examine an ethical dilemma that exists in pediatric settings. You will examine the ethical dilemma from two opposing positions and consider ethical principles, conflict between the principles and the relationship of the ANA Code of Ethic’s provisions in relation to both positions. You will also discuss potential resources, possible outcomes of both positions and develop a plan for resolving the issue (for patient, family and the nurse). You will submit an individual paper grounded in scholarly sources with a reflection on your values.
Course outcomes: This assignment enables the student to meet the following course outcomes:
1. Provide individualized comprehensive care for pediatric individuals, families, aggregates, and/or communities with multiple health problems in a variety of patient population settings. (PO 1)
4. Utilize critical thinking skills in clinical decision making in the care of pediatric patients. (PO 4)
6. Utilize legal, ethical, and professional standards and principles, including those related to child abuse recognition and intervention, as a basis for pediatric clinical decision-making. (PO 6)
8. Utilize research findings as a basis for pediatric nursing interventions in a variety of patient population settings and the development of professional nursing papers. (PO 8)
Opposing Ethical Positions
This dilemma pits the Principle of Parental Autonomy against the Ethical Obligation to Protect the Child's Best Interest (Beneficence).
Position 1: Respecting Parental Autonomy
This position argues that the parents' authority to make medical decisions for their minor child must be respected, even when those decisions conflict with medical advice.
Core Ethical Principle: Autonomy (specifically, parental autonomy/self-determination). This principle asserts the right of competent individuals (or their legal proxies) to choose their course of action based on their values and beliefs.
Conflict with Principles: This position directly conflicts with Beneficence (the duty to act in the patient's best interest) and Non-Maleficence (the duty to do no harm), as refusing treatment guarantees a lethal outcome.
ANA Code of Ethics Provision Alignment: Provision 1.4: The Right to Self-Determination (Applies to the parents as decision-makers). It emphasizes that the nurse should respect the patient's (or proxy's) ultimate right to accept or reject treatment.
Sample Answer
Ethical Dilemma in Pediatric Settings: Parental Refusal of Life-Saving Treatment
Introduction of the Ethical Dilemma
A significant ethical dilemma in pediatric settings is the conflict arising when parents refuse a medically necessary, life-saving treatment for their child due to religious, cultural, or philosophical beliefs, despite the high probability of the child's death or severe irreversible harm without the intervention.
Dilemma Scenario: A 10-year-old child is diagnosed with acute lymphoblastic leukemia (ALL) that is highly curable with chemotherapy (85-90% success rate). The parents, belonging to a faith that prohibits all modern medical interventions, refuse chemotherapy, opting instead for spiritual healing and prayer. The child is medically stable but faces certain progression of the disease and death within months without treatment.