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It was reported that the child had been crying since picked up at daycare. The nurse found that the child’s vital signs were slightly elevated and child’s thighs were edematous and warm to the touch. The assessment was then presented to the physician; concern was expressed that the child may have been injured. An x-ray was ordered revealing fractures to both femurs. The mother was informed of the findings by the physician; after speaking with the mother the physician decided It was not child abuse and therefore, he situation did not need to be reported.
The ethical Issues Involved In this case study are the nurse and physician’s responsibility to report suspected child abuse. Social services should have been consulted to assist in the process of reporting the situation to Child Protective Services (CAPS). Hardy and Remarriage state “In all actions concerning children, the best interests of the child shall be a primary consideration” (2002, p. 109). In this case, the primary consideration was not in the best interest of the child.
According to Judson ND Harrison the physician has the responsibility to understand the tools for diagnosing and treating abuse and to be familiar with the available resources (2010). The nurse in this case has the ethical duty to report the physician for not having concern regarding a possible child abuse situation. Healthcare professionals have an ethical duty to expose unethical behaviors by other members of the healthcare field. Nursing has progressed over the years into a respected and honorable profession.
Incas Alton (2008) states it best by saying, “The six key roles of nursing are: advocacy, rendition of a safe environment, research, participation in shaping health policy, in patient and health systems management, and education” (p. 839). The two key roles the nurse in this case study failed to provide for the patient are advocacy and promotion of a safe environment. If the nurse was using good moral and professional judgment, he or she would have reported the situation immediately for the wellbeing of the child.
Three of the ethical principles that are discussed are malefaction, veracity and paternalism. The first ethical principle Is malefaction, meaning first do no harm Dodson and Harrison, 2010). A question asked by Milton and Cody (2001 p. 290) was, “How can one keep from doing harm if one acts without knowing what the reality of ten lave experience Is Tort ten person? ” In ten case study, kneeler ten nurse nor physician knows what happened to the child or the reality of the circumstances that led to fractured femurs.
The healthcare professional would have upheld this ethical principle and the law by reporting the suspected abuse, thus doing no harm and protecting the child from further harm. Another ethical principle that the physician could have used is veracity. The ethical principle of veracity deals with the truth or truth telling (Henry, 2005). The physician in this case should have discussed the health status of the child with the mother, made a “good” moral Judgment, and told the mother the incident must be reported to CAPS; the case could have been presented to the mother in a non-accusatory manner.
The physician should have been reported for assuming the incident did not need to be reported. Furthermore, the nurse should have stepped forward and reported the incident, thereby promoting veracity on behalf of the case at hand. The third ethical principle in the case study to discuss is paternalism. At times paternalism viewed as a negative act because it allows healthcare providers to make decisions for the patients (Andre & Velasquez, 2008). The facts in the case study provide for an excellent example of when paternalism should be exercised.
The nurse or physician in the case study could have used paternalism as a guiding ethical principle to do what was right for the safety of the child by reporting the incident. The child has no voice to defend or protect him or herself and in this tuition, the nurse should have advocated for the patient. The three ethical principles mentioned above are valued in my personal and professional life as a mother, nurse and student. The first ethical principle discussed malefaction has been a personal value of mine throughout my life, used in all aspects of my life. The second ethical principle, veracity is maintained most of the time.
I believe there are situations where telling the person the whole truth would not have an optimal outcome. The third ethical principle mentioned paternalism is seed at times in my professional life as a nurse and in my personal life as a mother. The outcome of the case study could have been optimal for all involved the child, mother, nurse, and physician if the situation occurred at a children’s hospital. The likelihood of staff in a children’s hospital to have the proper training on signs of, diagnosing, treating, and reporting suspected abuse is much higher than an adult focused medical center.
The American Association of Heart Failure Nurses incorporates ethical principles in the respect of advancement of care, education, and research to promote the best outcomes for patients’ with heart failure. One ethical principle used by the association is beneficence; this principle is used by providing evidence-based research, treatment, and education for patients and healthcare professionals. Using evidence-based medicine the association is giving optimal care for this patient population. Slung tentacle principles unaltered professionals can ensure teen are making g moral decisions regarding care and treatment of patients.