The Ethical Dilemma
The ethical dilemma here is that there is a conflict of interest between the child’s parents regarding the treatment of the child. This case entails parental refusal and deferment of medically important treatment based on religious belief that illnesses have underlying spiritual aspects that need prayers to be resolved (Arritt, 2014). The child’s symptoms point towards meningitis, which is a severe illness. The deferment of treatment may result in death or life-long complications in the child. Therefore, the nurse needs to make the right decision promptly to safeguard the child’s well-being (Grimaldi, 2007).
The Decision Making Model Selected
Uustal’s decision making model was selected and used to resolve the dilemma. This model is useful in resolving ethical dilemmas because it follows the nursing process and includes explanations of values, which simplifies the application of an ethical decision making model (Adam, Odell, & Welch, 2013).
How I would resolve this dilemma using the model
The first step would be identifying the problem by recognizing the people involved, their relationship and the situation. This dilemma involves a six-year-old child and his divorced parents. The step-mother has primary custody of the child while the father stays in a different state. The situation at hand is that the step-mother does not want the child to receive medical treatment following the diagnosis of meningitis due to her religious conviction. The child’s father, on the other hand, wants the child to be treated and has sought an impartial consultation from another doctor. The ethical dilemma is the parental deferment of a child’s treatment, which leads to the conflict of three shared values of parental responsibility and good judgment, specialized and public protection of helpless children and freedom of religion (Mitchell & Riley, 2014).
The second step would involve stating my values and ethical position regarding the problem. I believe that everybody has a right to treatment irrespective of their ethnicity, gender and religious affiliation. I also respect the freedom of religion but believe that it should not interfere with the ability to receive treatment, especially in cases of urgency. My personal values are congruent with the father’s wishes to give the child immediate medical attention. However, I would disagree with the mother’s choice to postpone treatment and let God heal the child. I believe that it is God that grants wisdom to physicians to enable them to treat the sick.
The third step would be to generate alternatives for resolving the dilemma. The first option (alternative A) is respecting the mother’s choice and letting the child go without treatment. The second option (alternative B) is disregarding the mother’s wishes and proceeding with treatment.
Alternatives B is consistent with my personal values because they allow the child to obtain treatment. Conversely, alternative A is inconsistent with my values because it does not allow the child to be treated. The most appropriate alternative is B because the child’s health condition requires urgent intervention and making this choice will protect the child from medical neglect.
Disregarding the mother’s wishes and treating the child would save the child’s life and prevent future health complications. However, the child’s mother could sue the hospital for violating her right to religion. In the event that the mother files a case, the hospital could respond by reporting the mother of medical neglect.
The most acceptable alternative would be treating the child followed by seeking the opinion of an independent physician and finally obeying the mother’s wishes. The plan of action would involve initiating the treatment of the child by administering antibiotics then informing the mother of the hospital’s choice and why it is important to set aside the mother’s wishes for the well-being of the child. The final step would involve convincing the mother to accept this choice so that she ensures the child completes the antibiotics course.
I would evaluate my actions and comfort myself that I did the right thing by initiating treatment to save the child’s life. My actions were ethical because they promote life and prevent harmful health outcomes.
Dialogue
Nurse: I would like to inform you that your child has been diagnosed with meningitis, which may be caused by bacteria or virus. I understand that you both love your son and want the best for him. Is that true?
Family: Yes, it is.
Nurse: Following the diagnosis, it is important that we initiate treatment as soon as possible as we carry out additional tests. Meningitis is severe and can lead to the death of your son if we delay treatment. Another possible outcome of delaying treatment is that your child may recover from the disease, but he may suffer permanent damage including deafness, developmental impediment, learning debilities, paralysis of the muscles, and seizures. Is this the kind of life that you want for your child?
Family: No. We would like our child to get well.
Nurse: I hope you now realize the importance of initiating treatment as soon as possible because your child’s condition is a medical emergency. I would also like you to know that I respect your religious conviction, and I have faith that God will still heal your child even as we try to intervene by fighting the cause of the disease using medications.
References
Adam, S., Odell, M., & Welch, J. (2013). Rapid assessment of the acutely ill patient. Chichester, United Kingdom: John Wiley & Sons.
Arritt, T. (2014). Caring for patients of different religions. Nursing Made Incredibly Easy, 12(6), 38-45.
Grimaldi, M. E. (2007). Ethics: Ethical decisions in times of disaster: Choices healthcare workers must make. Journal of Trauma Nursing, 14(3), 163- 164.
Mitchell, B. C. & Riley, D. J. (2014). Christian bioethics: A guide for pastors, health care professionals, and families. Nashville, TN: B&H Publishing Group.