Reply must be at least 250 words.
The case study we were provided presents an ethical dilemma I have previously come across in my nursing career. The dynamics between health care providers and patients and their families can vary greatly. I think it is important to remember in any subject area that encompasses the human experience, the solution to the problem may not always be the same.
In our given scenario, the physician was placed in a very difficult position, that due to the patient age, went beyond personal belief and extended on to legal limitations.
The Nurse had made the moral judgement that dishonesty with the patient, would ultimately affect her ability to prepare herself for the struggle that lies ahead. The nurse felt the physician was dishonouring the rule of always being honest with your patients.
Respecting the dignity of the patient by including them in the decision-making process, is a principle the physician side stepped by following the parent’s wishes (Foreman, 2011). Nurse Chan is exhibiting the ethical theory of deontology, dealing in absolutes of right vs wrong; truth vs lies.
In this situation, the physician may be bound by legal measures that require him to follow the legal guardian’s discretion in sharing the diagnosis and treatment plan.
I feel the physician is making the right decision to follow the parents lead, however, as this is an older child, her diagnosis and treatment plan will need to be discussed with her, very soon, but in a supportive manner. A multidisciplinary team approach involving a social worker or therapist can help the family move forward together.
The physician is forced to follow the consequentialist theory as the parents current thought process is withholding information (lying), to their daughter is necessary to protect her mental health (Foreman, 2011). The physician’s responsibility is to ensure that the parents have a very thorough understanding of the disease
process and treatment options. As the parents also, had just lost a loved one to cancer, their fears may also be affecting their ability to process this new news. Herein lies a major problem in healthcare today. Are we providing the patient and family with all the necessary details while having the crucial conversations needed to establish a shared responsibility in the care continuum?
As Karen is considered a minor at age seventeen, I do think the law plays a big part in this case. In this situation, it would appear the parents are concerned with the child’s ability to process the cancer diagnosis.
As there is no evidence of emancipation or other health related decision maker noted, Karen’s care decisions fall under the responsibility of her parents (Rosoff, 2017). We typically do not reach our fully effective ability to make decisions until we are in our young twenties (Rosoff, 2017).
Due to the recent family loss, and Karen’s potential immaturity, her parents are practising the rule of protecting their child from harm. The parents are well within their legal rights to withhold this information from Karen. Morally, the parents are taking a risk at destroying the trust their daughter has in them by not being truthful.
What sort of message are they sending their child in not being honest? In the theory of virtue ethics, will Karen understand their protective nature or will this affect her ability to develop into a person full of virtuous integrity?