Nursing Ethical Dilemma

Background

The ability to recognize, understand and treat symptoms related to illnesses, along with crafting the right questions in order to promote optimal care is considered a fine art in the field of healthcare. However, sensitive and time-critical conditions can pose questions that could challenge the status quo in relation to healthcare policy and decision making. Challenging circumstances often call for drastic measures that make difficult to decide right vs wrong. An ethical dilemma defines this decision-making process. Healthcare providers, such as nurses, confront this type of situations often in an array of clinical settings. Factors such as religion, demographics, and culture can determine if an ethical dilemma could potentially

After several studies, a care conference with her parents was held and a mandarin interpreter was used to explain the findings and care plan. Her parents informed the medical team that they will take her back home as it is their filial duty, based on Chinese culture, to care for a sick family member (Turner, 2010, p.60). The medical team, which comprise of nurses alike, felt differently. The team believed that her parents had not been able to provide proper care, and Ting had shown great improvement in foster care. While some disagreed with the use of Palliative Care, several healthcare providers agreed that it’s not in her best interest to return home, since her quality of life would harshly reduce. The ethical question at hand, states Turner (2010), is “do parental preferences override the right of a child to receive appropriate care in medical foster care?” (p.60). Nurses and doctors who have cared for Ting submitted a request for an ethics consultant to be involved in the outcome of Ting’s care. A thorough and in-depth analysis was performed using tools such as the Four Quadrants of Ethical Decision Making. It was stated that Ting would not lead a normal life, her health, in time, would become much more impaired, her parent’s lack of understanding, inability to identify problems and seek help could prematurely end her life. Furthermore,

It would be fair to point out that the cultural component related to the situation was not considered. In Chinese culture, explains Yam, Rossiter, & Cheung (2001), all wishes from the family must be respected since the family is the center of Chinese culture (p.652). The medical staff assigned to Ting tried to place her in palliative care. A deeper observation shows that instead of finding other solutions to the problem they should’ve treated the root cause, which was the parent’s lack of understanding and resources, coupled with a language barrier and cultural beliefs. Although Ting was considered first by the medical staff under code two, Relationship with Patients, their initial support for the parent’s decision and their inability to create a trusting relationship became a barrier when Ting became ill. “Code two calls for the consideration of culture, religion, gender, and primary language to be taken into account when planning patient-centered care” (ANA, 2001, p.18). The proper steps would’ve been to have open discussions from the beginning in order to build trust and create a comfortable environment for both the patient and her family. The last code, Primacy of interest, was exemplified when the healthcare team used translating services to communicate with the parents. This, however, was unsuccessful since the majority of the discussion took place with her