Once in a person’s life, they can find themselves in a situation where they have to choose between two answers which are neither morally right nor wrong, that is they find themselves in a dilemma. According to yourdictionary.com, “Ethical dilemmas are situations in which there is a choice to be made between two options neither of which resolves the situation in an ethically acceptable fashion”. This paper discusses an ethical dilemma of a cystic fibrosis patient, his parents, and the use of stem cell transplant as a treatment option.
The ethical dilemma discussed in this research paper is about stem cell transplant for a patient who has cystic fibrosis and the fact that the stem cell is coming from an aborted fetus. The case is about T. J. a four-year-old male who has been diagnosed with cystic fibrosis. His parents have talked to a couple of physicians about his treatment options and they were told that there was no cure for the disease.
His aunt who is very close to T.J. and pregnant with a healthy baby did research on cystic fibrosis and found out about the great success there has been in stem cell research in helping to cure cystic fibrosis. She volunteered to use her unborn fetus to help cure T.J. of cystic fibrosis. T.J.’s parents had a meeting with the research physicians about the stem cell transplant and found out that the stem cells come from aborted fetus. They then decided not to go for the transplant due to religious and ethical beliefs.
This case study was given to the class by our instructor and that is how we became aware of it. The people involved in the situation are the patient(T.J.), his parents, his aunt who is very close to him, and the research physicians.
The American Nurses Association (ANA) has a code of ethics that contains principles and provisions which discusses ethical violations by nurses. According to the ANA, “The American Nurses Association Center for Ethics and Human Rights was established to help nurses navigate ethical and value conflicts, and life and death decisions many of which are common to everyday practice”. The Center helps to promote nurses’ competence on how to deal with ethical situation like the one mentioned above. The article, “The ANA code of ethics for Nurses with Interpretive statements: Resources for Nursing Regulation” by Olson. L and Stokes F (2016), discuses the ANA’s nine provisions of the code of ethics and give examples of cases of ethical violations and the disciplinary actions that was taken.
The two provisions that would be used in this research paper are provision 1 and 3. Provision 1 states, “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person” (ANA 2015a, p.1). This provision means that nurses must respect their patients and families in terms of their culture, beliefs, and values without any bias or prejudice. It is irrefutable that nurses in the course of their career would work with people from different backgrounds, but just because they are not familiar with that culture does not mean that they can disrespect them. This provision emphasizes on the fact that nurses must show compassion and provide quality care to everyone regardless of race, background, culture, and beliefs. Provision 3 states, “The nurse promotes, advocates for, and protects the rights, health, and safety of the patient” (ANA 2015a. p.9). Provision 3 talks about the fact that it is the duty of nurses to advocate for their patients and families as well as protect their right to privacy and confidentiality.
Provision 1 relates to the ethical dilemma under discussion in the sense that, although some nurses might disagree with T.J.’s parent refusal to go on with the stem cell transplant on the bases of religious and ethical concerns, they must respect their decision and help them through that phase of care. According to the article, Ethical Issues in Stem Cell Research, “Some people believe that an embryo is a person with the same moral status as an adult or a live-born child” (Lo B. and Parham L., 2009). Therefore if T.J.’s parents belief in pro-life and do not want to cause an abortion, nurses have to respect that although they might not agree with their decision. Provision 3 relate to the ethical dilemma because patients and their families have the right to refuse care for whatever reason they deem fit. According to Provision 3, the nurse has to protect the rights of patients, therefore nurses in this case scenario has to protects T.J.’s parents right to refuse the stem cell transplant. Nurses can have different opinions than that of the patients or their family, but that should not affect the way they care for their patients. In this case, T.J.’s aunt has agreed to use her unborn child to help cure his disease, but his parents are against abortion and refused to go on with it. One can argue that the parents are doing harm to their son for refusing a cure, but it is their son and they have the right to refuse treatment, what anyone can do is to support them and provide the best possible care for T.J.
Although the case study stated clearly that T.J.’s parents decided not to go for the stem cell transplant for religious and ethical beliefs, one cannot conclude the outcome. This is because we did not witness the case study, rather it was provided by our instructor. Moreover, the case study did not provide more information with regard to the outcome of the case. In terms of resources at the clinical agency provided for the family, they had the opportunity to sit down in a meeting with physicians at the stem cell research facility to discuss about the transplant process and what it takes. They also have social services available to help them through this process. Although it was not stated in the case study, every or most healthcare facilities has an ethics committee that can assist in dealing with dilemmas like this one and they can serve as a resource to the families.
To conclude, ethical dilemmas are bound to happen in clinical settings since people are from different cultures and backgrounds with different religious beliefs. However, nurses have to make sure they do not impose their opinions on patients and their families, but rather give them the chance to make their own decisions while protecting patients’ rights and confidentiality. It is also important for nurses to follow the ANA code of ethics in other not to violate any rules and regulations regarding ethical issues.
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