Ethical dilemma and patients beliefs conflict case study

Ethical dilemma and patients beliefs conflict case study
As an advanced practice nurse, you will run into situations where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur?
In this Assignment, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.
Scenario 1:
The parents of a 5-year-old boy have accompanied their son for his required physical examination before starting kindergarten. His parents are opposed to him receiving any vaccines.
Scenario 2:
A 49-year-old woman with advanced stage cancer has been admitted to the emergency room with cardiac arrest. Her husband and one of her children accompanied the ambulance.
Scenario 3:
A 27-year-old man with Crohn’s disease has been admitted to the emergency room with an extreme flare-up of his condition. He explains that he has not been able to afford his medications for the last few months and is concerned about the costs he may incur for treatment.
Scenario 4:
A single mother has accompanied her two daughters, aged 15 and 13, to a women’s health clinic and has requested that the girls receive a pelvic examination and be put on birth control. The girls have consented to the exam but seem unsettled.
Scenario 5:
A 17-year-old boy has come in for a check-up after a head injury during a football game. He has indicated that he would like to be able to play in the next game, which is in 3 days.
Scenario 6:
A 12-year-old girl has come in for a routine check-up and has not yet received the HPV vaccine. Her family is very religious and believes that the vaccine would encourage premarital sexual activity.
Scenario 7:
A 57-year-old man who was diagnosed with motor neuron disease 2 years ago is experiencing a rapid decline in his condition. He prefers to be admitted to the in-patient unit at a hospice to receive end-of-life care, but his wife wants him to remain at home.
To prepare:
Select one scenarios, and reflect on the material presented throughout this course.
What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?
Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.
To complete:
Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least 3 different references from current evidence based literature.

Scenario discussion and solution

The parents of the boy are against him receiving any vaccines and he is about to join kindergarten. More information to obtain will include previous history of vaccination, medical history, surgical history and a full physical examination. The vaccination history is to find out whether he has received any previous vaccines. The physical exam is to check for any signs of injury that would warrant a tetanus toxoid vaccine. The medical surgical history is to find out whether he has been admitted in hospital before or undergone any surgical procedure (Chadwick, & Gallagher, 2016). It is also important to find out the religious history of the parents. This is because their belief in not vaccinating usually has a religious background.

As an advanced practice nurse, I wound advice the parents on the importance of vaccination. It is protective against preventable diseases. The child is joining kindergarten where there are many other children. This exposes him to many medical conditions given that he has not been vaccinated. According to ethics, what health practitioners do should be beneficial to the patient (Burstin, Leatherman, & Goldmann, 2016). It should not be harmful to the patient. In this case, vaccination is meant to help the five year old boy be safe from certain infections when he joins kindergarten.

Evidence has shown that vaccines offer great preventive services to children. Rarely do adverse effects occur. The parents of the boy should consider having him vaccinated before exposing him to other children in kindergarten (Rickert, 2019). Even though the parents make the decisions for their child, they should consider making one that they will not regret later on in life.



Burstin, H., Leatherman, S., & Goldmann, D. (2016). The evolution of healthcare quality measurement in the United States. Journal of internal medicine279(2), 154-159.

Chadwick, R., & Gallagher, A. (2016). Ethics and nursing practice. Macmillan International Higher Education.

Rickert, J. (2019). On Patient Safety: The Importance of Vaccinations—Avoiding the Mistakes of the Past. Clinical Orthopaedics and Related Research®477(1), 28-30.