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An ethical dilemma is a complex decision-making process that involves personal and professional morals and values. In healthcare, the team faces multiple circumstances that require concise moral decisions every day. Dilemmas occur when the providers cannot solve values and social justice challenges. Situations such as cultural beliefs, technological advancements, economic stress, honesty, and respect are examples that contribute to a dilemma. Beneficence and the will to do good unto others drive the difficult choice in moral conflict. Hamric & Delgado (2014) mention that the obligatory requirement of a person to adopt two or more separate actions but cannot perform all alternatives is an ethical or moral dilemma. Not all predicaments are unequal (acceptable vs. unacceptable), most are created equally unacceptable, and the provider has to meet a resolution unwillingly (Hamric & Delgado, 2014).

           The diagnostic approach in solving the ethical problem will examine one's self, morals, and beliefs. Thenceforth, exploring the professional and interdisciplinary knowledge to conclude. The American Nurses Association created the code of ethics for nurses to oblige when fulfilling their daily duties of the profession. Advanced practice nurses (APN) have a tremendous responsibility in recognizing moral issues due to the leadership role displayed and the skills acquired from the core competencies (Hamric & Delgado, 2014). Patients, families, and physicians turn toward the APN's expertise to aid in the strategy of ethical decision-making. The relationship that nurses and APN's have with the patient builds trust and honesty to advocate for them. On the contrary, the professional and medical education background may cause conflict with the provider-patient relationship.

           An example of an ethical dilemma experience I encountered was working in the neonatal intensive care unit (NICU) as a registered nurse. In that unit, exposure to premature and full-term babies with many health complications is evident. In addition, different cultural and religious beliefs amongst the families of the patients took place. For example, I took care of a patient's mother who refused to have her baby vaccinated to prevent Hepatitis B. Not only did she refuse vaccinations, but she also refused specific treatment management and nutritional regimens to promote the health and growth of the baby for cultural reasons. The medical knowledge and experience I had working in this nursing field and the consequences I know might adhere to the patient's refusal of treatment made it difficult to perform my duties. I resolved the issue by first examining my own beliefs and recognize other individual's beliefs as well by utilizing the principle of respect for autonomy (Hamric & Delgado, 2014). Despite my reasons for the importance of receiving the vaccine and other treatment modalities for the developing baby, I respected the mother's wishes. I fulfilled my obligatory duties within the nurse code of ethics. According to Meyer et al., (2020), the principle of autonomy is related to informed consent in healthcare. Therefore, the risks and benefits of treatment discussed with the patient or family have the right to exercise self-determination.

           Practicing appropriate ethical decision-making will improve patient outcomes. In addition, the promotion of social justice and complying with legalities during the uncertain healthcare environment can raise ethical awareness. 

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