Mrs. L was born in China and has been living in the United States for three years. She is 75 years old and was recently diagnosed with metastatic lung cancer. All the necessary treatment information has been provided to the patient as part of her nursing care and patient education. However, Mrs. L has refused to receive any conventional medications and treatment procedures; instead, she would like to use the means of traditional Chinese medicine, including herbs, to treat her cancer.
A major ethical issue that arises in the presented case is that the medical staff’s insistence on conventional care can insult Mrs. L and make her reluctant to use any medications recommended to her by the health care providers; moreover, the patient’s trust to care providers can be undermined if they imply in conversations with her that her decisions concerning her health problem are unwise. Also, it is noteworthy that Mrs. L is not reluctant to address her health problem; she recognizes that the condition requires treatment, which is a valuable resource for health care providers to use, but it should be done delicately not to prevent the patient from having an opportunity to be provided with adequate care.
A major complication that can arise is the patient’s impression that her choices in terms of her treatment are neglected or disrespected by the medical team. If the nurses or physicians who provide care to Mrs. L are too pushy in their advice of conventional treatment methods, she may become unwilling to be engaged in her health care, and the lack of engagement will undermine the work of doctors and nurses. Also, it should not be overlooked that one of the main principles of nursing ethics is autonomy, i.e. the respect for the patients’ personal and independent decisions regarding their treatment plans.
Insisting on Mrs. L’s use of conventional treatment methods, while the patient explicitly demonstrates her unwillingness to adopt them, would be a violation of the principle. It should also be recognized that the treatment that Mrs. L proposes can be beneficial in terms of ultimate health outcomes (Li et al., 2013). However, another principle of nursing ethics is non-maleficence; letting the patient restrict the activities conducted as part of her treatment to the herbal therapy would be a violation of this principle because it is obvious that her condition can deteriorate if proper medications are not received.
The main ethical technique to be employed in the presented case is demonstrating respect toward Mrs. L’s decision and her proposed methods of treatment. It is crucial that the patient feels comfortable in the clinical setting (Lamino, Turrini, & Kolcaba, 2014); otherwise, various adverse psychological effects can be expected that will undermine her treatment. Upon expressing due respect to the patient’s decision, however, nurse practitioners involved in providing care to her should delicately express their doubts concerning the chosen treatment plan. All the aspects of differences between conventional and traditional Chinese medicine should be explained to the patient.
Besides, Mrs. L lives in the United States with her children; her family should be engaged in the process of health care provision, too. If a nurse manages to convey to Mrs. L’s family in a personal communication session the message that the patient’s chosen treatment plan can be improved, the members of her family may persuade the patient to reconsider her treatment decision.
References
Lamino, D. D. A., Turrini, R. N. T., & Kolcaba, K. (2014). Cancer patients caregivers comfort. Revista da Escola de Enfermagem da USP, 48(2), 278-284.
Li, X., Yang, G., Li, X., Zhang, Y., Yang, J., Chang, J., … Liu, J. (2013). Traditional Chinese medicine in cancer care: A review of controlled clinical studies published in Chinese. Plus One, 8(4), 10-13.