Applying Ethical Frameworks in Practice: Empirical Knowledge vs Personal Belief Nurses encounter ethical dilemmas in the workplace quite often, and though the author for one dislikes ethical dilemmas, the author is driven to resolve the dilemma due to their desire to achieve a favorable outcome for their patient. The presented situation is a complicated one where nursing ethics and duties, religious beliefs, as well as parenting rights conflict with each other. Ethical Dilemma
There are various conflicts in this dilemma, but the primary problem in this case is in the treatment of the child. The ethical dilemmas is conflict between Empirical Knowedge vs Personal Belief. This is defined as a conflict between research based knowledge in nursing practice and the beliefs gained from personal preference or religious beliefs (Fant, 2013).
Decision Making Model
In order to solve the given dilemma, the nurse may employ the 6 step decision making process which is a step-by-step process and is overall, a formalized approach to analyzing and reflecting on the morality of a given situation (Purtilo & Doherty, 2011) Information Gathering. The first step in solving an ethical dilemma is the gathering of information. In this case, we are able to gather that the family structure of the boy is different and that parents are in conflict with regards to the medical treatment of the child. We also know from the diagnosis that the boy is in dire need of treatment since meningitis if left untreated for long, carries debilitating complications and may result in death (Mayo Clinic, 2014). Identifying the ethical problem. The second step involves identifying the actual dilemma of the situation. The primary conflict here is that of Empirical Knowedge vs Personal Belief. There is also the potential Locus of Authority issue between the two parents but this will have to wait since resolving this may involve lengthy legal procedures. Using ethical theories or approaches to analyze the problem.
The third step is the identification of the values involved in the situation. In this case, it would be the autonomy of the patient’s mother in choosing to refuse treatment because of religious belief, and the view of the author regarding beneficence, utilitarianism and deontology, as the author deems that no harm should come to the child, and that it is the duty of a nurse to assist and deliver treatment to their patients. Exploring practical alternatives. The author may choose to do nothing and let the mother and the father resolve who will have the final say in the decision with regards to providing treatment for the child, but the author feels that doing so will be in violation of their personal beliefs as well as their obligation and duties as a nurse. Another course of action is to educate the mother regarding the dire situation that her child is in and to ensure that she is making an informed decision. As a last resort, the Author has the option to seek the services of the government’s child protective services since the child is in a way, being neglected by the parent who is failing to provide adequate medical care to the child (DSS, 2007).
Completing the determined course of action. Taking action after all the facts and moral implications have been thoroughly considered is the next logical step. Taking no action and letting the situation resolve itself is out of the question since this is tantamount to the abandonment of the duties as a nurse that the Author has sworn to fulfill. The author’s first course of action is to educate the mother of the child, as well as ensuring that she is making an informed decision. If the mother relents and agrees to the treatment, then the issue is now resolved. If the mother is still unwilling to allow treatment for her child, the next course of action will be to report the Mother to Child Protective Services. Evaluating the process and the outcomes.
The reflection on the Author’s part on whether the action undertaken by the Author was effective in achieving the goal that was set in accordance to their moral judgment and their professional duties as a nurse, is the final step in ethical decision making. Educating the mother of the child, as well as making sure that the mother was making an informed decision was the most efficient and timely way to obtain resolution, if it was effective. If not, the second course of action which was to report the mother to Child Protective Services is the next best alternative since a custody hearing between the child’s parents will take too much time. The mother in this case may lose custody of her child, and may be charged for neglecting her child. Both courses of action served a single goal, which is to ensure that no harm comes to the child which is the highest priority of a nurse.
The nurse should approach the Mother in a caring and non-threatening way, and should always project understanding and respect for the mother’s religious beliefs. Nurse: good evening Mrs. X. I was told that you do not agree to the treatments for your son, and that this is because of your religious belief? Mrs. X.: Yes this is true.
Nurse: has the doctor talked to you about his condition and what will be the result of not treating the meningitis will do to your son? Mrs. X: Yes he has. He told me that he may suffer damage to his brain and to his nerves. Nurse: and you still do not want your son to receive treatment even when you know that it may harm your son? Mrs. X: well there is a chance that it will go away by itself right? He’ll be fine. Nurse: as I have heard the doctor explain to you, the damage to his brain and nerves may cause him to become mentally and/or physically disabled if we do not treat him as soon as possible . Are you sure you still would not agree to the treatments? I know that your religious beliefs are very important to you, but the risk to your son is just to great to ignore. Mrs. X: I still do not want any treatment for my son.
Nurse: Then I regret to inform you Mrs. X that in cases like this when the Doctors and the Nurses think that a child is in danger, we need to notify Social Services, and we have already done so. I have Ms. Y from Social Services who is going to talk to you about your son.
Bandman, E. & Bandman, B. (2002). Nursing Ethics Through the Life Span. (4th ed.).
Department of Social Services (2007) Child Protective Services retrieved from
Fant, C. (2013) Major Ethical Dilemmas in Nursing, Retrieved from http://www.nursetogether.com/ethical-dilemmas-in-nursing
Mayo Clinic (2014) Meningitis retrieved from http://www.mayoclinic.org/diseases-conditions/meningitis/basics/complications/con-20019713
Purtilo, R., & Doherty, R. (2011). Ethical Dimensions in the Health Professions, 5th Edition. [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-1-4377-0896-7/id/B978143770896700014X_p0460