Process of Decision-Making as a Nurse

Ethical Decision Making Models

The case scenario given involves an attending physician who is caught up in a situation where two parents make conflicting decisions about their daughter and the doctor has the role of not only listening to the directions from the parents, but also saving the life of the child. The dilemma is that in the process of saving the lives of the child, she cannot ignore the advice that is given by the parents of the child since he needs their consent and direction to commence treatment.

The ethical dilemma here is that the physician has the moral obligation to listen to the parents for direction on what to do and doing otherwise could lead to legal prosecution, and yet the parents give mixed advice and the physician has to now make a decision on what to follow. Despite the fact that the mother is not the biological mother, she has the primary custody and has the legal say over the child, and on the other hand, the biological father has the right to recommend treatment for the daughter despite not having the legal custody. The mother, who has the legal custody, gives religious reasons for rejecting any form of treatment for the daughter and yet the physician must determine the way forward, hence the need to use the rational decision making model (Cathy F., 2012).

The rational decision making model is one of the most widely used and accepted models used especially in times when the situation raises ethical dilemma. The decision making model seeks to determine the most morally upright thing to do in a situation that has raised some form of dilemma. It involves four steps sequence which involves;

i. Identification of the problem- the decision maker will identify what the matter at hand is. Here, he avoids concentrating on the aftermaths of the situation and the fringe symptoms but the real problem at hand. In the case scenario, the physician would focus on the challenge of the sick child and the need to save the child from possible harm by the meningitis attack and even the need for speedy action to keep away the possible effects of adverse infection like deafness or stiffening of the neck.

ii. Generating alternative solution - at this step, once the decision maker has identified the main problem, he will outline some of the options that he has towards solving the problem or reducing the problem to a non-critical level or manageable level. The alternatives are then prioritized with the most applicable ones being at the preference side of the list. In generating the alternatives, the decision maker may consult widely with other relevant partners and parties to the dilemma at hand. In the case above, the physician ought to consider the possibility of talking to the parents from a medical perspective and bring them to agreement. He also needs to consult the children's department to help intervene especially in regards to the mother who turned down any form of medical treatment. The physician also needs to consult with his lawyer or the organizational lawyers on the best step to take in such a situation.

iii. Select a solution -- from the list of alternatives that the individual shall have listed down from the wide consultation with relevant parties, there will be need to pick out the most applicable solution to the prevailing condition. In the above case, I would use this step to pick on the advise that the lawyer shall have given since it will be a sober decision that would not only take care of the legal aspects of the case on the side of the organization, but will also take into consideration first, the interest of the child.

iv. Implementing and evaluating the solution -- this is the final stage in this model of decision making and here the decision maker will have to put into action the considered solution after the consultations and various alternatives and after implementing the solution, he will monitor the effects of the solution and also evaluate the effectiveness of the solution after the implementation. This is the step that involves active process as compared to the other three steps since it puts the ideas generated into real action. In the case scenario, the advise of the lawyers to go ahead and treat the child as that would form the most ethical and moral measure to take bearing that meningitis is a deadly disease (Lunenburg F.C., 2010).

Decision on the medication of the 6-year-old patient

Having receives the child with symptoms that proved later to be those of meningitis, it was prudent to notify you two as the closest next of kin and guardians of the child. It was in the interest of the child that I decided to inform you and get both your attention on the matter and the consent to proceed with the treatment. However, it emerges that the advice that emanate from the two of you are contradictory with the mother refuting any form of medical treatment for the suffering child on the grounds of religious persuasions.