Legal and Ethical Edge Cases

An ethical dilemma becomes more manageable when the nurse separates four questions: 1. What does the patient want? 2. Can the patient make this particular decision now? 3. Who has legal authority if the patient cannot decide? 4. Is the proposed nursing action within the nurse’s scope, competence, and authority? Ethics helps examine values such as autonomy, beneficence, non-maleficence, and fairness. Law establishes enforceable boundaries. Professional standards then define how the nurse is expected to practise within those boundaries. A choice may feel compassionate yet still be unlawful, outside scope, or unsafe. In Ontario, the Nursing Act and College of Nurses of Ontario standards form part of the regulatory framework for nursing practice. Failure to follow the CNO Code of Conduct or applicable practice standards may constitute professional misconduct and can trigger regulatory investigation or discipline. An employer’s policy cannot authorise an act that legislation prohibits, and a prescriber’s order does not automatically make an act legal for the nurse to perform. The experienced nurse notices the decision point before becoming absorbed in the surrounding emotion. A family may be...