Introduction
The nursing professional code of ethics summarizes the professional act in nursing as functioning on inter and intrapersonal interactions with the patients. However, there are ethical dilemmas that often arise. For instance, a nurse may face two ethical dilemmas in handling a victim of child abuse. In the stance of sexual abuse of a minor, the main ethical dilemmas may arise out of autonomy and beneficence. A patient has fundamental autonomy right for confidentiality. At the same time, it is of beneficence to reveal some information to a parent to facilitate the healing and future protection of such a minor (Fowler, 2010).
This paper summarized ethical dilemmas, the role of nurses, ethical principles, and the ethical decision-making model for handling a child abuse victim from a nursing perspective.
Autonomy and Beneficence Dilemmas
In a case of sexual abuse of a minor, a nurse may be faced with two ethical dilemmas. The first dilemma would be whether to inform the parent or guardian of the victim as a measure for ensuring maximum support and protection to ensure quick recovery (Fowler, 2010). At the same time, every patient has the basic fundamental right of confidentially (autonomy) in deciding on who is to share some information, apart from the nurse (American Nurses Association, 2010). From the first dilemma, the element of beneficence aims to benefit the victim through protection and parental support.
The second ethical dilemma is the betrayal of the autonomy of the victim by revealing information to the parents, even when the minor is opposed to it. Therefore, a nurse has to balance these dilemmas in handling such a situation. In the above example, a nurse has to apply rational judgment to analyze the extent and threats when making decisions in the best interest of the victim of child abuse.
Ethical Principles Related to Child Abuse
The main ethical principles related to child abuse include confidentiality, rationality, effective communication, respect, and maximum support to fasten the recovery process (Fowler, 2010). These principles form the strength of a successful nursing intervention when handling a child abuse case. These positive ethical principles are achievable through action-oriented respect, mutual coexistence, and deeply entrenched social values, which are vital in the nursing intercession (Judith, Baile, Anderson, & Docherty, 2011).
The ethical relationship in the nursing practice revolves around exercising rational judgment in course of actions when dealing with the victim of child abuse to make such actions ethically correct. Therefore, a nurse handling a child abuse case has the responsibility of maintaining confidentiality, professionalism, and due care within the confines of what is morally upright.
Caring for a Victim of Child Abuse
In caring for a victim of child abuse, nurses have several roles.
The first role is bonding with the victim to gain trust and create a friendly interactive environment as a strategy for reducing fear as a result of trauma. The second role would be an observation of the verbal and nonverbal communication from the victim to guarantee an accurate diagnosis. The third role is the identification of the form of abuse through direct interaction with the victim.
Where necessary, the nurse has the role of informing the parent of the observations before treatment to ensure that the interest of the patient is addressed (Fowler, 2010). The nurse has the role of reporting the findings to a medical doctor or relevant authority as a remedy for handling any legal dilemma which might arise. Lastly, the nurse has the role of offering treatment to the victim based on standardized procedures.
Ethical Decision Making: Handling Child Abuse
Determinants of ethical decision making
The process of decision-making is dependent on heuristic since it provides assumptions, integration of options, and ethical control. The decision environment often experiences dynamics and swings which create short- and long-term effects on chances of survival for two alternatives to solve a child abuse dilemma (Judith et al. 2011).
When faced with a decision dilemma that requires critical assessments, a nurse must resort to analytical tools which ensure that the interests of the minor are well served. Each option is assigned to a quadrant with predetermined response strategies and ‘follow-ups’ upon implementation. Therefore, a nurse must find a balancing act for the above elements for the final decision to be declared effective and morally upright.
Application in management of child abuse case
There is a very fine line between the rationally correct and ethically correct decision when handling a child abuse case. Decision-making, in this case, must be based on addressing all the two aspects and not only one of them. This is necessary to ensure that the rights of the victim are protected, while the most appropriate model of communication is maintained with the minor’s parents. It is necessary to communicate sensitive information about the ordeal to the parents to ensure that the minor gets maximum support (Fowler, 2010). The support may be in the form of protection and emotional understanding to shorten the recovery process. In reporting the sensitive information, a nurse has the responsibility of consulting and convincing the victim why this is necessary.
Applying the Ethical Decision-Making Model in Finding a Solution
The steps followed in identifying the steps were:
- First, the dilemmas of beneficence and autonomy were identified as the primary reason for ethical decision-making.
- The guidelines already at disposal were consulted to see the strategies that are important to set up an ethical decision-making process in handling the two dilemmas.
- Then all the options were evaluated that might influence the decision-making process such as individual and group prejudices, attitudes, and needs.
- The strategies that evolved from the beneficence and autonomy dilemmas were brainstormed against how the victim will benefit.
- Since the minor victim would benefit more from revealing the abuse information to parents, the nurse opted to ignore the autonomy principle since the victim is still a minor (Judith et al. 2011).
The Rationale for the Decision
An ethically right decision is important to help the nurse to make sound choices in the best interest of the minor. Further, a culture that helps promote ethical behavior is important for enforced ethical conduct in the decision-making process. There was a need to inform the parent about the abuse to ensure that they become part of the recovery process. This was necessary for the parents to guarantee better protection of their minor from a similar occurrence after the recovery process (Fowler, 2010).
Conclusion
The ethical dilemmas in the child abuse case revolved around autonomy and beneficence in involving the parent of the minor in the treatment and recovery. Through reviewing several alternatives, the nursing ethical principles informed the ethical decision-making model applied to solve the dilemmas. The nurse opted to inform the parent since it would benefit the minor more than it would interfere with the principle of autonomy. Through this information, the parent of the minor is made aware of the necessary social support and protection to accord the minor recovering from child abuse.
References
American Nurses Association. (2010). Code of ethics for nurses with interpretive statements. Washington, DC: Wiley and Son.
Fowler, M. (2010). Guide to the code of ethics for nurses: Interpretation and application. Silver Springs, MD: Nursebooks.
Judith A. A., Baile, D.E., Anderson, R. A., & Docherty, S. L. (2011). Nursing roles and strategies in end-of-life decision making in acute care: A systematic review of the literature. Nursing Research and Practice, 2(5), 45-67.