Provision 2: “The nurse’s primary commitment is to the patient,whether an individual, family, group or community.” In a changingmedical world that is continually advancing and demanding more fromall involved, priorities can get mixed up and patients can beforgotten. Consider the following two scenarios.
Scenario 1: A 10-year-old child has suffered a motor vehicleaccident. Due to multiple traumas associated with the injury, thepatient is now ventilator-dependent, G-tube dependent, and showslittle activity on the EKG beyond consistent seizures. (This meansthe patient cannot breathe on his own, cannot eat on his own, andbrain testing shows little activity, but confirms frequent seizureactivity). The mother of the child is ready to withdrawal care forpalliation purposes. The father is committed to providing everymedical intervention possible to sustain the child’s life.
Question #1 Who is the nurse responsible for in this scenario,the patient, the parents, or both? Who is “right” in this scenario,the mother or the father? You must pick a side and build anargument to support your answer, credit will not be given if you donot pick a side, and there is no middle ground. Can the nurse betruly objective in this situation? How could the emotions of thenurse affect patient care?
Scenario 2: A 17-year-old patient has Duchenne musculardystrophy complicated with multi-organ failure. The patient isneurologically alert but again has entered multi-organ failure.From a medical perspective, there is no way to save the patient’slife. The 17-year-old patient will die soon. The parents havedecided to not tell the patient about the decline in his condition.Instead, they have asked the medical staff to stay upbeat andoptimistic, encouraging the patient to work toward gettingbetter.
Question #2 Is the nurse ethically obligated to tell the patientabout the decline in his condition, or is the nurse ethicallyobligated to honor the parents’ wishes? Again, pick a side, buildan argument, and articulate your perspective.
