End of life or palliative care is complex, demanding, and comprises of various ethical and moral issues for both the patients, provider, and family members. Palliative care may involve 3 ethical principles, i.e. beneficence, autonomy and veracity (Houser 2015).
Describe the ways the subjects were vulnerable.
In the article, the author provides an ethical and moral issue on how Josh, a 11-year old boy was not informed and consented for his lymphoma and palliative care. Josh was vulnerable since his parents decided to not disclose the line of treatment services that would be offered to him (Stringer 2013).
Is there any conflict of interest?
In Josh’s case, there is clear conflict of interest. Both parents decided to continue with chemotherapy without passing on the burden of knowledge and distress to their son. The oncology team agreed to continue with the treatment, leaving Josh in a confused state, where he felt isolated and uncertain about the consequences (Houser 2015 and Stringer 2013).
Which protections should be put in place to protect these subjects from harm?
Josh who was 11-years old at the time of treatment should be subject to the same ethical and moral values. Josh’s decision to continue or decline treatment should have been taken in a way to protect him from distress and uncertainty. It is important to abide and respect the patient’s decision which is based on the principle of veracity (Stringer 2013).
What are the incidence and prevalence of moral distress in nursing today?
In paediatric end-of-life care, nurses and healthcare providers are often confused with protecting the child and providing the best of medical services but may need an affirmation from the child to continue with the treatment. Most nurses are morally distressed to decide on the continuation of treatment and depend on parent’s consent (Houser 2015).
References
Houser, J (2015). Nursing research: Reading, using, and creating evidence (3rd ed.). Sudbury,
MA: Jones & Bartlett.
Shepard, A. (2010). Moral distress: A consequence of caring. Clinical Journal of Oncology
Nursing, 14(1), 25–27.
Stringer, S. (2013). Moral choices in end of life care for children. Cancer Nursing Practice,
12(7), 27–32.
