Professional Identity 92434
Assessment 2: Case Study
Due: 9th September 2018
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Student Number:
1. Clearly define the problem – Objectively note the ethical issue that the nurse (Sam) must address
In this case study, there is one major problem. The problem is that the healthcare provider who is Sam is in dilemma. The dilemma is that the patient who is a 15 year old teenager has presented with pregnancy which she feels that the mother should not know (Preshaw, Brazil, McLaughlin, & Frolic, 2016, p. 496) The ethical dilemma in this case is truth telling. As a nurse, it is necessary to share the patient information with their family members and with them too. The nurse is supposed to share crucial information regarding proposed treatment plans(Ramos et al., 2014, p.429). However in this case, the patient Jessica does not want the nurse to tell her mother of her pregnancy status. This therefore presents a very big headache to the nurse. It is therefore not clear if Sam should disobey the confidentiality of the patient and share the issue of pregnancy with the mother.
2. Examine the ethical and legal principles that apply to the case study
There are different ethical principles in this case study. One of the ethical principle is Autonomy. This is a principle that allows every patient the self-determination, freedom and independence to make their choices. In the healthcare perspective, the principle of autonomy allows the patient to make decisions regarding their health status (Parahoo, 2014, p.12). Like in this case study of Jessica, she has the freedom to dictate if the nurse should share the information with the mother or not.
Informed consent is another important ethical principle in this case study. Informed consent is a principle which allows the patient to decide what medical procedures should be done regarding their health status. Jessica has no idea of what she should do concerning the pregnancy(Trobec & Starcic, 2014, p. 340). It is therefore the role of the nurse to provide an outline of what procedure should be carried out and the consequences of failing to accomplish the procedure. From there, Jessica can then decide.
The other ethical principles are truthfulness and confidentiality. Truthfulness is the ethical principle which allows the healthcare profession to tell the truth to whoever has the right to know. Like in this case, the mother has the right to know the medical status of her daughter and therefore the nurse should share the information with him.
Contrary to truthfulness is another ethical principle called confidentiality. This principle urges the healthcare provider to keep any patient information as a secret. Even if the family members ask for it, the nurse has no mandate to disclose the information unless the patient gives permission. In this case study, Jessica does not want the nurse to disclose her pregnancy status to the mother and the nurse should therefore obey her confidentiality.
3. Identify 2 options available to Sam in addressing the ethical problem identified in question 1 as they apply to the International Council of Nurses (ICN) Code of Ethics for Nurses (2012)
According to the International Council of Nurses (ICN) Code of Ethics for Nurses (2012), there are two options in this case study that Sam can utilize to address the ethical problems identified. One of the options is to obey the ethical principle of confidentiality and keep away from sharing Jessica’s pregnancy status with the mother(Trobec & Starcic, 2014, p. 48). The other option is to go by the ethical principle of truthfulness and share the true information with one of the family members who is the mother in this case. Both of the two options have consequences, in the vent of withholding information, sometimes it is beneficial. This is because it can save the negative emotions of the family members. Like in this case, the mother might be completely heartbroken by the fact that the daughter is pregnant. Such information can be heartbreaking to the extent of leading to other medical conditions like high blood pressure. The International Council of Nurses always advocates truth telling and it is therefore the duty of the nurse to find out a way in which to finally deliver the news or the information to the mother .About obeying confidentiality of the patient, this is a good option yes but if you look at the long term impacts, it can be very detrimental (Judkins-Cohn, Kielwasser-Withrow, Owen, & Ward, 2013, p 36). This is still a young girl who does not understand much and can therefore make healthcare demands out of ignorance. The nurse should therefore take time and educate her on the importance of sharing the information with the parents. Disclosing the information would also make her peaceful at mind rather being curious of how her mother would react if she came to learn of the situation.
4. Reflect on the options identified in question 3 and present a rationale as to which ONE of the options you would follow if you were in Sam’s position.
In this case study, there are two important ethical principles that include confidentiality and truth telling. This two ethical principles often present dilemmas to nurses in their routine practices. Like in this case study of a girl who is pregnant yet she does not want the mother to know, there are two options. The two options identified in the case study are telling the mother the truth or obeying the wishes of the patient who is Jessica. All the two options will however have consequences. As for me, the best option would be truth telling. According to the ethical principle of truth telling, the nurse has the mandate to share any relevant information to the people who have the right to know. The mother of the patient is therefore entitled to any information regarding her daughter. Besides, the patient is very young since she is only 15 years. You realize that at this age, the patient is not yet mature enough to make any sound decision. Failure to conceal the necessary information would lead to severe consequences. One of the potential consequence is abortion. Abortion is the termination of pregnancy before the fetus fully matures. Abortion is another ethical principle that has had heated debates over the decade. Jessica is still a minor and entirely depends on her parents and therefore as a nurse, I would tell the mother the truth so that she can be watched over keenly (Heale & Shorten, 2016, p 7). As a nurse, I would weigh the two options keenly and find out which one would benefit both the mother and the daughter before eventually deciding.
In as much as ethical guidelines are important frameworks that provides the scope of operation of the nursing practices, the nurses should at tomes think critically and act in the interest of both the patient and the family members as long as it has quality or better outcome for the two parties involved.
References
Heale, R., & Shorten, A. (2016). Ethical context of nursing research. Evidence Based Nursing, 20(1), 7-7. doi:10.1136/eb-2016-102514
Judkins-Cohn, T. M., Kielwasser- Withrow, K., Owen, M., & Ward, J. (2013). Ethical Principles of Informed Consent: Exploring Nurses’ Dual Role of Care Provider and Researcher. The Journal of Continuing Education in Nursing, 45(1), 35-42. doi:10.3928/00220124-20131223-03
Parahoo, K. (2014). The Research Process and Ethical Issues. Nursing Research, 24(2),95-109. doi:10.1007/978-1-137-28127-2_7
Preshaw, D. H., Brazil, K., McLaughlin, D., & Frolic, A. (2016). Ethical issues experienced by healthcare workers in nursing homes. Nursing Ethics, 23(5), 490-506. doi:10.1177/0969733015576357
Ramos, F. R., Brehmer, L. C., Vargas, M. A., Trombetta, A. P., Silveira, L. R., & Drago, L. (2014). Ethical conflicts and the process of reflection in undergraduate nursing students in Brazil. Nursing Ethics, 22(4), 428-439. doi:10.1177/0969733014538890
Trobec, I., & Starcic, A. I. (2014). Developing nursing ethical competences online versus in the traditional classroom. Nursing Ethics, 22(3), 352-366. doi:10.1177/0969733014533241
Walls, P. (2014). Understanding Research for Nursing Students Ellis Peter Understanding Research for Nursing Students 168pp £16.99 Sage/Learning Matters 9871446267615 144626761X. Nurse Researcher, 22(1), 48-48. doi:10.7748/nr.22.1.48.s5
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