ethical 2
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School
Chamberlain College of Nursing *
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Course
2539
Subject
Medicine
Date
Dec 6, 2023
Type
docx
Pages
2
Uploaded by mercedes222
Should Joshua's autonomy be considered and/or honored with respect to his treatment? (Respect for
persons)
Yes, Joshua’s autonomy should be considered and honored with respect to his treatment. He is of an age
where he can understand what is going on and he can feel it in his body. According to the AMA Code of
Ethics, “Physicians who treat minors have an ethical duty to promote the developing autonomy of minor
patients by involving children in making decisions about their health care to a degree commensurate
with the child’s abilities. A minor’s decision-making capacity depends on many factors, including not only
chronological age, but also emotional maturity and the individual’s medical experience (Author, 2023).”
Is Joshua being needlessly harmed by withholding information and continuing aggressive treatment?
(nonmaleficence)
I do believe that Joshua is being needlessly harmed by withholding information from him. He does not
want to continue aggressive treatment and knows he isn’t doing good. He is old enough to understand
what is going on, but it is not right to not allow him the opportunity to grieve the life he isn’t going to
have. It is not right that he be kept in the dark regarding his care.
Are Joshua's parents and physician acting in his best interests? (beneficence)
No, they are not acting in his best interests. They are acting in their own interests. They are also in denial
at what is happening and are projecting that onto their son. It is never easy to lose someone, and
parents should never have to bury their kids, but at the same time, life isn’t fair, and we must make
these hard decisions. It is the duty of the healthcare team to help not only Joshua through this difficult
time, but his parents as well.
Does Joshua have a moral right to be told the truth of his condition? (veracity)
Yes, Joshua does have a moral right to be told the truth of his condition. Every patient should be
informed of their care so that they can make the best decision for themselves. This is where informed
consent plays a big role. With minors, certain things need to be explained in age-appropriate terms, but
they should still be told what is happening. This helps with trust in the patient and the healthcare team.
Research shows that children not aware of their diagnosis may experience more anxiety than those who
do know because they are imagining the absolute worst scenario (Cristie M. Cole, 2013).
To whom do I, as a nurse, owe my loyalty? (fidelity)
As a nurse, I owe my loyalty to the entire family but mainly my patients. It is my job to know and
understand what exactly my patient wants and to help find a way to convey that to the family so that
they can have an open discussion regarding the patient’s care.
Is Joshua being treated fairly and equitably? (justice)
No, Joshua is not being treated fairly and equitably. He is being treated like his opinion doesn’t matter
and that he doesn’t have a say in what is happening to his own body. This is not a fair position for anyone
to be in.
Is the health care team caring for Joshua being treated fairly and equitably? (justice)
No, the healthcare team is not being treated fairly and equitably either. As medical professionals, we
have an obligation to our patients and to an extent, their families. We want to make sure the patient gets
well and can go home and live a long, healthy life, but sometimes we can’t do that no matter how badly
we want that to happen. By the parents asking the healthcare team to withhold information from the
patient, it does not allow for informed consent, autonomy, or respect of person. This violates the code of
ethics medical professionals go by. To me, this is like asking a judge to not tell the minor child who just
committed a major crime, how long his sentence in prison will be because it might damage his mental
health. This is very unlikely to happen because when someone commits a severe crime as a minor, they
assess the person to see if they are mentally capable of standing trial as an adult. This should be the
same in healthcare. There are times when a patient will not understand and it would do more harm than
good, but in Joshua’s case, this was unethical for the parents to ask of his healthcare team.
How would you respond to Joshua?
First, I would explain to Joshua how much his parents love him and have been trying to protect him and
how they would never want to do anything to harm him. I would also tell him that as someone who has
watched him grow up and become the person he is today, is both amazing and difficult. I would also
explain that I am going to be speaking to him professionally to answer his questions and not as a friend.
I would encourage him to speak to his doctor privately. If his parents are in the room when the doctor
comes around, still tell the doctor you want to speak to him alone. He will then ask your parents to step
outside and wait.
Also, every patient has the right to refuse treatment. No one can make you take the medication or do
the treatment. You can always say no and as medical professionals, we cannot make you take it.
I would have him ask for a social worker so that they can talk through and make certain arrangements
that he wants to make and have them there when talking to his parents about his wishes.
I would tell him that if he wants to talk to a clergy member, we can arrange that also and that all these
visits can be done privately but that ultimately, he is going to need to talk to his parents.
Let him know that he has a team of people ready to stand behind him and help him any way they can. I
would assure him he is not alone and that we want to cultivate a healthy relationship between him and
his parents so that when the time comes to say goodbye, there are no regrets on either side.
References
Author, A. (2023). Confidential Health Care for Minors. AMA Code of Medical Ethics: IV, 2.2.2.
Cristie M. Cole, J. a. (2013, August). Minors’ Right to Know and Therapeutic Privilege. Retrieved from
AMA Journal of Ethics: Illuminating the Art of Medicine: https://journalofethics.ama-
assn.org/article/minors-right-know-and-therapeutic-privilege/2013-08
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