Fundamentals of Nursing Q 230
The nurse is working with the parents of a seriously ill newborn. Surgery has been proposed for the infant, but the chances of success are unclear. In helping the parents resolve this ethical conflict, the nurse knows that the first step is:
A. Exploring reasonable courses of action.
B. Collecting all available information about the situation.
C. Clarifying values related to the cause of the dilemma.
D. Identifying people who can solve the difficulty.
Correct Answer: B. Collecting all available information about the situation.
Autonomy allows healthcare teams to respect and support a patient’s decision to accept or refuse life-sustaining treatments. As patient advocates, it’s our duty to ensure that our patients receive all of the necessary information, such as potential risks, benefits, and complications, to make well-informed decisions. The healthcare team can then formulate care in compliance with the patient’s wishes.
Option A: Nurses use nonmaleficence by selecting interventions that will cause the least amount of harm to achieve a beneficial outcome. For example, if a patient verbalizes homicidal ideations with a plan, we may be torn between wanting to ensure patient privacy and our duty to escalate the patient’s care to safeguard the public. The principle of nonmaleficence points us to place the safety of the patient and community first in all care delivery.
Option C: Family members should refrain from making decisions for the patient or inflicting undue pressure to alter his or her decisions unless the patient is incapacitated or found to be legally incompetent. Many factors may influence a patient’s acceptance or refusal of medical treatment, such as culture, age, general health, social support system, and previous exposure to individuals who received a similar treatment modality with negative clinical outcomes.
Option D: Paternalism provides the power for healthcare professionals to make decisions to reveal or conceal a diagnosis, potential treatment modalities, or expected prognosis. An example of paternalism is when we admit an adolescent with multiple complete cervical spine fractures whose family is stating that the teen needs to participate in a state basketball championship in 3 months. The benefit of sharing the anticipated prognosis of quadriplegia at this time is far outweighed by the potential emotional trauma it may cause the family.