Nurses are constantly confronting various ethical issues in their everyday clinical practice. An ethical dilemma is complex situation emerging from the conflict between moral obligations in which complying with one would result in contravening another (College of Nurses of Ontario [CNO], 2009). Nurses using CNO’s ethical conducts and decision-making framework will help in directing their ethical course of action. This framework involves the use of moral component such as claim, evidence, warrant, basis, rebuttal and ethical decision to guide in resolving the conflict (Arnold & Boggs, 2011). Thus, the aim of this paper is to use ethical decision-making framework step by step in exploring an ethical issue by analyzing a pediatric case study to make significant decisions.Health Conflict With Evidence Essay
Claim is the first moral component of the framework. It emphasizes on various dilemmas arising from the case study such as pediatric advance directive, consent to treatment by being competent minor and decision-making capacity. The ethical dilemma arises from this case study is whether to choose wishes of adolescent patient considering his treatment or should the wishes of his parents outweigh his request. The case study describes Kyle 14 years old male who has stake in outcome of the decision, and suffering from lymphocytic leukemia cancer. The case study involves Kyle as patient with physicians and his parents to determine the care in best interest of patient. The involved Physicians in care stated Kyle’s health is deteriorating and not responding to the chemotherapy treatment. Hence, the value of Kyle’s parents is to continue with the chemotherapy treatment in hope to work and prolong his life. However, Kyle having different point of view, refused to take any heroic measure and asked for DNR order to be placed in his chart.Health Conflict With Evidence Essay This way, his parents’ value would be violated if nurse chooses to accept the decision of Kyle. According to article by Tabak and zvi (2008), patient being mature minor competent has right to refuse treatment and is allowed to choose decisions regarding all the aspects of his treatment. Hence, nurse is caught in conflict between parents and Kyle. Thus, Kyle being in client center care, whichever decision nurse chooses from patient and parents will impact the Kyle’s care.Health Conflict With Evidence Essay
The evidence is next moral component of the framework. According to the scenario, physician sharing information with patient about the health status shows their mutual trust in relationship. This relationship indicates Kyle’s right to know as being cognitively capable to understand pros and cons of the treatment and participate in the discussion. According to Tabak and zvi (2009), the norm of informed consent is that patient has right to know truthful information about his health status from health care professionals to make informed decisions. From the case study another evidence indicates, Kyle being cognitively mature adolescent with a chronic illness (at the age of 5), knowledge to make informed decisions (DNR) and, experienced with treatments (several dose of chemotherapy). According to the article by Tabak and Zvi (2008), if the adolescent being minor is coping with long term and life threatening situation then patient is cognitively aware of the nature of the illness and has right to give consent. With this fact, his parents are seizing over his autonomy by denying his choices or capacity to make decisions. According to the article by Rogers, Alex, Macdoland, Gallant and Austin (2009), states that allowing children to express and offering choices escalates their quality of life and dignity. In this case, parents emotional grief for child may prevent them understanding child’s moral value or quality of life.Health Conflict With Evidence Essay It seems parents’ attachment with child making them not to understand child’s perception of suffering from medications and wishes to extend his life even if it has to do with holding on to the hope of future medication to work (Macgrawth & Phillip, 2008). As a result, parents are going against standards and not performing critical thinking. The evidences found in the case study are true, relevant to make decision, but lacks in sufficiency due to having inadequate in-depth reasoning behind klye’s decisions.Health Conflict With Evidence Essay
Warrant is another part of the framework. It requires using professional standard of care, and legal precedents and policies. If I were a nurse confronting ethical dilemma conflict between patient and parents’ decision over treatment, I would critically examine choices using professional standards. First thing I will take child’s age into consideration for informed consent. As stated in pediatric Cancer Society (CPS) (2008), in Ontario there is no age of cons
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