Cancer and breaking the bad news
Order Instructions:
Please follow the instructions carefully…. they are in bold and underlined…… please use APA referencing and required turntin report thanks….. also required 1500 words
SAMPLE ANSWER
Table of Contents
Introduction……………………………………………………………………………… Page- 3
Critical Thinking and Analysis………………………………………………………….Page 4-7
Conclusion……………………………………………………………………….………..Page- 8
References………………………………………………………………..……………. Page 9-10
(i) Introduction
Communication between healthcare professionals and patients is often critical in that the latter could react unexpectedly to the information they get (Konstantis, & Exiara, 2015, Pg. 35). As such, healthcare practitioners should evaluate the beneficence and maleficence of their approaches before making decisions (Punjani, 2013). Clinicians need honoring the trust accorded to them by their clients and ensure that they do not harm rather than encourage them (Reinke, Shannon, Engelberg, Young, & Curtis, 2010, Pg. 982). However, some situations present dilemmas, especially when information is not friendly to the patient. Clinicians have to consider ethical principles of practice and still ensure that they act within the relevant laws.
(ii)Critical Thinking and Analysis:
The Australian code of ethics for nurses specifies ethical standards that practitioners should meet in their duties. Among the highlighted requirements are the recognition and appreciation of the diversity of people (Waubra Foundation, 2015). In the case scenario, Mrs. Y’s daughters explained their beliefs to the surgeon and warned against the hospital informing their mother about her poor prognosis. The physician’s consideration of the proposal was an expression of understanding of the diversity of people. Again, the code requires nurses to manage information in an ethical manner and to take caution regarding possible undesirable outcomes (Waubra Foundation, 2015). Therefore, it was necessary to communicate to Mrs. Y cautiously. Though Mrs. Y was entitled to know her health status, the manner in which she got the information would have determined her reactions both emotionally and physiologically. The code of ethics requires that nurses promote patient wellness and avoid actions that would hinder recovery (Waubra Foundation, 2015). It was important for the doctor to consult Mrs. Y’s family members to understand how negative information would impact the health status of the patient. As revealed in the case scenario, cancer was intimidating, and the patient was more likely to find it inconceivable and horrifying rather than understand the condition. On such basis, the doctor’s and daughters’ act of concealing the health status of Mrs. Y was justifiable.
On the other hand, the code requires nurses to grant patients an opportunity to make informed decisions concerning their lives and well-being. Concealing the information compromises the appropriateness of decisions that Mrs. Y would make concerning her life. It was necessary that she participate actively in making decisions that concerned the management and treatment of her disease (Gracia C., Gracia J., & Chen, 2010, Pg. 195). Also, she had the right to know the outcomes she was to expect about her wellness.
From a moral perspective, Mrs. Y’s daughters and the doctor should have told the truth but take an optimistic approach (Reinke et al., 2010, Pg. 982). On such considerations, the parties would not disclose everything to the patient nor would they lie. However minimal Mrs. Y’s survival chances could be, nurses should not imply that they are pessimistic about her recovery. Though nurses would be negative about the outcomes of the patient, it would be morally questionable for them to tell the patient that she was likely to succumb to the ailment. Practitioners should express empathy and compassion in their interactions with their patients (Russell & Ward, 2011, Pg. 193). Telling patients that they are dying is questionable from a moral perspective. So as to avoid discouraging the patient, the doctor was morally justified to withhold information concerning the health of Mrs. Y. It was a wise act for the daughters to fear the reactions of their parents and inform the surgeon concerning the issue. The daughters were morally right in that they sought to protect their parents by ensuring that they would receive the breaking news only when they were prepared for it (Narayanan, Bista, & Koshy, 2010, Pg. 61). Their communication with the doctor was for the betterment of the situation, and it did not bear an immoral motivation. Their concerns were an expression of their love and care for their parents.
On the other hand, it was morally questionable for Mrs. Y’s daughters and the physician to exploit Mrs. Y’s failure to understand English as an opportunity to discuss her health status without her knowledge. The parties were obliged to help Mrs. Y overcome the challenge of the language barrier and let her understand her situation. The patient trusted her daughters as facilitators of communication. By discussing her and suggesting that she should not be told that she had cancer, Mrs. Y’s daughters were betraying their mother’s trust. The daughters also betrayed the trust of their family when they requested that the information be concealed to their father as well. Also, the daughters assumed that their parents would not make appropriate decisions upon their learning of Mrs. Y having bladder cancer, an occurrence she had feared for long. The assumption prompted them to overlook the contributions of the patient and her husband hence limiting her autonomy. The doctor also failed to meet his moral role of interacting openly with the patient (King, & Hoppe, 2013, Pg. 385). The surgeon gave in to pressure exerted by Mrs. Y’s daughters and failed to meet the moral obligation of being available to the patient. The patient had a right to connect directly to her physician and express her wishes as well as seek the doctor’s assurance. It was also incorrect for the surgeon to assume that Mrs. Y’s daughters would deliver accurate information to their family regarding the critical issue. It was possible that the daughters would conceal necessary information to the patient. Again, it was not a guarantee that the two daughters would inform the rest of the family in the safest manner. The surgeon had the moral duty to protect the patient from potential harm by letting her know her condition in the most appropriate way. Trusting the patient’s daughters was a risky move by the physician.
Clinicians employ fundamental ethical principles in ensuring that they practice what is right while refraining from what is wrong (Scholl, Zill, Härter, & Dirmaier, 2014). It is such principles that guide practitioners in making decisions that are ethically and morally defensible. In the case scenario, the physician applied such principles when determining whether or not to inform Mrs. Y about her health status. The surgeon felt it ethically acceptable to withhold critical information considering the understanding that the patient’s daughters offered. The clinician considered various values and balanced them in the ultimate decision made. Both the physician and Mrs. Y’s daughters utilized fundamental ethical principles when they avoided lying and purposed to give information that would not cause severity in the health of the patient. One of the most conspicuously applied fundamental principles was beneficence. The parties evaluated the benefits of informing the patient against the associated disadvantages (Punjani, 2013). They also applied non-maleficence by ensuring that their move would not harm the patient regardless of whether it was beneficial or not.
However, the physician and the patient’s daughters failed to respect Mrs. Y’s autonomy when they decided to handle the patient’s condition without engaging her (Entwistle, Carter, Cribb, & McCaffery, 2010, Pg. 741). They ought to have offered full information and given the patient an opportunity to make informed choices.
With the advancement in healthcare, there is increased application of the law and clinicians would be sued in situations where their conduct hurts their clients. The law required that the physician protect the patient by offering her necessary information that would benefit her when making decisions (Scholl et al., 2014). Also, the law required that the clinician consider the concerns of the members of the patient’s family. The surgeon acted within the law by consulting the family and making reasonable considerations of their culture. Also, the physician expressed cultural competence by paying attention to the customs and beliefs explained by the patient’s daughters (Kodjo, 2009, Pg. 57). Considering the cultural background, acknowledging it, and orienting patient care in such a way that it incorporated the expected concepts was an expression of cultural competence by the physician (Kodjo, 2009, Pg. 57). Mrs. Y would learn her disease in a manner that was acceptable in her culture.
(iii)Conclusion
Mrs. Y’s daughters’ and physician’s decision to withhold diagnostic information to the patient and her husband was justifiable. The move was to facilitate the well-being of the patient, and it was not under ill motivations. Their decision paid attention to culture, and it was ethically and morally appropriate. Though the decision was questionable considering the rights and autonomy of the patient, its benefits outweighed its limitations. Also, the decision was defensible from a legal perspective as it had the ultimate intention of protecting the patient rather than harming her. In conclusion, the nurse assigned to Mrs. Y should concur with the surgeon and conceal the poor prognosis concerning the patient. The nurse’s response should be optimistic, and it should not cause an adverse impact on the patient.
References
Entwistle, V. A., Carter, S. M., Cribb, A., & McCaffery, K. (2010). Supporting Patient Autonomy: The Importance of Clinician-patient Relationships. Journal of General Internal Medicine, 25(7), 741–745. http://doi.org/10.1007/s11606-010-1292-2
Gracia, C. R., Gracia, J. J. E., & Chen, S. (2010). Ethical Dilemmas in Oncofertility: An Exploration of Three Clinical Scenarios. Cancer Treatment and Research, 156, 195–208. http://doi.org/10.1007/978-1-4419-6518-9_15
King, A., & Hoppe, R. B. (2013). “Best Practice” for Patient-Centered Communication: A Narrative Review. Journal of Graduate Medical Education, 5(3), 385–393. http://doi.org/10.4300/JGME-D-13-00072.1
Kodjo, C. (2009). Cultural competence in clinician communication. Pediatrics in Review / American Academy of Pediatrics, 30(2), 57–64. http://doi.org/10.1542/pir.30-2-57
Konstantis, A., & Exiara, T. (2015). Breaking Bad News in Cancer Patients. Indian Journal of Palliative Care, 21(1), 35–38. http://doi.org/10.4103/0973-1075.150172
Narayanan, V., Bista, B., & Koshy, C. (2010). Breaks: protocol for breaking bad news. Indian J Palliat Care, 16(2), 61-65.
Punjani, N. S. (2013) Truth Telling to Terminally Ill Patients: To Tell or not to Tell. J Clin Res Bioeth, 4(159). doi: 10.4172/2155-9627.1000159
Reinke, L. F., Shannon, S. E., Engelberg, R. A., Young, J. P., & Curtis, J. R. (2010). Supporting hope and prognostic information: nurses’ perspectives on their role when patients have life-limiting prognoses. Journal of Pain and Symptom Management, 39(6), 982–992. http://doi.org/10.1016/j.jpainsymman.2009.11.315
Russell, B. J., & Ward, A. M. (2011). Deciding what information is necessary: do patients with advanced cancer want to know all the details? Cancer Management and Research, 3, 191–199. http://doi.org/10.2147/CMR.S12998
Scholl, I., Zill, J. M., Härter, M., & Dirmaier, J. (2014). An Integrative Model of Patient-Centeredness – A Systematic Review and Concept Analysis. PLoS ONE, 9(9), e107828. http://doi.org/10.1371/journal.pone.0107828
Waubra Foundation. (2015). Code of ethics for nurses in Australia. Retrieved from http://waubrafoundation.org.au/resources/code-ethics-for-nurses-australia/
We can write this or a similar paper for you! Simply fill the order form!
