Ethical Decision Making and Spirituality

Ethical Decision Making and Spirituality
“Spirituality is the appreciation of existence and purpose giving the individual a sense of meaning or self-worth” (Ramezani et al, 2014). Spiritual care is providing care to persons that their spiritual beliefs have been affected as a consequence of trauma, life-threatening illness or loss. Spiritual beliefs vary from person to person and may depend on culture and religion values. Each person is to be treated differently when providing this kind of care because of different beliefs. It’s only provided to persons that have lost their spirituality, they do not cope with illness and trauma. Spiritual coping helps and individual in integrating mind, body and spirit to maintain good health. This care is provided by nurses or spiritual care providers.

Ethical Decision Making and Spirituality

The largest population receiving spiritual care are in the intensive care unit and palliative care unit. This patients have endured a lot of loss financially, socially and physically, and only spiritual care may help them recover or die in dignity (Balbon et al, 2013). The client’s lack capacity to make decisions and the nurse is expected to make them. It becomes very hard for a nurse to make an ethical decisions while considering the clients beliefs. Ethical spiritual intervention by nurses is influenced by nurse’s education, own learned potential inhibitors such as personal and professional experiences, beliefs and culture.

            Effects of ethical interventions

Ethics decisions and interventions in most cases defer with the clients beliefs when initiating spiritual support. According to Cerit & Dinç (2013), ethical decisions and interventions can give raise to ethical conflicts especially among professionals and patients. The patient is to discuss her concerns and values in a therapeutic environment and the nurse obligation is to respects them. A decision made cannot be implemented without client consent even if its life threatening situation. Its can consider unethical when clients parameters of well-being especially spiritual are not put into consideration. Spiritual care provider need to treat each patient as a unique being and consider as him/her bring right in whatever he/she recommends suits her in terms of interventions/care. The patient is always considered right even if the nurse does not agree. This becomes a challenge to the nurse to make a decision to intervene or abandon.

On the other side, spiritual beliefs influence positive decisions without creating an ethical dilemma for the nurses. This happens especially happens when the nurse has mastered the culture and religion of the client had    which facilities ease in spiritual understanding and support. In case of an ethical conflict arises, the nurse should follow the ethical decision making process, let there be discussions and an agreement reached if possible in presence of a witness. The nurse is the patients advocate and should educate the patient on medical interventions that good for her and avoid proselytize.

Spiritual care is less provided by nurses due to lack of competency and visibility leading to inappropriate interventions. Reflective nursing should be practiced by all nurses as frequent as possible to improve competency. The nursing curricula should incorporate spiritual care to equip our nurses with better understanding. A nurse should be professionally capable of analyzing different situations and make the right choices after considering all the tentative solutions before making ethical decisions. Therefore, as spiritual care provider confidence in making decisions between what is right and wrong should be applied ensuring total respect of patient’s values and beliefs.


Balboni, M. J., Sullivan, A., Amobi, A., Phelps, A. C., Gorman, D. P., Zollfrank, A., … & Balboni,          T. A. (2013). Why is spiritual care infrequent at the end of life? Spiritual care perceptions         among patients, nurses, and physicians and the role of training. Journal of Clinical             Oncology31(4), 461.

Cerit, B., & Dinç, L. (2013). Ethical decision-making and professional behaviour among nurses: a           correlational study. Nursing Ethics20(2), 200-212.

Ramezani, M., Ahmadi, F., Mohammadi, E., & Kazemnejad, A. (2014). Spiritual care in nursing:            a concept analysis. International Nursing Review61(2), 211-219.

Tiew, L. H., Creedy, D. K., & Chan, M. F. (2013). Student nurses’ perspectives of spirituality and            spiritual care. Nurse education today33(6), 574-579.

VanderWeele, T. J., Balboni, T. A., & Koh, H. K. (2017). Health and spirituality. Jama318(6), 519-520.