Kuhse's Dilemma Case

In Joseph Collins article, “Should Doctors Tell the Truth?” he states that doctors shouldn’t tell the truth to their patients that deals with their life and death. Collins argued that doctor should withhold the truth on any circumstances. For example, when Collins blamed himself because of the death of a lawyer who suffered from kidney disease, only if he had lied to the lawyer about his health issue, the lawyer still could have been alive. However, I believe that doctors should always tell the truth to their patients regardless of the circumstances because withholding information violates patient’s autonomy and harms the doctor-patient relationship.

You started your first job at a large hospital. You are assigned a patient to treat who no one wants to work with because the patient always says “NO”. The Occupational Therapy team leader tells you that you need to treat the patient because the doctor is angry that the patient has not been receiving therapy. You are told that the patient’s nurse has called to complain to the therapy department about the fact that the patient has not been receiving therapy

actions, and regrets for ethical situations in clinical practice. Journal of Nursing Scholarship, 43 (40): 385-395.

In this case study the primary nurse, Amelia Wilkerson, is caring for a patient, Katy Palmer who has recently been admitted to the hospital for fatigue and abnormal lab counts. The patient asks Amelia for information regarding her diagnosis. Amelia has seen Katy’s results and knows that she has been diagnosed with acute myelogenous leukemia. The ethical dilemma seen in this situation is that it is outside of the scope of practice for Amelia to discuss Katy’s original diagnosis with her. This is reserved for the doctor alone. However, as a nurse that has developed a relationship with her patient it would be very difficult to not answer her question honestly. In addition, the patient might feel more comforted hearing the diagnosis from her nurse rather than the doctor as the nurse has been caring for her and they have developed a therapeutic relationship.

You did a great job. You are acting as an advocate for the patient for their interest. We must support the rights of patients who are unable to advocate for themselves .We are facing lot of ethical problems in our workplace. Nurses must take a decision in Ethical dilemmas. These decisions affected by so many factors, including principles learned in school and nurses personal beliefs, and values. It is important that all healthcare professionals value and support their peers who have the courage to stand up and speak out against unethical behavior even when others are silent or differ in opinion. Ethical dilemmas in practice arise when one feels drawn both to do and not to do the same thing.

The play Romeo and Juliet has many immature characters. Most of the decisions the individuals make are very childish and harm them. Many of the adults also just allow the kids to do whatever they want and comply with their decisions like the Nurse and Friar Lawrence. The adolescents and adults are not acting in an appropriate manner given because they are making bad and hasty decisions as if they don’t know how to make good ones.

According to the American Nurses Association, Deontology, an ethical theory founded by Immanuel Kant, applies judgments based on the underlying morality, or the rightness or wrongness of an action. It is based upon adherence to rules. The driving factor of decisions are evaluated through the intentions rather than the outcomes. Actions are classified into categories. Two of the most outstanding ones include universal law of humanity (categorical imperative) and principle of ends, which perceives that actions should be based in the end and never merely as a means (2011).

Duty of care plays a major role for health professionals, Duty of care follows codes and principles put into action for facilities such as hospitals via external sources such as the Government, in order achieve one core goal which is to ensure that the patient is subject to the best possible care that can be given by the facility and the Health Professionals working at the health facility.

Primarily, Caring Memorial Hospital will be held liable in this malpractice case under the premise of respondeat superior. “Under respondeat superior an employer is liable for the negligent act or omission of any employee acting within the course and scope of his employment” (Thornton, 2010, para. 2). The risk manager Susan Post, JD and the quality assurance director Amy Green were both aware of the potential for increased risk on the Oncology unit. They had been making observations several months prior to incident that related to deficiencies in staffing and safety standards. Per, ASCO and ONS (2012) new staff are required to demonstrate competency and receive comprehensive chemotherapy education. Jeffery Chambers, RN was

Evans and the Ohio Department of Corrections failed Tomcik in applying basic ethical theories. Normative and applied ethics were not followed because the minimal standard of care in this case called for palpitation of the breasts, which was not done. If the physician knew that palpitation of the side of Tomcik’s breasts was the correct minimal procedure to detect cancer and he did not complete it, he failed to apply the theory of how he should behave. Deontological ethics were failed as the doctor was duty-bound to “do no harm or injustice”. (Greek Medicine, 2012)

I respectfully disagree with you. In your post you stated “I believe that as a nurse I might have more knowledge of what is best for the health of the patient.” I don’t believe that a medical professional always “has more knowledge [or always knows] what is best for the health of the patient”. The Josie King story is a good example of the nurse thinking she “had more knowledge” and knew what was best for the patient. Mrs. King questioned the nurses several times throughout the care of her daughter, and if a nurse had listened to her, we might not be having this discussion today.

Veracity, or truth telling, “engenders respect, open communication, trust, and shared responsibility. It is promoted in all professional codes of nursing ethics” (Burkhardt & Nathaniel, 2014, p. 73). In order to effectively illustrate veracity in the workplace, a nurse must openly communicate with their patient, deleting any barriers that exist. In the case study, Jackson assumed that her patient abused pain medication, which prompted her to offer a placebo in its place. Upholding the nursing ethics, I agree with you that the nurse obtains an obligation to speak the truth, when questioned on procedures, treatments, and diagnoses. According to the ANA Code of Ethics (American Nurses Association, 2015, p. 2), provision

Nurses experience moral distress in situations such as Amelia Wilkerson's. In cases similar to this, nurses are sometimes left feeling powerless to take action on the appropriate decision. Rathert, May, and Chung (2016) explain that ethical dilemmas and conflicts are unavoidable in healthcare today. The ethical dilemma for Amelia comes after responding to Katy Palmer's question. By Amelia informing Katy that the doctor may not have reviewed the biopsy results, it confirms to Katy that the results are back and in turn Katy assumes that they are bad because Amelia will not discuss them. Ethically, Katy has the right to know the results, but Amelia is unable to provide the appropriate answer without the doctor and only

Hippocrates advocated “concealing most things from the patient while you are attending to him…revealing nothing of the patient’s future or present condition.” This attitude would undoubtedly be troublesome today. Competent adult patients have a moral and legal right not to be subjected to medical interventions without their informed and voluntary consent, but to seeking appropriate treatment for their autonomy also. Lying or withholding information from patients can seriously undermine their ability to make informed decisions about life-altering treatments. In order to give their informed consent and exercise their right of self-determination, patients must have access to all relevant information. Several

Being formed in 1948, the Universal Declaration of Human Rights helps recognize “the inherent dignity” and the “equal and unalienable rights of all members of the human family”. Based on this very concept of the person, and the fundamental dignity and equality of all human beings, that the notion of patient rights was developed.