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.


    The project aimed to develop an ethical framework that can be used in the design and implementation of self-management interventions. In order to identify possible dilemmas a qualitative study consisting of semi-structured interviews was conducted. Six experts on self-management and medical ethics and 15 nurses participated. Nurses providing self-management support face three types of ethical dilemmas: respecting patient autonomy versus reaching optimal health outcomes, respecting patient autonomy versus stimulating patient involvement, and a holistic approach to self-management support versus safeguarding professional boundaries. The studies’ results were translated into a practical guide for professional practice and nursing education. This guide provides a helping hand for team discussion and moral deliberation about such dilemmas and suggests some useful strategies to help them in their self-management support.