Ethical Dilemma in Pediatric Care: A 7-Step Decision Model
This paper examines an ethical dilemma arising in a pediatric healthcare setting, where a six-year-old patient's non-biological mother refuses medical treatment on religious grounds while his biological father, residing in another state, consents to treatment. Drawing on Kitchener's five moral principles — justice, non-maleficence, beneficence, autonomy, and fidelity — the paper applies a pragmatic seven-step ethical decision-making model synthesized from multiple scholarly works. Each step, from identifying the problem through implementing a course of action, is analyzed in the context of the case. The paper concludes by recommending that the physician treat the child and communicate directly with the non-biological guardian, citing professional ethical codes and the patient's fundamental right to healthcare.
- Introduction to the Ethical Dilemma: Pediatric case involving contested medical consent
- Moral Principles in Ethical Decision-Making: Kitchener's five principles applied to clinical ethics
- A Seven-Step Guide to Ethical Decision-Making: Composite seven-step framework for resolving dilemmas
- Communicating with Those Concerned: Physician communication strategy and recommended resolution
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What makes this paper effective
- It grounds an abstract ethical conflict in a concrete clinical scenario — a child whose guardians disagree on treatment — giving each principle discussed immediate practical relevance.
- It systematically applies a named, multi-source decision-making framework, showing the reader exactly how theoretical ethics translates into clinical action step by step.
- The concluding section integrates legal authority (the Healthcare Act) and professional codes (AMA ethics) alongside moral reasoning, demonstrating multi-layered justification for the recommended course of action.
Key academic technique demonstrated
The paper exemplifies applied ethical reasoning: it does not simply describe moral principles in the abstract but moves through identification, analysis, and resolution of a specific dilemma. By synthesizing several scholarly frameworks into a single seven-step model and attributing each source, the writer shows how to construct a composite methodological tool from existing literature — a common and valued technique in applied ethics and healthcare scholarship.
Structure breakdown
The paper opens by framing the dilemma and introducing Kitchener's five principles. It then presents a seven-step decision-making model, devoting a clearly labeled subsection to each step. The final section shifts from method to application, advising how the physician should communicate with the non-biological mother and justify the decision to treat the child. This three-part arc — problem, framework, application — gives the paper a logical and readable structure.
Introduction to the Ethical Dilemma
Taking into account ethical concerns is one of the key components in providing healthcare within the therapeutic nurse-patient relationship (Rosenbaum, 1982). Nurses face ethical uncertainty, distress, and conflict in their day-to-day work. When more than one ethical value applies to a particular case and each recommends a different course of action, an ethical dilemma exists — a situation in which a nurse cannot be sure which value takes precedence (College of Nurses of Ontario, 2009).
This specific case involves a six-year-old who is, by law, a minor; a physician must therefore obtain informed consent from the child's legal guardian. However, the child's primary guardian is his non-biological mother, who cites religious reasons for refusing medical treatment, while the biological father, who resides in another state, wants the child to be treated. This situation leaves the medical team in a difficult position, as the two possible courses of action could lead to very different outcomes. In making a decision regarding this case, it is crucial that the medical team employ a decision-making model to identify the most ethical and sound approach to resolving the dilemma.
Moral Principles in Ethical Decision-Making
To make a decision on ethical dilemmas, healthcare professionals need to be aware of their personal values. Nurses must be aware of clinical ethics and must be able to analyze a problem logically and reach a decision that they can justify using ethical values. Identifying and resolving ethical dilemmas requires intellectual curiosity, commitment, and sensitivity. When in doubt, nurses should consult their senior colleagues. By analyzing and discussing ethical values and reviewing case histories, nurses can prepare themselves to address ethical problems (College of Nurses of Ontario, 2009).
Kitchener (1984) identified five moral principles that he regarded as central to ethical guidelines: justice, non-maleficence, beneficence, autonomy, and fidelity — each of which is an absolute truth in itself. Reviewing these ethical principles with a specific case in mind can help clarify key issues in a given situation. At times, this review process alone will help a nurse to identify a means of resolving the dilemma (Forester-Miller & Davis, 1996).
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