Postoperative Patient Care: A Case Study

In the case presented about a 9-yearold postoperative patient, Carla, the overt discussion surrounds the correct use of pain control by the provider, education of her family, and the rights of patient, family and physician in decision making (Post & Bluestein, 2007, pp. 113-115). Core ethical principles are also questioned in the space between the overt discussions. The moral considerations include the “moral imperative to relieve pain” (Post & Bluestein, 2007, p. 113), the consideration of a child’s autonomy and decision making ability, the autonomy and consent of the family, the autonomy and social contract of the physician and the beneficence of providing to the imperative to relieve Carla’s pain. The policy by the Regional Children’s

The lack of expansion on the principles, primarily of autonomy and discussion on beneficence should not be left to the subtlety if the providers basis of knowledge. To leave these principles to the two, short bullet points, assumes the provider is thinking of these important tools which should be part of the overall assessment of the child. That is to say that the policy assumes that the provider need not be reminded of these tools, and their importance, yet the provider apparently needed to be reminded of the assessment tools to identify pain itself. In fact, the tools have nuances about them that would involve ethical, social and psychological consideration in their design. For example, the FLACC (face, legs, activity, cry, consolability) Scale is useful for patients age 2 months to 7 years, but is not reliant on self-reporting by the patient (Walker & Arnold, 2009; National Hospice and Palliative Care Organization, n.d.) which can be gauged in a child as young as 3 years of age (Walker & Arnold, 2009). Certainly the subjectivity of pain should be evaluated using the patient’s own view of the experience as a means of ensuring a basic tenet of