic.

Unit 4 Individual Paper

Advanced Practice Nursing Decisions that Cause Moral Distress (End of Life)

As an advanced practice nurse, we will sooner or later come across an issue or more than one issue that will cause us moral distress.According to Westrick, moral distress occurs when there is a mismatch or disequilibrium between moral obligations and principles, and the ability to implement them, (2014 p. 310).As a nurse practitioner working in a hospital setting we will come across issues of how to advocate for our patients when it comes to quality of life rather than quantity of life.“Every day nurses make great moral decisions in their workplace, but in practice they cannot always act according to their moral obligations,” (Williams, Wang, & Kitchen, 2014,p.7).One thing that we must assist the patient and family member is to understand and choose the proper treatment.The physicians should speak to the patient and family member about the disease and the prognosis, also be able to answer questions about death, and pain relief.

Patients and families are still under the impression that if they sign up with hospice that the patient will only be alive for a few hours or days.“Accepting and preparing for death is sometimes unbearably frightening for families,” (Bülbül et. al., 2015 p. 1242).Hospice even today is underutilized and family members will only agree to it when death is imminent.As an advance practice nurse caring for a terminally ill patient, who is suffering it will increase your moral distress.Families and patients should also be explained that there is the choice of Palliative care which it’s goal is to prevent or treat the symptoms and side effects of the diseasebesides the social and spiritual problems.According to Williams, Wang, and Kitchen, the terms ‘palliative’ and ‘end-of-life’ care are often used interchangeably by researchers and health practitioners, (2014, p.188).Palliative care will not cure the disease but it provides comfort and supportive care, and management of the symptom.

Ethical Dilemma

Ethical Principle and Law

Preventing Violation of Principle/Law

Legal Principles and Law

Legal Cases

Ethical and Legal Reasoning




Ameri, M.; Safavibayatneed, Z.; Kavousi, A.; (2016),Moral distress of oncology nurses and morally distressing situations in oncology units, Australian Journal of Advanced Nursing

Bülbül, S.; Sürücü, M.; Karavaizoğlu, C.; & Eke, M.; Limitations in the approach health caregivers can take in end-of-life care decisions, Child: Care, Health & Development, Nov2015; 41(6): 1242-1245. 4p.

Westrick, S.J.; (2014), Nursing Law and Ethics,Edition 2ndJones & Bartlett

Williams, A.M.; Wang, L.; and Kitchen, P.; (2014) Differential impacts of care-giving across three caregiver groups in Canada: end-of-life care, long-term care and short-term care, Health and Social Care in the Community 22(2), 187–196 doi: 10.1111/hsc.12075

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