NURS FPX 4000 Assignment 3 Applying Ethical Principles

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Capella university

NURS-FPX4000 Developing a Nursing Perspective

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Date

 Applying Ethical Principles

Ethical principles provide essential guidance for making morally sound and socially responsible choices. These principles assist professionals in addressing challenging situations, ensuring actions uphold patient autonomy, prioritizing beneficence, and avoiding causing harm (non-maleficence). Healthcare providers often face ethical challenges that test their decision-making abilities, particularly when caring for patients at the End of Life (EOL) (Akdeniz et al., 2021). This paper focuses on analyzing a resolution to an ethical dilemma encountered by a healthcare professional, utilizing these ethical principles as a framework.

Overview and Analysis of the Case Study

Timothy Collins, a 16-year-old high school minor, dealing with leukemia for the past two years. Although he experienced a brief remission early on, his condition has since deteriorated. Exhausted from repeated treatments, Timothy has decided to forgo further medical interventions, expressing his desire to transition to EOL care at home with his family. His parents, heartbroken by his decision, hold onto hope and want to explore an experimental treatment available overseas. Dr. Angela Foster, Timothy’s oncologist, acknowledges Timothy’s maturity and respects his preference for hospice care but also empathizes with his parents’ determination to seek any chance to save their son. This scenario presents an ethical conflict between the principles of autonomy and beneficence, leaving Dr. Foster to balance Timothy’s best interests with the hopes and wishes of his parents (Capella University, n.d.).

Examining Timothy’s case requires a nuanced exploration of the ethical principles involved. According to a peer-reviewed study by Akdeniz et al. (2021), respecting the autonomy of adolescent patients is critical, even in life-threatening situations. The article emphasizes that adolescents who clearly understand their condition and the consequences of their decisions should have an active voice in their treatment plans. This aligns with Timothy’s decision to decline further aggressive treatments and prioritize hospice care, supporting the principle of autonomy. Similarly, research by Mack et al. (2021) found that adolescents with terminal illnesses often value quality of life and emotional well-being over prolonged medical interventions. This echoes Timothy’s wish to spend his remaining time in comfort, surrounded by loved ones.

On the other hand, a contrasting perspective is presented in a study by Caporali et al. (2020), which explores the role of parents in making medical decisions for their minor children, particularly in critical care situations. The research highlights that parents’ viewpoints should carry significant weight due to their deep emotional involvement and legal responsibility for their child’s welfare. This perspective supports Timothy’s parents’ desire to pursue experimental treatment abroad, seeing it as a final attempt to save their son. Together, these studies illustrate the complexity of Dr. Foster’s ethical dilemma, where Timothy’s autonomy conflicts with his parents’ hopes. Resolving this case requires a delicate approach that carefully considers Timothy’s informed wishes while acknowledging his parents’ emotional and ethical concerns.

Effectiveness of Communication Approaches in the Case Study

In the ethical dilemma of Timothy Collins’s case, communication is important for Dr. Angela Foster. Any discussion related to EOL care should be done with openness and empathy. That is why Dr. Foster should call a family meeting and involve both parents and Timothy in conversation about his condition and desire to enroll in EOL care. She should also use listening skills to acknowledge the feelings of the families she is meeting with during this session. This way, Dr. Foster can build up mutual respect with Timothy and his parents, especially because Timothy’s parents are understandably upset.

Another important communication approach is the Shared Decision Making (SDM) (Glaría et al., 2024). In Timothy’s case, this method can be of noble use to Dr. Foster in that it will enable the family to consider all the possible avenues of treatment together. She should explain the medical facts to the patient and her family, the ineffectiveness of additional aggressive treatments, and the advantages and disadvantages of the parental-suggested therapy. As the discussion moderator, where everyone is allowed to express his/her opinion, Dr. Foster can assist the Collins family in arriving at a decision acknowledging Timothy’s self-determination and his parents’ desire for other therapies.

In this situation, the utilization of decision aids is likely to be particularly useful (Glaría et al., 2024). Decision aids are interventions created to assist patients or families to make a choice and understand the consequences of their choice. Dr. Foster can recommend the Collins family literature and information on EOL care and experimental treatments. Such information can assist them in making an acceptable decision that will serve the principle of beneficence and autonomy. Dr. Foster must adopt empathetic communication, shared decision-making, and decision aids to help the Collins family in this difficult time. They make sure that they honor Timothy’s decisions and, at the same time, take their parents’ views into account.

Ethical Decision-Making Model 

The ethical Decision-making model was applied to Dr. Angela Foster’s decision-making process in treating Timothy Collins. Look at the Ethical Decision Making Model in three ways: moral awareness, moral judgement and ethical behaviour. Moral awareness is defined by the ability to see the moral dilemmas involved in a case. In the given case, moral awareness is evident when Dr. Foster realizes that the moral conflict is between Timothy, who wants to be enrolled in hospice care, and his parents, who want to seek experimental treatment. She accepts the legal and moral rules of autonomy to let Timothy decide and be beneficent in meeting his parents’ desire for treatment (Capella University, n.d.). This awareness creates the necessary platform to address ethical dilemmas comprehensively.

Morality, on the other hand, means making a moral judgment on the correct thing to do. Dr. Foster considers the patient’s preferences and his parents, as well as the advantages and disadvantages of aggressive treatment and EOL care. She honors Timothy’s decision and understands that his parents are overwhelmed, demonstrating excellent decision-making ethical standards. Ethical behaviour refers to performing activities guided by ethical standards and a sound ethical reasoning process (Akdeniz et al., 2021). Dr. Foster encourages the development of effective communication with Timothy and his parents and arranges a family conference and the use of decision-making tools. This approach concurs with ethical objectives, and it comes up with a decision that respects both the quality of life of Timothy and the parents’ desire.

By adopting Dr Foster’s communication strategies, it is possible to gain all the information necessary for informed consent and, at the same time, value Timothy’s autonomy. About parents’ concerns, it would be easier for healthcare workers to improve trust and emotional support among the family. This can lead to a better transition to hospice care, enhance the quality of Timothy’s life, and give the family much-needed relief. Ineffective communication strategies that lack open communication and decision-making through shared power produce elevated amounts of conflict, suffering, and resentment or guilt in the family (Hemberg & Bergdahl, 2020). This can result in a decision that fails to fully consider Timothy’s wishes or the family’s hopes. It can also cause long-term emotional harm and undermine trust in the healthcare provider.

Resolving the Ethical Dilemma by Applying Ethical Principles

A potential resolution to Timothy Collins’s case is to honor his decision to transition to EOL care while offering extensive support to his parents. This approach aligns with the core ethical principles of autonomy, beneficence, non-maleficence, and justice. By respecting Timothy’s choice, Dr. Foster upholds his autonomy, recognizing his right to make informed decisions about his care. Beneficence is reflected in prioritizing Timothy’s comfort and quality of life through hospice care, focusing on reducing his suffering and providing a nurturing environment. This solution also adheres to non-maleficence by avoiding further aggressive treatments that are unlikely to provide meaningful benefits and may instead prolong Timothy’s pain and discomfort. Hospice care emphasizes symptom relief and emotional well-being, ensuring his remaining time is as peaceful as possible (Akdeniz et al., 2021).

The principle of justice is addressed by ensuring that Timothy and his parents have a voice in the decision-making process. Dr. Foster’s approach ensures fairness by balancing Timothy’s wishes with the emotional needs of his parents, offering them the necessary resources and psychological support to navigate this challenging time. This collaborative and empathetic strategy fosters understanding, providing a pathway to honor Timothy’s preference for hospice care while acknowledging his parents’ hope for additional treatment. By aligning with ethical principles, this solution supports Timothy’s autonomy, prioritizes his well-being, minimizes harm, and treats all parties fairly and compassionately. It creates a framework for navigating the ethical dilemma with sensitivity and respect for everyone involved (Hemberg & Bergdahl, 2020).

Conclusion

Timothy’s case highlights the importance of balancing ethical principles to navigate complex dilemmas in healthcare. Dr. Foster demonstrates compassion and moral integrity by respecting his autonomy and prioritizing his comfort through EOL care. Supporting the parents with effective communication and decision aids addresses their emotional needs while fostering understanding. This approach minimizes harm, upholds fairness, and ensures Timothy’s well-being remains central. Ultimately, a collaborative resolution honors Timothy’s wishes while helping his family find peace during a profoundly challenging time.

References

Akdeniz, M., Yardımcı, B., & Kavukcu, E. (2021). Ethical considerations in end-of-life care. SAGE Medicine, 9(9). https://doi.org/10.1177/20503121211000918 

Capella University. (n.d.). Case study: End-of-life care for a minor. capella.edu. https://www.capella.edu/  

NURS FPX 4000 Assignment 3 Applying Ethical Principles

Caporali, C., Pisoni, C., Gasparini, L., Ballante, E., Zecca, M., Orcesi, S., & Provenzi, L. (2020). A global perspective on parental stress in the neonatal intensive care unit: A meta-analytic study. Journal of Perinatology, 40(12), 1739–1752. https://doi.org/10.1038/s41372-020-00798-6 

Glaría, M. G., Fernández, M. M., Salgado, C., & Hernández, M. J. (2024). A Joanna Briggs Institute framework approach to shared decision making in end‐of‐life. Health Expectations, 27(5). https://doi.org/10.1111/hex.70041 

Hemberg, J., & Bergdahl, E. (2020). Ethical sensitivity and perceptiveness in palliative home care through co-creation. Nursing Ethics, 27(2), 446–460. https://doi.org/10.1177/0969733019849464 

NURS FPX 4000 Assignment 3 Applying Ethical Principles

Mack, J. W., Fisher, L., Kushi, L., Chao, C. R., Vega, B., Rodrigues, G., Josephs, I., Brock, K. E., Buchanan, S., Casperson, M., Cooper, R. M., Fasciano, K. M., Kolevska, T., Lakin, J. R., Lefebvre, A., Schwartz, C. M., Shalman, D. M., Wall, C. B., Wiener, L., & Altschuler, A. (2021). Patient, family, and clinician perspectives on end-of-life care quality domains and candidate indicators for adolescents and young adults with cancer. Journal of the American Medical Association, 4(8), e2121888. https://doi.org/10.1001/jamanetworkopen.2021.21888