Nurses Role in Upholding Ethical Responsibilities at Work

Compassion and Ethics in Healthcare

Do you agree with Mark's decision not to tell Annie about the seriousness of her illness?

Often, families tend to ask physicians to withhold a serious or terminal prognosis or diagnosis from the patient. In this case, Mark's motive is laudable; he wants to spare Annie the possibly harmful experience of hearing the painful or difficult facts. However, this fear seems to be unfounded. For instance, the physician's thoughtful discussion with Mark, reassuring him that the disclosure will be conducted in a sensitive manner, could help allay this concern (Ozawa-De et al. 146). Nevertheless, in this scenario, Mark has revealed to the physician that disclosure of the diagnosis might cause real and predictable harm; hence withholding is appropriate.

Should the physician have spoken to Annie as to the seriousness of her illness?

I believe that the physician has the right to withhold information about the seriousness of Annie's illness. In many cases, experts have proven that disclosing such sensitive information is dangerous and harmful to the patient. From this perspective, all physicians have sworn in the Hippocratic Oath of keeping the health of their patients as their primary consideration. Here, the principles of non-maleficence and autonomy come into play. Autonomy refers to the patient's right to make informed decisions independently while non-maleficence refers to the physician's duty to do no harm. In Annie's situation, there is a conflict between these two predominant medical principles. As such, the principle of non-maleficence is viewed as predominant. The physician is expected to assess Annie and decide whether autonomy weights much greatly or if the non-maleficence principle weighs heavily. It must be noted that the Hippocratic Oath holds that even if there is a possibility to do harm to Annie (the patient) then it ought to be avoided at all costs. This includes psychological trauma due to diagnosis disclosure (Wendy 159).

The physician has the right to withhold the information because the society has ascribed the role to medics of deciding the importance of autonomy and competency. Competency is the capacity to reason, weigh and make reasonable decisions regarding the benefits and risks of treatment. Annie's case is a perfect case example in which diagnosis information should be withheld.

Describe the ethical dilemmas in this case?

Most people would react negatively to this nondisclosure. Nevertheless, in many nations, the expectation that patients have the right to information has never been the norm and still, it is not the norm. As such, the issue of non-disclosure remains a topic of debate across the world. Bioethics is championing honesty and the inclusion of Annie in the decision regarding her medical condition and care. It is argued that leaving Annie out of the decision-making process is a violation of autonomy and human dignity. While the principle of respect for autonomy assumes center stage, the principles of non-maleficence, non-disclosure and beneficence are emerging in evaluating whether to tell Annie the truth. Respecting Annie's autonomy does not mean that a one-size-fits-all strategy to disclosing the truth (Ozawa-De et al. 149). It does not need "truth dumping" but instead it must be conducted in a manner that fosters a trust-oriented relationship. The primary consideration of the physician must be to protect the health of Annie. Based on the Hippocratic Oath, even if the physician sees a possibility to do harm to Annie (the patient) he should avoid it at all costs. This includes psychological trauma associated with diagnosis disclosure. This could be attained by considering Annie's preferences for receiving the information and expressed wishes regarding participation in medical decisions (Wendy 160).