Dilemma Description ANA Code of Ethics

A pregnant woman who had been injured in an accident on the stairwell was admitted to the hospital. We were able to identify that the fetus’ cardiac valves were obstructed after analyzing the patient using ultrasound. Following consultations with the nurses, attending doctor, and hospital administrative body, it was concluded that the lady would have to be committed to surgery in order to save the baby’s life. The fetal operation was geared toward repairing the fetus’ heart valves. But, after being informed, the woman refused to participate in the initiative. Despite the immensity of the situation, she emphasized on her freedom as the mother of the fetus to decide on his life. Additionally, the woman’s husband declared that the choice solely lay with her wife since she was carrying the child. Nonetheless, if the fetal surgery was not conducted then the fetus would die. I became aware of the situation because at the time I was interning at the subject hospital and was directly tasked with attending to the basic needs of the pregnant woman. The principles that are addressed in the dilemma include the principles of respect for autonomy and the principle of beneficence.

ANA Code of Ethics

The principle of respect for autonomy entails the serious consideration of the individual’s opinions irrespective of their persons. It also involves the facilitation of the right of the individual to air their concerns. The principle of beneficence reinforces the need for the protection of an individual’s wellbeing. In the dilemma, the principle of autonomy is reflected on when the woman decides, against the wishes of the doctors and the health of the fetus. She practices her right to autonomy (Olson & Stokes, 2016). The principle of beneficence provides the major ethical dilemma. If the doctors chose to continue with the operation, it will be breach of the patient’s autonomy and the principle of beneficence as is documented in the ANA Code of Ethics.

The ANA Code of Ethics indicates in provision three that the nurse ought to promote and protect the rights, health and safety of the patient (Olson & Stokes, 2016). Additionally, provision one of the ANA Code of ethics demands that a nurse practice with compassion and respect for the inherent dignity and uniqueness of each individual. Thus, should the nurses encourage the overseeing of the fetus operation, they stand to negate the ANA code of ethics. However, if they side with the patient they may play a part in facilitating the loss of a life which is in this case the life of the fetus. Alternatively, provision 4 reinforces the authority of the nurse in making decisions which promote health and the provision of optimal care.

Relationship Between the ANA Code of Ethics and the Dilemma

Principally, the dilemma exposes the contradictory nature of the ANA code of ethics. For instance, if the nurses, in order to protect the life of the fetus, choose to engage fetal surgery they are going against the principle of respect for autonomy which is succinctly captured in the nursing codes (Olson & Stokes, 2016). Fetal surgery may also result in harm for the mother. There are several complications which may result from the surgery. The surgery may further result in complications with future pregnancies (Danzer, Johnson & Adzick, 2012). While the nurses have to protect the life of the uterus, they are also bound to the principle of respect for autonomy of the patient. Furthermore, they are also accountable for the health of the pregnant mother as well. Thus, there is need for the determination of compromise that will both serve to protect the life of the uterus while at the same time promoting the interests of the mother.

Outcome of the Dilemma

Ultimately, the nurses and the practitioners were compelled to abide by the wishes of the mother. Nonetheless, the act may have further increased the risk of a still birth and the death of the fetus before it is born (O’Connor, 2012). It was a decision that was supported by the woman’s husband and her family against the counsel of the family doctor and the majority of the practitioners who were involved in the dilemma.

Development of the Dilemma

After caring for the patient’s minor injuries resulting from the fall, I was informed that the patient would be released after a week. The patient did not change her mind on the surgical invasion of her body and predicated her decision on the risks that such an action would have on the life of the baby, her life and the future pregnancies. I, and the involved practitioners had hoped that the patient would allow the fetal surgery to take place. Alternatively, some of the resources that were used in resolving the dilemma included the ANA Code of Ethics, literature on researches on the successes of fetal surgery and pregnancy-related educational materials such as books. In my opinions, all the resources available to the clinic were used in the dilemma. This is because it is the duty of the nurses and practitioners to ensure that the patient is fully informed of their situation, possible outcomes and the need for the intervention engaged

References

Danzer, E., Johnson, M. P., & Adzick, N. S. (2012). Fetal surgery for myelomeningocele: progress and perspectives. Dev. Med. Child Neorol., 54(1), 8-14.

O’Connor, K. (2012). Ethics of Fetal Surgery. Embryo Project Encyclopedia. ISSN: 1940-5030 http://embryo.asu.edu/handle/10776/8011

Olson, L. L., & Stokes, F. (2016). The ANA Code of Ethics with Interpretive Statements: Resource for Nursing Regulation. Journal of Nursing Regulation, 7(2), 9-20.