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Discussion Board Forum 1 Case: Withholding Information Karen Scullion, seventeen

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Discussion Board Forum 1 Case: Withholding Information Karen Scullion, seventeen years old, has been admitted for surgery to evaluate a soft tissue mass suspicious for sarcoma. Radical resection of the tissue mass along with extensive skin grafting was performed. While Karen was in the recovery room, the physicians saw her parents to inform them of the results of the surgery. They were understandably shaken. Both parents insisted that Karen not be told the results until she “gets stronger.” The mother informed the physician that Karen’s favorite aunt recently died of cancer. Karen became so upset that in a matter of months she went from being near the top of her class at school to being in danger of failing several subjects. Her parents expressed the fear that, if Karen learns that she has cancer, she will suffer an even more serious breakdown. At first the physician insisted that Karen must be told the truth, but, after considerable pressure from the parents, agree to withhold the information from her. A few days later when the physician was making rounds with Nurse Chan, Karen asked if the surgery went well. The physician assured her that everything was okay, and said that she should just focus on her physiotherapy and concentrate on getting home. Nurse Chan and the other nurses feel that Karen has a right to know the results of the surgery as soon as possible, and are further concerned that without such knowledge she cannot give informed consent to the extensive post-surgery rehabilitation she requires. When Nurse Chan approached the physician about this, he responded that the parents probably do know their daughter best, and said that he wants to wait until the parents “come around.” (Michael Yeo, Concepts and Cases in Nursing Ethics [Lewistown, NY: Broadview Press, 1991], 104.) Using the case study above, address the following questions on ethical reasoning. Remember: At this point, you do not need to address what the right thing to do is so much, but to reason about determining right and wrong. Using the levels of justification discussed in the Module/Week 1 Reading & Study material, what moral judgment(s) did Nurse Chan make concerning the behavior of the physician? To which rule(s) do you think she would appeal as justification of her judgment? What general principles might support those rules? To which ethical theory do you think Nurse Chan might appeal to justify those principles? Do you agree with the physician or Nurse Chan and her colleagues on what to tell Karen? What moral justification (rules, principles, and/or theories) would you give for your position? In many states, a person must be at least 18 years old before being treated as a full adult in medical decision making. Do you think that law plays a part in this case? What is the relationship between that which is legal and that which is moral?

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