Ethical Considerations

Grant and Ballard (2011) define non-maleficence as the act of protecting those we care for from harm, whether with or without intention to do so. When examining the practice of palliative sedation, a nurse practitioner could be at risk of violating this ethical principle. In Annie’s case, the nurse practitioner, Karen, must balance her duty to promote health and prevent illness with her duty to alleviate suffering and support the dying (American Nurses Association, 2001). Karen understands that the process of palliative sedation can present some harming effects such as respiratory suppression and inability to interact with family or friends, as well as inhibiting the opportunity to make continued decisions regarding health treatments (Lubbe & Stange, 2009). Yet, Karen has also witnessed the agony of Annie’s deteriorating health and believes that palliative sedation could be the key to a dignified and comfortable departure for her from this life of relentless torment. Karen is challenged in having to balance the possible negative outcomes of the treatment with the apparent negative results of Annie’s current health condition. Karen also ponders the valuable idea of intention in non-maleficence. Although the aim in palliative care may be directed at relieving pain and not hastening death, there is no guarantee that its effects will not be the precise thing that kills Annie. Karen wonders if she is being true to the principle of non-maleficence by participating in an action that has the potential to cause death, even if unintentionally.