A 20-year-old girl is brought into the ER by her parents. The parents write on the sign-in sheet that their daughter was caught having sex at her parent’s home with her boyfriend and the parents are demanding that the physician prescribe her the “morning after” pill. What should/can the nurse do? 1. Which of the provisions of ANA code of ethics apply in the scenario? Choose three provisions and explain why?
Title: Ethical Considerations in a Challenging Clinical Scenario
Introduction:
In the given scenario, a 20-year-old girl is brought to the emergency room (ER) by her parents after being caught engaging in sexual activity with her boyfriend at their home. The parents demand that the physician prescribe their daughter the “morning after” pill. This situation raises various ethical concerns, necessitating an examination of the relevant provisions of the American Nurses Association (ANA) Code of Ethics.
Provisions of the ANA Code of Ethics:
The ANA Code of Ethics provides a comprehensive framework to guide nurses in their ethical decision-making process. It includes nine provisions that outline the fundamental values and principles nurses should adhere to when providing care to individuals, families, and communities. In the given scenario, three provisions of the ANA Code of Ethics are particularly relevant:
1. Provision 1:
“The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.”
This provision underscores the importance of treating every individual with respect and dignity, regardless of their personal choices or circumstances. In the scenario at hand, the nurse should approach the 20-year-old girl with empathy and sensitivity, acknowledging her autonomy and privacy rights. The nurse should recognize the girl’s right to make decisions about her own body and reproductive health.
2. Provision 2:
“The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.”
This provision highlights the nurse’s obligation to advocate for the best interests and well-being of their patients. In the given situation, the nurse should prioritize the girl’s needs and provide her with the necessary resources and support to make an informed decision regarding her reproductive health. The nurse should ensure that communication between the girl, her parents, and the healthcare team remains confidential, respecting the girl’s autonomy and confidentiality.
3. Provision 5:
“The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.”
This provision emphasizes the nurse’s responsibility to promote their own well-being and maintain professional competence. In the presented scenario, the nurse should seek to maintain their own emotional composure and professionalism while responding to the parents’ demands. The nurse should engage in ongoing professional growth and remain up-to-date with evidence-based practices related to sexual and reproductive health.
Ethical Analysis:
The ethical analysis of this scenario requires considering the principles of autonomy, beneficence, non-maleficence, and justice. Autonomy refers to an individual’s right to make decisions regarding their own body and health, while beneficence and non-maleficence address the obligation to act in the patient’s best interests and avoid causing harm. Justice pertains to the fair and equitable distribution of healthcare resources.
The girl in the scenario is a consenting adult, and therefore, her autonomy should be respected. The nurse should engage her in a non-judgmental conversation to explore her understanding of the situation and her preferences regarding emergency contraception. It is crucial to provide her with accurate and unbiased information about the available options, potential risks, and benefits of emergency contraception.
The nurse should also consider the principles of beneficence and non-maleficence in navigating this situation. While the parents may have expressed concerns about their daughter’s well-being, it is essential to prioritize the girl’s autonomy and respect her right to make decisions about her own reproductive health. The nurse should ensure that the girl understands her available options and support her in accessing appropriate care.
However, justice is a complex consideration in this case. While the parents may believe that their demand for the “morning after” pill is justified, the nurse must evaluate the ethical implications from a broader perspective. As healthcare professionals, nurses have an obligation to consider both individual and societal needs. They should strive for equitable allocation of healthcare resources and ensure that no individual or group is denied essential care or subjected to discrimination.
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In this scenario, the nurse should weigh the potential consequences of different actions. If the healthcare facility adheres to a policy that allows for the provision of emergency contraception, the nurse can facilitate its administration and provide appropriate counseling to the girl. If the facility does not have such a policy, the nurse can advocate for the development of a protocol that addresses this type of situation in accordance with legal and ethical standards.
If, however, the facility does not permit the provision of emergency contraception due to religious or personal beliefs, the nurse should consider invoking Provision 8 of the ANA Code of Ethics. Provision 8 states that nurses have the right to conscientiously object to specific interventions or procedures based on moral, ethical, or religious grounds. However, nurses also have an ethical duty to ensure that alternative care options are made available.
Conclusion:
The presented scenario raises complex ethical considerations for the nurse in accordance with the ANA Code of Ethics. The nurse should uphold the provisions related to respect for patient autonomy, commitment to the patient’s best interests, and maintenance of professional integrity. By approaching the situation with compassion, respecting the girl’s autonomy, and advocating for equitable access to care, the nurse can navigate this challenging clinical scenario in an ethical manner. It is imperative that nurses continually strive to integrate ethical principles into their practice to provide the highest level of patient-centered care.