Question

Case:

Katie is a 15-year old female living with her parents. Katie is lively and intelligent. Several months ago, she was diagnosed with an aggressive bone cancer and underwent a below the knee amputation of her left leg. You were working the night shift during her hospital stay and cared for Katie. She often talked to you about her disease. She said that talking about it upset her parents and made her friends uncomfortable so it was nice to have someone she could be honest with. In fact, you were impressed throughout her lengthy care with the level of maturity and insight she demonstrated. Katie’s cancer has spread and she has been readmitted for removal of the rest of her left leg. You are now working days. Katie is not your assigned patient but you recognize her name and make a mental note to look in on her. At the morning shift change meeting, you hear that she has also been diagnosed with metastases of the cancer to the lung. Her prognosis is poor. Katie remembers you and is happy to have someone to talk with. She tells you her parents and physician never told her this might happen. She is a little scared about the cancer coming back even though she’s been told they “got it all” this time. She says she is afraid her parents won’t tell her everything. She also tells you that she will be staying in the hospital a little longer this time so they can treat her pneumonia. You mostly listen but are confused since you don’t recall anyone mentioning her being treated for pneumonia. You ask Katie’s nurse. She shakes her head and explains that the parents have been adamant that Katie not be told about the metastases despite the many questions she has asked her nurses. She notes that the physician is “old school” and doesn’t see anything wrong with the situation. He believes she will respond better to treatment if she is not frightened or discouraged with the full truth. You discuss the situation with your manager. You express discomfort both because of your fondness for the patient and being party to the deception. Your manager agrees with you in principle but insists that this is between the physician, the parents and the patient. She directs you not to get involved and to respect the wishes of the parents to avoid any legal problems. The next day you see Katie in a patient patio area. She asks you to sit down. This time she has overheard other nurses talking about her and suspects she has not been told everything. She says she knows she can trust you to tell her the truth….

• Katie and Truth-telling
  After reading the assigned case study, think about ways in which the various ethical theories would approach the situation. How would they be similar and how might they differ?
  
  Select two ethical theories and describe who they might compare in their approaches to Katie's case.

Answer 1

1. Utilitarianism:- here the Katie's nurse as well as parents are hiding her the actual disease, for the well being or mental stability of the girl

she will be happy that she is not going to die or she has a very poor prognostic disease

but a 15 year old girl can or doubt the dealings of her parents, as they will be sad or worried which can be evident on the face by their daughter .

2. Ethics of care :- as modern medicine is very keen in the care of the patients,

here the nurse also abide with the adamancy of Katie's parents that she should not know her condition.

1. Similarities of the theories is that they are concentrated on the welfare of the patient, outweighing the truth of the diagnosis.
2. Divine command theory which states that it is God who determines what to occur in a person
3. Natural law:moral principles which deals with action of people.