Yes, the case involves an ethical dilemma. The patient’s family and the healthcare providers are at crossroads as regards making a choice because decision making has become difficult and needs a well thought out solution that adheres to the ethical guidelines. The healthcare providers feel that they should let the patient know the condition that the patient is suffering from, but the grandmother who also adds up as the guardian has directed that the child should not be told about the diagnosis with HIV/AIDS.
One of the ethical values in the CNO Ethics standard that relates to the case is truthfulness and acting with integrity and honesty. The healthcare team is being compelled to lie to the patient hence breaching professional ethical values. Healthcare practitioners are expected to be truthful in their practice but they are compelled to lie by the guardian of the patient, and this is in conflict with the case. The privacy and confidentiality ethical value also relates to the case because the guardian wants the confidentiality of the diagnosis maintained so that the patient is not informed about the two conditions. The healthcare providers feel that the patient should know about all the diagnosis results but the guardian advises otherwise.
The ethical principles from LHO that relate to the case include the nonmaleficence and veracity ethical principles. The nonmaleficence ethical principle dictates that the patients should be protected from harm and any actions that may cause harm. The principle is applied when healthcare practitioners identify a patient risk and work to prevent the patient from any harm as a result of the risk. While the healthcare providers have not seen any harm of telling the patient about the diagnosis with HV/AIDS, the Guardian thinks that telling the patient about the condition could be a risk and asks the team not to tell the patient about it.
The veracity ethical principle also comes in when the healthcare team is asked to protect the patient from the truth intentionally. The healthcare team is not comfortable with the request from the guarding to protect the patient from the truth because this is contrary to the ethical principles.
Step 2a: Gather all relevant information. Identify known and unknown facts and evidence. Consider medical indications, client capacity, and preferences, quality of life and client safety, social, legal and economic factors.
The child has a long history of sickness which seems to be well documented and the healthcare team knows that she has a few days to live. The guardian doesn't want the healthcare team to reveal to the child about the diagnosis of HIV/AIDS. Such a shocking revelation can cause stigma and may also end the life of the patient before the right time comes because of stress. Knowledge of the diagnosis can contribute to further deterioration of the patient’s condition. The patient may not be in a position to make a decision concerning confidentiality and privacy because they are young and may not understand most of the ethical guidelines. The patient may not benefit from the autonomy ethical principle because they are still young to make choices and decisions on their own. The Guardian is therefore justified to make some of these decisions on behalf of the patient because it is clear from the case study that there are growth problems and the long medical history indicated that they are critically ill to make any decisions on their treatment and diagnosis. The long medical history of the patient at their age makes it difficult to save their life because the immune system is not well developed at that age. The patient does not have the capacity to make decisions because they are facing death as the case points out. Critically ill patients have no capacity to make decisions and give their preferences and can only depend on their families, relatives, guardi
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