Treating a cancer patient is a complicated task as some cancer patients often present with signs and symptoms of depression, anxiety, and in worse case scenarios, episodes of violent reactions . In this case, we are talking about a 12-year old boy with cancer who has finally learned and accepted the fact, as stated by his physician, that he will eventually die and wants to stop chemotherapy. However, the legal and ethical dilemma comes when the boy’s parents expressed and consented to try a new and a more aggressive course of chemotherapy. Learning this from the parents of the patient themselves, the nurses in the department go ahead and administered the chemotherapy as ordered by the physician. Now, there are two things that have to be pointed in this case. Firstly, in cases wherein the patient is a minor—in most countries a minor is classified as an individual who is under the age of 18, the patient’s parents would often be the one that the medical team will ask regarding treatment and management decisions . In the United States for example, this is the case. In some countries however, this may differ because generally, a patient has the right to refuse treatment despite regardless whether doing so is necessary for his recovery or whatnot. The big question for the nurses in the case now would be, who are they going to follow? Are they going to follow the orders of the 12-year old boy to stop the chemotherapy sessions and just allow himself to wither and die, or are they going to follow the consent and orders of the parents to try a new and more aggressive form of chemotherapeutic treatment? In most clinical and or hospital setting, nurses are required to take orders from the physician or basically any medical practitioner in-charge of a particular patient. In this case, it can be recalled that the physician acknowledged, legally, the consent of the 12 year old boy’s parents, which means that that physician had been guided by the universal statement of patient rights suggesting that only patients who are aged 18 and above and are not considered mentally and or behaviorally challenged would be allowed to decide for themselves in any medical situation. In a scenario wherein at least one of the mentioned factors is present such as the presence of mental and or behavioral disorders, or if the patient is under-aged, the next of kin or most of the time, the parents often take charge of the decision-making responsibilities. Now this may be the legal thing to do, at least in most countries and in a general clinical setting, but that does not automatically make it the ethical thing to do. Every person reserves the right to decide for himself regardless of his age. God has given every one of us the freedom to decide what is good for us and if the 12-year old boy thinks that the medical efforts of the doctors and his family are futile, then by all means, he deserves the right to be heard and for his wish to be granted.
In this case, we are talking about a physician who informed his nurse about his routine practice of prescribing antidepressants for every new patient admitted to the nursing home without the patient knowing it. The physician instructs the nurses to say to the patients that the medications they are taking are just pills that the physician prescribed for their health, intentionally hiding the fact that those medications are in fact, antidepressants. The question here is whether the nurses should follow the orders of the physician or not. In general, what the physician did is both ethically and legally wrong. In some countries where there is a strict implementation of medical and healthcare ethics, his license to practice his profession as a physician, despite having invested time, effort, and resources to study and pass the licensure examination, can be permanently revoked . The same is true for the nurses. If someone, a relative of the patients or even one of the patients perhaps, would discover this routine, the nurses may also be held liable and just like what could potentially happen to the physicians, the nursing regulatory board in their state may also revoke their license to practice, especially when we consider the fact that they were fully aware of what the doctor was trying to make them do and that such action directly violated the oath they swore after they passed the licensing examination . From the patients’ perspective on the other hand, every patient reserves the right to know the type and rationale behind every treatment they receive, something which has been directly violated by the physician’s routine prescription practices. People like these practicing in the field of allied medicine should never go unpunished because they will only serve as an example that wrongdoings in the field can go unrecognized and unpunished, which could motivate other practitioners to do the same.
References
Armstrong, A. (2007). Nursing Ethics: A Virtue-based approach. Palgrave Macmilan.
Baille, L., Gallagher, A., & Wainwright, P. (2008). Defending Dignity. Royal College of Nursing Press.
Dingli, D., & Nowak, M. (2006). Cancer Biology: Infectious Tumor Cells. Nature 443, 35-36.
Tolar, J., & Neglia, J. (2003). Transplacental and Other Routes of Cancer Transmission between Individuals. Journal of Pediatric Hematology and Oncology, 430.
Tuckett, A. (2004). Truth-telling in Clinical Practice and the Arguments for and Against: A Review of the Literature. Journal of Nursing Ethics.
