Explain How To Deal With Nursing Ethical Dilemma

Armand is a Good-natured and intelligent 15-year-old male who was diagnosed with an aggressive bone cancer and underwent a below-the-knee amputation of his right leg.  His cancer has metastasized to his chest, skull, and lungs, and two months later, he was readmitted for removal of the remainder of his right leg.  Armand and your son have been friends at school for close to four years and you had met Armand many times before his illness.  Since then, you have been his nurse on occasion and he has talked to you about his illness.  He has told you that talking about it upsets his parents and makes his friends feel uneasy; he likes talking with you stating it is nice to have someone with whom he can be open and honest.  You have always been impressed with his level of maturity and insight.

Armand has been readmitted with a grim prognosis, and he is experiencing a great deal of pain.  Although you have not been assigned to care of Armand during this admission, you are aware that members of his clinical team have been uncomfortable with his situation throughout his treatment. This is because Armand’s parents have requested that health care personnel limit the information they share with Armand.  This time, despite the many questions he asks, Armand has not been told the extent of the metastases or that he will likely die within the next few weeks. Members of his care team have frequently omitted information and even lied to Armand at the insistence of his parents and with the reluctant agreement of his attending physician.  Members of his care team have questioned the unit director several times about this policy.  She continues to instruct them to respect the wishes of his parents to avoid any legal problems. Armand’s parents also insist that he continue to receive every possible intervention and another clinical trial is being considered.

Last evening, Armand saw you in the hall and called you into his room.  He confronted you and told you he knows he is not being told everything.  He said he believes he is dying and, although it frightens him, he is ready to die.  He told you he has not been able to attend school for several months and that his friends no longer come to see him.  He also said that his younger brother and sister get very little attention because of him and that he is in constant pain.  He said he is tired of putting on a brave face pretending to be strong and brave.  He said he has tried to talk to his parents but they refuse to listen to him.  He commented, “I trust that you will tell me exactly what is going on and what I need to do to stop all treatment even if it is against my parents’ wishes.”

Answer these 5 questions

  1. Describe all ethical principles and values that are relevant to this case. Use your textbook to support your discussion. (Autonomy, veracity, justice, beneficence, nonmaleficence)
  2. Describe any unethical behaviors related to this dilemma.
  3. Describe how it relates to the professional American Nurses Association (ANA) Code of Ethics for Nurses (2016). Discuss the specific provision(s) related to the case. Use your textbook to support your discussion.
  4. Discuss options for how you would best address this situation.
  5. Be sure to use proper APA format rules when referencing both your textbook and the provisions of the ANA Code

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