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Ethical dilemmas

Ethical dilemmas in self-management support

Publication date: 01 July 2013

Self-management is a hot item in health care today, and it promises the world. It would enhance patients’ quality of life and curtail the rising health care costs. However, in practice, nurses are faced with conflicting values.

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What should nurses do if a patient makes choices that have negative consequences for their health? What if a patient is unable or not prepared to manage their own illness or disorder? Should you take on some or all of the patient’s self-management tasks or emphasise their individual responsibility and autonomy?

The current studies into self-management have hardly looked into such dilemmas as yet. That is why the Research Centre Innovations in Care, together with Erasmus University Rotterdam (Institute of Health Policy and Management), have researched nurses’ ethical dilemmas in self-management support.

Interviews with both nurses and patients helped to map out several ethical dilemmas. In addition, nurse-patient interaction was observed in various outpatient settings. The project ties in with the NURSE-CC research programme that focuses on nurses’ competences for self-management support and the effectiveness of self-management interventions.