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
By looking further into this dilemma using various ethical standpoints allows for a broad understanding of principles and complexity in a specific situation with these paradigms. The focuses are three prominent ethical paradigms such as: teleological utilitarianism, deontological duty theories and virtue based ethics. Each of these three paradigms will be applied to the aforementioned dilemma, each will be evaluated and the best option will be revealed.
In everyday experience one is likely to encounter ethical dilemmas. This paper presents one framework for working through any given dilemma. I have chosen to integrate three theories from Ruggerio Vicent, Bernard Lonergan and Robert Kegan. When making a deceison you must collabrate different views to come to a one conclusion. Ruggerio factors in different aspects that will take effect. Depending on which order of conciousness you are in by Kegan we can closely compare this with Ruggerio's theories also. As I continue I will closely describe the three theories with Kegan and how this will compare with Lonerga's theory combining the three. While Family,
This paper will talk about the book No Good Deed and how there are many ethical dilemmas that healthcare providers deal with every day. Each day there are ethical issues that arise, especially when caring for terminally ill patients. The book No Good Deed talks about how two nurses struggle with a situation that is far too common in healthcare today. Despite the literature about end of life care, it still remains an issue for many providers and patients. Nurses are lead to deal with multiple ethical issues seen in the book No Good Deed. After reading the book No Good Deed one is able to see how literature about end of life care is viewed and how beneficence plays are large role in nursing care.
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
The right to assisted suicide is a significant topic that concerns people all over the United States. The debates go back and forth about whether a dying patient has the right to die with the assistance of a physician. Some are against it because of religious and moral reasons. Others are for it because of their compassion and respect for the dying. Physicians are also divided on the issue. They differ where they place the line that separates relief from dying--and killing. For many the main concern with assisted suicide lies with the competence of the terminally ill. Many terminally ill patients who are in the final stages of their lives have requested doctors to aid them in exercising active euthanasia. It is sad to realize that these people are in great agony and that to them the only hope of bringing that agony to a halt is through assisted suicide.When people see the word euthanasia, they see the meaning of the word in two different lights. Euthanasia for some carries a negative connotation; it is the same as murder. For others, however, euthanasia is the act of putting someone to death painlessly, or allowing a person suffering from an incurable and painful disease or condition to die by withholding extreme medical measures. But after studying both sides of the issue, a compassionate individual must conclude that competent terminal patients should be given the right to assisted suicide in order to end their suffering, reduce the damaging financial effects of hospital care on their families, and preserve the individual right of people to determine their own fate.
...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.
Several ethical principles that are incorporated in the nursing care of patients on a daily basis are nonmalificence, autonomy, beneficence, justice, fidelity and paternalism. Nurses should strive to comply to as many of the principles as possible. In this case there are principles which support and conflict with the wishes of the patient. The first principle that supports the wish of the patient is autonomy. Autonomy means that competent patients have the right to make decisions for themselves and the delivery of the healthcare that they receive. Another factor that would support the patient’s wish to not be resuscitated is nonmalificence. Non maleficence means that nurses should not cause harm or injury to their patients. In this case the likelihood of injury after resuscitation was greater than if the patient were allowed to expire. A principle that could have negatively affected the outcome of the provision of ethical care was paternalism. Paternalism is when a healthcare provider feels that they know what is best for a patient, regardless of the patient’s desire for their own care. I demonstrated the principle of paternalism because I thought that I knew what was best for the patient without first consulting with the patient or family. This situation might have had some very negative consequences had the patient not have been competent. Practicing a paternalistic mindset might have caused a practitioner in the same instance to force their ideas about not resuscitating the loved one onto the family. This could have caused a sense of remorse and loss of control of care amongst the
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...
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.
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.
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
Opposing Viewpoints."Introduction to Euthanasia: Opposing Viewpoints." Euthanasia. Ed. Carrie Snyder. Detroit: Greenhaven Press, 2000. Opposing Viewpoints. Gale Opposing Viewpoints In Context. Web. 18 Nov. 2011. http://ic.galegroup.com.library.collin.edu/ic/ovic/ReferenceDetailsPage/ReferenceDetailsWindow?displayGroupName=Reference&disableHighlighting=false&prodId=OVIC&action=2&catId=&documentId=GALE%7CEJ3010134107&userGroupName=txshracd2497&jsid=af2eacb374dfea6a89c0773d16c35a50
Neonatal resuscitation is intervention after a baby is born to strengthen it’s breathe or to boost its heartbeat. Approximately 10% of neonates require some assistance to begin breathing at birth, but only 1% require serious resuscitative measures. Informed consent regarding neonatal resuscitation is a constant ethical debate. This discourse ordinarily occurs between doctors and parents; parents often feel that the decision has been made for them, believing that they were not fully informed of any consequences that may occur before making their final action plan, or thinking that their opinion was not taken seriously; however, doctors see the procedure in a different light, that the parents can’t choose the best option for the child regardless of counseling, or performing as the parents wished but believing that the result could have differed if the parents had known all the effects that it will have further down the line, or convinced that they would have made a better
Mesler, M. A., & Miller, P. J. (2000). Hospice and assisted suicide: The structure and process of an inherent dilemma
First, let’s consider the reasoning behind the patients choosing to forego extraordinary treatment for their cancer. They have decided, as Beauchamp would put it, that refusing to prolong their lives in the face of pain and suffering “neither harms nor wrongs [them] and may provide a benefit” (Beauchamp, 76). They “intend to quit life because of its bleak possibilities” (Beauchamp, 77). The doctor readily complies with their wishes out of moral, legal, and professional obligation. A choice has been made to let both patients die, as a response to their “competent and authoritative refusal of treatment” (Beauchamp 74).