Writing an essay regarding ethical dilemmas

Hi,

I am very new to this website, so please excuse if this topic has been covered before...

I am required to write an essay regarding the ethical dilemmas faced by nurses in a scenario of a Jehovah's witness who has been involved in a car accident, who has internal bleeding and requires surgery, but is also 8 months pregnant and is refusing treatment.

It asks to go through Autonomy, beneficience, non-maleficience, justice and confidentiality relating to the case.

It then goes on to ask to analyze the ethical dilemmas regarding the unborn baby.. the hurt mother and the impact of the decision that the nurse chooses with other members of the hospital team..

I am unsure whether I would have a duty of care to ensure the safety of the baby whilst upholding the wishes of the mother or whether I would only have a duty of care to the mother?

Thanks in Advance

JSBCP
the terms, i would have to refresh my memory however; i can easily describe my duties and responsibilities in such a case.the following is true of any scenario, any diagnoses, and any clinical dilemma.#1 is that i can do nothing that exceeds the limitations of my clinical privileges. the flip side of this particular coin is that i must also intervene in a timely and appropriate manner to circumvent the limitations of those privileges. (i.e., being the timely involvement of the appropriately privileged personnel).#2 is that i must follow the laws of the land, which in this case would no doubt be dictated by the intervention of the judicial branch of the state where this would be taking place.our job, from a clinical perspective is deceptively easy; the moral dilemma is a personal issue.

Quote from JSBCPI am unsure whether I would have a duty of care to ensure the safety of the baby whilst upholding the wishes of the mother or whether I would only have a duty of care to the mother? Thanks in Advance JSBCP

Autonomy -- the mom has autonomy to make her own decisions AND her minor children unless you can prove she can't give informed consent/refusal of care. Beneficience -- well, obviously the best thing is to help both mom and baby, but if mom refuses, you can't do much legally unless you get the hospital's legal department/social services involved and then try to get a court appointed guardian for the baby, which wouldn't probably happen fast enough to do any good. Non-maleficience -- that's where I'd "live" in the paper -- first do no wrong. If you don't help the baby, you've wronged the chld, if you contact social services, you may have religiously "wronged" the mom in the expression of her religious beliefs, and if you treat her against her will, you've committed assault and battery. You'd also have to be careful about the "confidentially" issue (nice side dish of HIPAA compliance). Justice would be getting the mom to allow a C-section so that the child could be treated separately, and if the mom decided to bleed to death, she didn't take along innocent passengers. In the real world, if she continued to refuse, I'd get a fast psych consult to try to get someone to say blood loss plus trauma would render her incapable of informed refusal.In reality, the patient would probably end up filing wrongful death charges against you when the baby died, stating the stress you put her under caused the death of the child (as opposed to the untreated injury and blood loss), file a HIPAA complaint because her health care info was released to a judge (even though it's legal in that situation), and while she'd lose in criminal court, she'd win in civil court.

I know I sound grumpy when I say this, but I really hate it when students ask us to do their homework for them.

Keep in mind two things:1. At 8 months gestation the baby is likely viable outside of the womb.2. Jehovah's witnesses rarely refuse all treatment, usually just blood products. Is she refusing all treatment for purposes of your paper?

Quote from SlightlyMental_RNI know I sound grumpy when I say this, but I really hate it when students ask us to do their homework for them.

I don't see how someone could crank an essay out on that. They don't want you touching them so don't. I can't see it being any more clear than that.

If I were writing this paper, I would first focus on the side where the mother has the right to be respected. I would also include that many states do not consider the baby a baby but an unborn fetus and therefore does not have the same rights as a born child. Therefore the mothers wishes should be upheld. The second aspect is obvious, that many believe the baby is a baby. And that baby has the right to treatment. Who is to say that the baby once grown will also be a J.W. and have the same beliefs of the mom. Who is to say that the baby if an adult would not accept a blood transfussion... Etc, etcTo conlude I would throw in the alternatives for this case which could make both parties happy - that instead of a blood transfusion you could educate the mom on blood expanders or artifcial blood. As well as clearly educating the mom on the risks of refusing treatment for herself and baby.

I dont mean to sound cranky when I say this either but I cant stand it when someone posts for advice and other people post things like - refer to other threads, or this topic has been discussed or my favorite - I dont want to help students because of bla bla bla.... Yea whatever! If you dont want to then dont. Why post anything at all? She wasnt asking for someone to write her paper... Have you ever heard of writers block? Or better yet if she is a student maybe she doesnt understand all the aspects that this assignment is looking for. I commend her for thinking to ask experienced nurses about this topic. That doesnt mean anything more than she wanted someones insight on the topic.

never mind

The fetus has no legal rights until born. Whatever your person feelings are about this, it is true. It is also not in your role to question the beliefs of the mother (at least publicly). You do have a nursing responsibility to the fetus, but only in the manner the mother allows.

Thankyou to all that have given advice. I didnt mean to *ask* for anyone to write my assignment, as that was not my intention at all, I was merely asking seasoned Nurses, whether I have any duty of care to the Baby, or just the presenting pt, i.e just the mother and her issues such as the internal bleeding.. I have written most of my assignment, such as the ethical principles, and how they relate to the case, but now I am writing the section on "ethical dilemmas faced by the nurse regarding the foetus". I know personally I would have a hard time morally not thinking about the unborn child, and I probably would question whether nursing was in fact what I wanted to continue to do, as I always thought nursing was to help others and do no wrong ... and if the baby were to die, due to my actions or inactions then I am not sure whether I would forgive myself, for at least not trying...I being a brand new parent to twins who are just going on 4 months old, and knowing that they were born at 33+4 and lived , I would have ethical and legal issues running through my head faster than I could think ... and knowing that if the baby were to be born, it would have a greater chance of survival than being left insitu... I just hate these kinds of assignments as I feel it is hard to write about this stuff if we have never been put in similar situations... the only ethical dilemma I have ever been put in, is when my dad was dying of cancer and he was offered chemo but refused, and then when he was closer to death asked for it, but it was too late for him, I had to explain why it was too late and virtually 'bad luck you had you chance' type of thing ... pretty sad, but realistically it was the best decision... JSBCP...