Applying Ethical Frameworks in Practice
Ethical dilemmas are common in the workplace. They occur when nurses have two options, from which they have to choose one. Due to risks involved in the process, they have to use critical thinking and employ decision-making models to arrive at an appropriate conclusion. This paper will analyze the pediatric dilemma, discuss the six-step theory that a nurse can use, and provide a dialogue that can help the one in convincing parents to let a child receive treatment.
The Ethical Dilemma
In the case presented, the dilemma comes from having to make a decision and choose considering the differing views of the mother and the father. They are both parents and are expected to make appropriate decisions for their child. However, the father demands that the child should be treated, and the mother declines treatment for religious reasons. The physician is confused because he understands that it is an emergency. He has explained the condition to the parents. Unfortunately, both of them have conflicting views regarding the treatment of the child. Both parents understand that the latter is in a difficult situation. Similarly, the physician is aware that the failure to treat the child can promptly cause serious effects. He now has to make a decision after carrying the consent of both parents. It is a hard choice to make because both parents differ in views and are not available to see and understand the condition of the child. If the attending physician does according to what he thinks, he will go against the law. If he follows one parent, he will certainly go against the other. If the one fails to take action, the health of the child will be in danger. This dilemma will force the physician together with the nurse to make a decision.
Their decision will start by considering that the mother is not a biological parent. However, if they choose not to follow her orders without convincing her, they will act against ethics because she is a guardian of the child at the moment. Thus, considering mother’s view to make a decision is vital. Further, the nurse swore to the nursing pledge, which advocates for respecting patients. Similarly, the doctor took the Hippocratic oath that directs physicians to uphold various ethical standards, including the opinions of patients. In the case, it is not the patient who should make a decision, but the parents who have to choose because the patient is still a minor. Therefore, the physician and the nurse will have to respect their decision because it is one way of upholding the ethical principles. Arguably, respecting the views of parents is one way a nurse or a physician can maintain dignity of the patient (Allen & Dennis, 2009). This scenario, which requires the nurse and the doctor to figure out how to come up with an appropriate decision, is a dilemma.
The Six-Step Decision Making Model
From the case above, it is evident that the six-step model is appropriate to use to arrive at a conclusion. However, the latter will not always be the right one because it will have to go against the wishes of one parent. Decision-making using this model requires intuitive thinking, which enables problem-solvers or decision-makers to find an accurate solution (Negulescu, 2014). Park (2011) examines the model, which has six steps. Firstly, it starts with defining an ethical problem, which is apparent from the case where the father and the mother argue over the care of the child. However, it is not just identifying the issue, but also coming up with strategic factors that help doing it correctly. One of the major aspects to look at is an obstacle that stands in the way preventing one from reaching an appropriate solution. Secondly, the collection of information is critical in solving the problem identified with the aim of achieving a solution because it will help in the following step. Thirdly, there is the development of alternatives for analysis and comparison. Here, the decision-maker has various options to choose from and looks at the impact it will create once the decision has been made. Fourthly, the best alternative is selected from different variants. Next, there is the development of diverse solutions that are practical in making ethical decisions. Lastly, the decision-maker will have to evaluate effects of the problem and develop strategies to prevent similar occurrences (Park, 2011).
How to Resolve the Dilemma Using the Six-Step Model
Solving this dilemma would require me to create a therapeutic relationship with the parents. Evidently, it promotes cooperation and is based on mutual trust and respect (Pullen & Mathias, 2010). First, I will specify the problem, which is apparently the conflict of interests of the father and the mother. Next, I will collect information from both parents on why their views are differing. Next, I will come up with alternatives, which will help both of them understand that the child needs treatment. For instance, I will consider educating them on meningitis or reporting them to the child welfare authorities. Next, I will choose the most appropriate method, which is explaining the parents the condition and telling them the importance of agreeing on child treatment. Patient education has been proven as a powerful tool in influencing the knowledge and attitude towards seeking medical and nursing care (Oyetunde & Akinmeye, 2015). Next, I will follow my ethical standards educating them on the condition. Lastly, I will evaluate the influence of my model and consider a suitable way of preventing such problems from occurring.
Explaining My Decision to the Family
I would use the following dialogue to explain my decision to the family: “I understand that both of you have the health of your child at heart, but I have noticed that your views are differing on what should be done to him. That said, you need to understand that meningitis is a life-threatening condition, and if not addressed early enough, this child is going to have severe complications.” I would say to the mother, “I respect your view. I also know that having faith is important, but you need to allow us to treat this child. If we do not, he will develop problems with eyes, ears and the brain. You also need to understand that he may not be able to grow mentally and intellectually if we fail to treat him.” I would explain the father, “Thank you for allowing your child to get treatment. However, you do not need to panic and start looking for help elsewhere because we are a competent team of specialized healthcare providers, and we will attend to your child’s concerns entirely. We hope you understand.” I would say to both of them, “This sick child needs both of you. If you continue differing in your decisions, it will affect him psychologically.”
Ethical decision-making is demanding. However, the six-step process of making a choice is useful and appropriate to handle any challenge, especially the one described in the case study. By means of this model, it is easy to examine ethical dilemmas, analyze various solutions, and come up with decisions benefiting all the parties involved. Therefore, specifying the problem, gathering information, determining alternatives, educating the parents on the importance of treatment, analyzing ethical aspects and evaluating possible outcomes of the decision can help to solve the ethical dilemma in the case study.