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The case study we were provided presents an ethical dilemma I have previously come across in my nursing career. The dynamics between health care providers and patients and their families can vary greatly.  I think it is important to remember in any subject area that encompasses the human experience, the solution to the problem may not always be the same.   

In our given scenario, the physician was placed in a very difficult position, that due to the patient age, went beyond personal belief and extended on to legal 

limitations.  The Nurse had made the moral judgment that dishonesty with the patient, would ultimately affect her ability to prepare herself for the struggle that lies 

ahead.  The nurse felt the physician was dishonoring the rule of always being honest with your patients.  Respecting the dignity of the patient by including them in the

decision-making process, is a principle the physician side stepped by following the parents wishes (Foreman, 2011).  Nurse Chan is exhibiting the ethical theory of 

deontology, dealing in absolutes of right vs wrong; truth vs lies.  

In this situation, the physician may be bound by legal measures that require him to follow the legal guardians discretion in sharing the diagnosis and treatment 

plan.  I feel the physician is making the right decision to follow the parents lead, however, as this is an older child, her diagnosis and treatment plan will need to be 

discussed with her, very soon, but in a supportive manner.  A multidisciplinary team approach involving a social worker or therapist can help the family move forward 

together.  The physician is forced to follow the consequentialist theory as the parents current thought process is withholding information (lying), to their daughter is 

necessary to protect her mental health (Foreman, 2011).  The physicians responsibility is to ensure that the parents have a very thorough understanding of the disease 

process and treatment options.  As the parents also, had just lost a loved one to cancer, their fears may also be affecting their ability to process this new news.  Herein 

lies a major problem in healthcare today.  Are we providing the patient and family with all the necessary details while having the crucial conversations needed to 

establish a shared responsibility in the care continuum?  

As Karen is considered a minor at age seventeen, I do think the law plays a big part in this case.  In this situation, it would appear the parents are concerned with 

the childs ability to process the cancer diagnosis.  As there is no evidence of emancipation or other health related decision maker noted, Karens care decisions fall

under the responsibility of her parents (Rosoff, 2017).  We typically do not reach our fully effective ability to make decisions until we are in our young twenties 

(Rosoff, 2017).  Due to the recent family loss, and Karens potential immaturity, her parents are practicing the rule of protecting their child from harm.  The parents 

are well within their legal rights to withhold this information from Karen.  Morally, the parents are taking a risk at destroying the trust their daughter has in them by 

not being truthful.  What sort of message are they sending their child in not being honest?  In the theory of virtue ethics, will Karen understand their protective nature 

or will this affect her ability to develop into a person full of virtuous integrity?

 

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