An Ethical Dilemma

[StudentRN_Sara]

Hello! I'm a second year nursing student with UWO, andwas hoping for some input. I'm taking a professional nursing course where I need to validate an ethical dilemma that was given to us and just wanted some opinions.

Here it goes...

A 14 y.o. female has just completed a 6 month checkup for a fractured ankle. The fracture had healed completely and with complications, but her blood results showed that her hemoglobin was in the low-normal range. As a percautionary measure, her doctor sent her to a nurse practitioner for diet counseling. Before long the patient had confided that she thought she was pregnant and she did not want anyone else to know, especially her mother. With more discussion it became evident that the 14 y.o. patient had no clear idea what she was going to do about the suspected pregnancy. Before the nurse practitioner could begin to help the patient think it through, the mother walks in. The mother tells the nurse that the patient has been nauseated and very tired lately, and asked the nurse if she had any idea what could be causing it. As the nurse prepares to respond, the patient is silent and glaring at her. The nurse has a dilemma.

So is this dilemma is based on confidentiality? Or being able to make decisions for herself?

It is essentially doing the most for the patient, without sacrificing her rights.?!

I'm just hoping for some opinions for a basis to my thoughts.

Thanks for your help in advance!

Sara

[z's playa]

I believe its based on both. Confidentiality and the mental status of the pt. Unless the pt is deemed incompetent, then the mother would take on power of attorny but if the pt is of sound mind, she has the right in all aspects of her own health care. Once again, here in Canada, a child of 14 has the right to take their health care into their own hands due to the child protection act. A 12 yr old can go to the ER on her own and the parents wouldn't be called unless otherwise asked. I would in this situation ask the mother to leave the room and continue on with the interview. If the mother begins to act defensively, then it gets complicatd but the trust between you and the pt begins as soon as you enter the room. Explain to the mother that unless her dauhgter wants her in the room, she would have to wait in the waiting room .I would leave it up to the pt to tell her mother what she wanted and offer counselling to the family.

Tough call.

It may even vary from clinic to ER scenarios. I'll look into it more.