The ethical dilemma is that the children of the woman with cancer are not being cared for adequately. The nurse must decide if it is ethically and morally sound to tell the school nurse about the daughters’ situation at home. Since the nurse is the caretaker of the mother and knows that she needs to keep her information about her health confidential. However, it is affecting the mental stability of her daughters because they are afraid of their mother’s declining health. Also, their intellectual abilities are being demised as shown by their worsening grades at school.
She also needs to decide if she needs to report the situation as a case of neglect. Since the mother cannot properly even care for herself, let alone her daughters, it is logical to think that as the mother’s health declines, so will her daughters. Views of Utilitarianism and Deontological Theorist Utilitarian theorist wants what is best for the greatest amount of people. These theorists would think that leaving the girls with their mother would be for the greater happiness of all involved. If the girls and their mother were separated, that could cause emotional and mental anguish for all involved.
This argument is only strengthened by the fact that the mother has terminal cancer, thus has limited time to spend with her daughters. A deontological theorist wants to do what is rational and right, morally and ethically. That means that in this case a deontologist would want the nurse to report the case of suspected neglect because she is legally obligated to do so. Even though this action may upset the children and the mother, it is the legally right thing to do for the interest of the children. Nurse’s Options
One choice the nurse has to make is whether or not to tell the school nurse about the mother’s condition at home and how it is affecting her daughters, despite patient confidentiality. She feels that the school has a right to know why the children’s grades are suffering. However, she is legally bound to keep her patients information private. The nurse must also decide if she should report the case as neglect since the children are not, and probably will not, be properly cared for due to the mother’s declining health.
She ould try to ask the mother if it is alright to disclose the information to the school nurse, so that her daughter’s do not receive reprimands for their lacking in school and the connecting work. If such a thing exists, the nurse could offer to find a full-time, in-home, around the clock nursing service for the mother and the girls. Along with this, a tutor and a nanny-like individual could help the girls stay on top of their schooling and with their day to day lives. This would keep the family together during the mother’s final days.
While this would be hard for the children, it would be best for them to spend as many days with their mother as possible. Another option could be that the nurse tries to change the mother’s mind about refusing treatment. If the mother could receive some sort of treatment that could help her recover, this would take away the need to try to have the girls stay with her at almost all times. The girls could live with a near-by relative and visit the mother while she is being treated.
If the mother is insistent on refusing treatment the nurse could still try to find out if a near-by relative would take the girls in or at least help with their home care. When the mother dies the girls have to go into someone’s care. The nurse can try to find out who that person is and seek out their help. Also, if the mother has any family, the nurse could try to convince the mother to reach out to them to help as well. Nurse’s Process to Decision To make the most ethical and moral decision the nurse needs to think about the situation and analyze each step. First, she needs to think if this is a true ethical dilemma.
Next, she needs to collect all available data and information about the situation. Following that, she will need to put aside her opinions and views about the matter and look solely at facts integrity. This means that she will need to clear away her judgements and do what is right ethically. Next, she needs to formulate a plan of the course of action that she wishes to take. With a step-by-step plan, it will help ensure that the outcome will be what is desired. After she makes her plan she must implement it. She will need to follow through with every step to the course that she made during her last step.
Finally, she will carefully watch and make sure that her decisions have made the proper outcomes and will adjust accordingly. My Ethical Principles I could see the view point of the utilitarianism theorist because I would want the children to stay with their dying mother. However, it makes the situation harder to judge if the children are being harmed. To me, abuse is the intentional hurting of another person whether it is physically, emotionally, mentally, sexually, or any other type of pain or unwanted action. So, I would not call this a case of abuse.
However, I would define neglect as the improper caring for another beings needs. Thus, this situation could fall under the jurisdiction of neglect. Even though the mother is not intentionally hurting her daughters, she is no longer able to take proper care of them. I would stick to my utilitarian views but, I would look at if the girls’ harm outweighs the good that they get from staying with their mother. If the neglect overshadowed the good that would come from staying with their mother, I would remove them from the situation. However, I would still want them to see their mother, just not be in her care.
My Course of Action First, I would tell the school nurse about the daughters’ situation at home. According to Griffith (2015), a nurse has the right to disclose information about a patient to a third party, especially if a child is involved, if disclosing the information outweighs the benefits of keeping the patients confidentiality. I firmly believe that this case fall under those circumstances. It would be extremely beneficial for the school to know the family’s situation. Also, almost no harm would come from the school knowing the mother’s health status.
This way the school would be able to help the children in class more, and be more understanding when papers are not signed, homework is not done correctly, or when the children miss school all together. Also, some school districts have an in home tutor for situations similar to this. A tutor could come and help the girls catch up on their school work and would allow them to miss days when needed to be with their mother. For the issue of the daughters’ neglect, I would first try to get the mother’s permission to reach out to family and close friends to help take care of the girls.
If this was allowed I would then try to assess whether the girls could continue living in their home or if it would be better suited that they live with a relative or family friend for the duration of the mother’s illness. If the person who stepped in to help was able to be at the family’s house almost constantly, I would feel okay to let the girls stay. However, if that person was not able to be there for the majority of the time, I would want the girls to stay in that person’s care while still being able to visit their mother almost every day.
All of this is assuming that the person who steps in is a caring, responsible, willing adult that is able to do the task required to care for two young girls. However, if the mother refuses to ask for help from loved ones, I would be forced to report the case as possible neglect. As mentioned by Maguire et al. (2015), any child in school that shows low academic performance or any unusual behaviors is enough to permit an investigation to discover is neglect is the cause. Also, said in the study by Maguire et al. 2015), just by being subjected to neglect, the chance of them developing depression increases.
This likelihood would obviously be even higher in two girls that lost their mother to cancer. I would also want to look into options of treatment to discuss with the mother so that she knows all of her options before she fully refuses treatment. In studies like the one that Lanson, B. , Sanfilippo, N. , Wang, B. , Grew, D. , & DeLacure, M. (2010) conducted showed that patients that a partial laryngectomy along with moderate rate dosing can be a tolerable yet effective way to try to treat her cancer.
While it is unlikely that she will ever be fully cancer free again, I think the owes it to her daughters to try to fight to stay with them while she is moderately healthy as long as she can. However, I do understand that there comes a point when continuing treatment can be more harmful than the cancer itself. It is unclear how much treatment the mother has received and she may have come to her limit of receiving treatment or her cancer progressed so far that no treatment would be beneficially, excluding pain management therapies.