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Case study #1: Diagnosis of a Congenital Disease Bianka Pizarro, Jocelyn Mazur, Amanda Fradsham, Amber Mello, Krithika Suresh, Gianna Bozzetti Northeastern University Independent Case Study Discussion NRSG 2150: Ethical Healthcare Integrating Genetics and Genomics September 19 th , 2020

One of the biggest key elements we spoke about in this case study was whether Emily should be able to decide on her surgery. As a group, we agreed that due to the information given on the case study, Emily has the right to decide whether she wants the surgery. According to chapter 5 in the textbook “Serious consideration must be given to the wishes of maturing children who are judged to have good insight about the benefits and burdens of their healthcare treatment.” (Butts & Rich, 2020). Emily was born with this condition that has had obvious complications throughout her life. She will have enough knowledge of her condition and treatment. Even though she is young, she has had a different life experience that gives her the capacity to make an educated decision on her treatment. Another one of the most important aspects of this case that was spoken about, is that if Emily’s parents had decided to go ahead with the procedure, would that be violating her autonomy? Children are legally incompetent individuals who have surrogate decision makers for important healthcare decisions (Butts & Rich, 2020). In Emily’s case, this would be her parents. In many cases, parents decide for their child by using the best interest standard. When using the best interest standard, surrogate decision makers base their decisions on what they believe will provide the most benefits and the least burdens for the child (Butts & Rich, 2020). This can also be addressed in a case-by-case manner. In most cases, it makes sense for the parents to make the best decision for the child, without even asking their permission. In Emily’s case, she had a full understanding of her situation and was sure of her decision to not have the procedure. Therefore, if her decision was overridden, we believe it would have been a violation of her autonomy. Provision 2 of the ANA code of conduct states that “The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.” (American Nurses Association, 2015). As nurses, our main purpose is to support the patient’s decision and

advocate no matter what. This specific situation can be a little difficult because it gives your perspective of the parents and the nurse. Our point of view may be different from that of a parent than it would be as a nurse. As a nurse though, our main priority is the patient. We must support and advocate whether we agree with the decision, or not, if it is what the patient wants. We need to make sure the patient is fully informed and aware of the risks and benefits when making their decision. It is important in this situation since our patient is so young, to ensure that the information is presented at her level of understanding and that she has enough understanding of the situation, to make an informed decision. Once the patient can decide given all the available information appropriately, it is the nurse’s responsibility to set the patient up a plan of care to follow the patient’s expressed desires.

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References American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements . American Nurses Association. Butts, J. B., & Rich, K. L. (2020). Nursing ethics: Across the curriculum and into practice (5th ed.). Burlington, MA: Jones & Bartlett Learning, LLC.

Case study written portion

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