Introduction
According to the Guttmacher Report on Public Policy, current laws in the United States of America indicate that minors under the age of eighteen, unless medically emancipated, must have the medical consent of their parent or parents before any health care decision can be made (Boonstra & Nash, 2000). These laws do not include health sensitive medical care like prescriptions for contraception, abortion of fetus, pregnancy care or drug addiction rehabilitation. Pediatric nurses are in a unique position that serves as the facilitator of patient care and patient care decision-making between the pediatric patient and the patient’s parents. In this position, pediatric nurses become immersed in the concept of family-centered care, and because of this, they often find themselves in situations fraught with ethical dilemmas. In health care, there are often times when the medical team and the patient disagree on the plan of care, but in pediatric health care, this becomes even more complex. This is because there are times where the decision made by the parents is deemed inappropriate by the health care team. What do you do if, as the caregiver, you do not agree with the decisions made for your patient by their surrogate decision-maker? It can be assumed that in most cases, parents only want what is best for their children. Research demonstrates, however, that parents do not always serve as the best voice for their child who is suffering, especially when the child is nearing the end of life. Is it ethical for the health care team to assume the role of decision-maker when disagreement ensues over the pediatric patient’s treatment course?
This paper will examine this ethical dilemma further, including why it is an important issue...
... middle of paper ...
...sion series episode]. In 60 Minutes. New York City: Steve Kroft.
Cummings, C. L., & Mecurio, M. R. (2011). Autonomy, beneficence, and the rights of parents and children: Exploring the application of ethical principles in pediatrics. American Academy of Pediatrics Bioethics Resident Curriculum: Care-Based Teaching Guides. Retrieved from http://www2.aap.org/sections/bioethics/PDFs/Curriculum_Session10.pdf
McGowan, C. M. (2011). Legal issues. Legal aspects of end-of-life care. Critical Care Nurse, 31(5), 64-69. doi:10.4037/ccn2011550
Stringer, S. (2013). Moral choices in end of life care for children. Cancer Nursing Practice, 12(7), 27-32.
Wier, R. F., & Peters, C. (2004). Affirming the decisions adolescents make about life and death (pp.166-172). In C. Levine (Ed.), Taking sides: Clashing views on controversial bioethical issues (10th ed.). Guilford, CT: McGraw-Hill
Nurses everywhere face problems and challenges in practice. Most of the challenges occur due to a struggle with the use of ethical principles in patient care. Ethical principles are “basic and obvious moral truths that guide deliberation and action,” (Burkhardt, Nathaniel, 2014). Ethical principles that are used in nursing practice include autonomy, beneficence, non-maleficence, veracity, confidentiality, justice, and fidelity. These challenges not only affect them, but the quality of care they provide as well. According to the article, some of the most frequently occurring and most stressful ethical issues were protecting patient rights, autonomy and informed consent to treatment, staffing problems, advanced care planning, and surrogate decision making (Ulrich et. al, 2013). The ethical issue of inadequate staffing conflicts with the principle of non-maleficence.
Levine, Carol. Taking Sides: Clashing Views on Controversial Bioethical Issues. 7th ed. Guilford: McGraw-Hill, 1997.
Ethics is an important proponent when considering any decision. Knowing the difference between right and wrong is something everyone should know. However, the importance of ethics gets minimized when a decision that seems wrong actually has benefits. In the efforts of improving society, often ethics is violated. Sometimes in order for society to be better off as a whole, there has to be little sacrificing of ethical practices along the way to do so.
One of the primary concerns coming from a rights and responsibilities lens is whether rules are being followed and met. As Baird (2005) highlights, universalizability of action is important when considering an ethical situation (187). In other words, this ethical lens questions, “what would happen if everyone adopted [a certain] reason for acting” (187). With regard to this ethical dilemma, the one concrete and notable rule is that only teens 13 or older can use the Teen Zone. As a volunteer, I am responsible for upholding this rule. From an universalizability standpoint, it is not possible for me to only make an exception for her and not other patients. Likewise, one of the primary duties this lens ascribes is the duty of “fidelity,” which
...endent judgments about their own fate. In keeping with this trend there is now a growing drive to review the current laws on euthanasia and assisted suicide.” (McCormack, 1998) Nurses are faced with various ethical dilemmas every day. If theses ethical decisions are not treated in a professional manner there can be harsh consequences for both the patient and the nurse.
The medical Profession recognizes that patients have a number of basic rights. These include but are not limited to the following: the right to reasonable response to his or her requests and need and needs for treatment within the hospital's capacity. The right to considerate, respectful care focused on the patient's individual needs. The right of the patient to make health care decisions, including the right to refuse treatment. The right to formulate advance directives. The right to be provided with information regarding treatment that enables the patient to make treatment decisions that reflect his or her wishes. The right to be provided upon admission to a health care facility with information about the health care provider's policies regarding advance directives, patient rights, and patient complaints. The right to participate in ethical decision making that may arise in the course of treatment. The right to be notified of any medical research or educational projects that may affect the patient's care. The right to privacy and confid...
When one initially chooses a career path, one rarely looks at all the negatives that may be associated with that choice. Most career paths have some negatives associated with the field, but few face the moral dilemmas associated with modern healthcare. Those who choose to be in the healthcare profession today are faced with moral and ethical dilemmas that would make King Solomon tear his hair out. In many cases, doctors, and sometimes nurses, are faced with life and death decisions without the benefit of knowing the patient’s, or the patient’s family’s, wishes. However, aside from those tragic times when a patient’s wishes are unknown, healthcare professionals must always put their own morals aside, and act
In “Killing, Letting Die, and the Trolley Problem,” Judith Thomson confronts the moral dilemma of how death comes about, whether one meets their demise through natural causes or by the hands of another (Shafer-Landau 544). If one does in fact lose their life through the action or inaction of another person, a second dilemma must also be considered. Does it matter whether a person was killed or simply allowed to die? The moral debate that arises from these issues is important because if forms opinions that ultimately sets the tone for what is socially acceptable behavior. Social issue such as legalization of euthanasia, abortions, and the distribution of medical resources all hinge on the “killing vs letting die problem”.
In an effort to provide the standard of care for such a patient the treating physicians placed Ms. Quinlan on mechanical ventilation preserving her basic life function. Ms. Quinlan’s condition persisted in a vegetative state for an extended period of time creating the ethical dilemma of quality of life, the right to choose, the right to privacy, and the end of life decision. The Quilan family believed they had their daughter’s best interests and her own personal wishes with regard to end of life treatment. The case became complicated with regard to Karen’s long-term care from the perspective of the attending physicians, the medical community, the legal community local/state/federal case law and the catholic hospital tenants. The attending physicians believed their obligation was to preserve life but feared legal action both criminal and malpractice if they instituted end of life procedures. There was prior case law to provide guidance for legal resolution of this case. The catholic hospital in New Jersey, St. Clare’s, and Vatican stated this was going down a slippery slope to legalization of euthanasia. The case continued for 11 years and 2 months with gaining national attention. The resolution was obtained following Karen’s father being granted guardianship and ultimately made decisions on Karen’s behalf regarding future medical
The delivery of healthcare mandates a lot of difficult decision making for healthcare providers as well as patients. For patients, much of the responsibility is left to them especially when serious health problems occur. This responsibility deals with what treatments could be accepted, what treatments could be continued, and what treatments could be stopped. Overall, it considers what route should be taken in regards to the health interests of the patient. However, there are circumstances in which patients cannot decide for themselves or communicate what they want in terms of their healthcare. This is where the ethical issue concerning who should be responsible for making these important healthcare decisions occur if a patient was to be in this sort of situation. Healthcare providers can play a role in the healthcare decision making as their duty is to act in the best interest of the patient.
The end-of-life nurse’s primary objective is to provide comfort and compassion to patients and their families during an extremely difficult time. They must satisfy all “physical, psychological, social, cultural and spiritual needs” of the patient and their family. (Wu & Volker, 2012) The nurse involves their patient in care planning, as well as educating them about the options available. They must follow the wishes of the patient and their family, as provided in the patient’s advance directive if there is one available. It is i...
Mesler, M. A., & Miller, P. J. (2000). Hospice and assisted suicide: The structure and process of an inherent dilemma
middle of paper ... ... I believe that for the sake of ‘B’, we come together, and finally pull the plug on this debate. Works Cited Ball, Howard. At Liberty to Die: The Battle for Death with Dignity in America.
The American Nurses Association Code of Ethics for Nurses has five elements that pertain to the Principle of Autonomy. Each individual element applies to “respect individual persons” (Baillie, McGeehan, Garrett T, M., Garrett R. M., 2013, p.33). In Chapter 2 of the Health Care ethics: Principles and problems text, it discusses thouroghly the consent of an individual to make their own decisions regarding their health and future requests of care. As a nurse or within all heath care professions, we must treat each individual patient with care, respect, and to remain mindful to the patient regarding any aspect of their lives. In the ANA Code of Ethics for Nurses, it explains ways of maintaining the empathy required in the health field. It further discusses that the respect for human dignity must be a priority, relationships to patients must remain neutral, the severity of the situation, the right to self-rule, and the professionalism that must be upheld by the nurse and their associates.
An ethical dilemma is only examined in a situation which has the following conditions; the first condition takes place in a situation, when an individual has to make a decision on which course of action is best. The second condition is there must be more than one course of action to choose from. The third action is no matter what course of action is taken, certain ethical principles are conceded. In other terms, there is no perfect result. When defining what forms an ethical dilemma, it is important to make a division between ethics, morals, values, laws and policies.