Nursing Ethical Dilemma in Case of Genetic Disorder

Ethical dilemma in diagnosis of a genetic disorder

In a case of diagnosis of a genetic disorder, the practicing nurse and I were faced with two ethical dilemmas as a student nurse (BSN) is a local children rehabilitation center, which is a pediatric acute care clinic. The first dilemma was whether to inform the parents of the victim as a measure for ensuring maximum support to ensure quick recovery or not. At the same time, it is of benefit to reveal some information to a parent to facilitate the healing of such a minor. The second ethical dilemma was a possible betrayal of the autonomy of the child patient by revealing information to the parents. Therefore, as a student nurse alongside the practicing nurse, we had to balance these dilemmas in handling the situation through the application of rational judgment to analyze the extent and threats when making decisions in the best interest the child patient (Fowler, 2010).

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Relevant and applicable principles within ANA code of ethics

The ANA code of ethics has mechanisms to minimize the impact of the two ethical dilemmas. The code of conduct has policies such as nursing care criterion, physician response regulation, and complaint procedure in line with the ANA’s code of ethics for nurses of 2015 (American Nurses Association, 2015). The first step would be a thorough examination by raising concerns from personal observations to the patient about the need to inform her parents and informing other physicians to ensure that she is given the right treatment within the shortest time possible. In fact, this course of action will reaffirm the ethical lens of personal responsibility and guaranteeing the patient a right to be accorded proper treatment as summarized in the ANA code of ethics 2015 (American Nurses Association, 2015).

The main ethical principles related to diagnosis of genetic disorder include confidentiality, rationality, good communication, respect, and maximum support to fasten the recovery process as listed in the ANA code of ethics 2015 (American Nurses Association, 2015). These principles form the strength of a successful nursing intervention when handling such a case. These positive ethical principles are achievable through action oriented respect, mutual coexistence, and deeply entrenched social values, which are vital in the nursing intercession (American Nurses Association, 2015). The ethical relationship with the practice revolves around exercising rational judgment in the course of actions when dealing with the patient to make such actions ethically correct. Therefore, a student nurse handling such a case has the responsibility of maintaining confidentiality, professionalism, and due care within the confines of what is morally upright. Since the ANA code of ethics indicates that every patient has the basic fundamental right of confidentiality (autonomy) in deciding on who is to share some information, there is a need for further questioning the patient to ensure that she understands the importance of her parents being part of the treatment and recovery process (American Nurses Association, 2015).

Relating the dilemma to principles identified

The patient has the right of self determination as enshrined in the determination act of the year 2010 (American Nurses Association, 2015). The patient’s parents had to be informed of the condition without her full knowledge and right to reject or accept the proposal despite the genuine gesture by the center. It is true that an otherwise decision of not informing the patient’s parents of her medical condition prior to the medical treatment would have not given her a chance to proactively participate in her treatment besides preparing her family for any eventuality. The practicing nurse alongside me would not be facing the current ethical dilemma as we would have performed this function of informing the parents with the full approval of the patient (Hockenberry & Wilson, 2013). The moral judgment exhibited in this situation can be described as a situational ethics. It is the responsibility of the parents to present to child the ethical lens of own decision making. However, provision 1 and provision 2 of the code of ethics for nurses dictate that a patient has a right to accurate information and utmost care of the nurses (American Nurses Association, 2015).

Outcome of the dilemma

The minor was not willing to let the practicing nurse explain the situation to the parents for the fear of victimization. The nurse explained to her that the condition has nothing to do with her personal decisions. At the end, the nurse had to gently explain to the parents about the patient’s condition before subjecting them to a three-day counseling period. When the parents informed her of our discussion, I noticed that she did not overreact since her initial fears were how the parents would handle the situation.

Resources within the clinical agency for dealing with the dilemma

The resources available for dealing with the ethical dilemmas are counseling unit and proactive communication channel. As the central player in the ethical dilemma, I observed the practicing nurse and she applied proactive communication to reassure the patient on the importance of bringing her parents on board. I noted that the practicing nurse applied counseling to prepare her parents for the diagnosis. To my best knowledge, the practicing nurse applied the most appropriate resources since they form the central framework for acceptance and supportive care (Hockenberry & Wilson, 2013).

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References

American Nurses Association. (2015). Code of ethics. Web.

Fowler, M. (2010). Guide to the Code of Ethics for Nurses: Interpretation and Application. Silver Springs, MD: Nursebooks

Hockenberry, M., & Wilson, D. (2013). Wong’s Nursing Care of Infants and Children Multimedia Enhanced Version (9th ed.). New York, NY: Elsevier Health Sciences.

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