The article under consideration discusses an ethical dilemma faced by a nurse working for one of the U.S. school-based health centers. The subject of the case study is John, aged 6, who has been delivered to the centre more than once with asthma attacks and whose mother ignores the medical professionals’ notices requesting her to discuss the management of her son’s disease (Huang, 2009). In the case study under consideration, the ethical dilemma consists in treating the child without the parental consent; on the one hand, the nurse is driven by the desire to help the patient (in this case, this is even more critical for the patient is a child), while on the other hand she does not have complete history of the patient, thus, risking to harm him.
There are two key ethical principles that underlie this ethical dilemma. One of them is beneficence; this is the obligation of a nurse to ensure health care of high quality to all the patients irrespective of their financial status, gender, race, etc and, thus, shield the patient from any harm (Matutina, 2009). Following this ethical principle, the nurse is obliged to help John because this is of his best interest as a patient. Another principle underlying this dilemma is nonmaleficence, which means doing no harm to the patient. In case with this principle, the nurse has an obligation to promote illness prevention even at the absence of the patient’s parents. In this case, the nurse cannot be sure whether she is acting in the best interests of the patient, thus, providing the best health care possible.
In addition, there are two primary professional parameters related to the ANA Code of Ethics that impact this dilemma. The first parameter is that “the nurse’s primary commitment is to the patient,” while the second is that “the nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient” (Aiken, 2004, p. 101). Keeping these parameters in mind and being obliged to follow the ANA Code of Ethics, the nurse is hesitant what exactly she should do in the given situation.
Furthermore, there are two practical alternatives that the medical center can use in this situation. The first alternative is to ensure the patient with all the necessary care, that is to stabilize the patient and to give him necessary medication (new inhaler) to prevent another asthma attack; at this, the parents have to be notified about the measures taken. Using this alternative, the nursing professionals will act completely in the interests of the patients. The second alternative is, again, to stabilize him, but refuse to provide him any other kind of help until his parents consult the medical centre. This, however, will not only cause harm to John, but will be unethical since, in this way, the child will suffer because of the negligence of his parents, which is unfair.
Therefore, these are the issues that ethical dilemma in this case involves. I support the nurse’s desire to help the patient, but I am no less concerned with whether this help will be purely beneficial for the patient. I have one more option to offer to the medical professionals of the school health care center: if the notifications do not work, then, perhaps, there is a sense in visiting John’s parents personally or even notifying necessary social services and sending a social worker to question the parents about their ignoring the notifications.
Aiken, T.D. (2004). Legal, ethical and political issues in nursing. (2nd ed.) Philadelphia: F.A. Davis.
Huang, M. (2009). Nurse practitioner’s ethical and legal dilemma: Caring for a young child without a parent in the school-based health center setting. Clinical Scholars Review 2(1), 19-22.
Matutina, R.E. (2009). Ethical issues in research with children and young people. Paediatric Nursing 21(8), 38-44.