DESCRIPTION OF THE CASE:
Ralph is a recent widower in his midi-60's, who was diagnosed with metatastasized colon cancer.
He is a home health agency patient, and his primary caregivers a re his two daughters. Ralph is unaware
of the severity of his condition and wanted to know what his state of health and prognosis were.
The nurse evaded his questions initially, and his daughters did not want to tell him that his cancer was terminal.
The nurse's position was not to continue providing care for Ralph, as she would be deceiving him
by not telling him the truth. When the nurse consulted with Ralph's physician, he agreed with the family's
decision, as he felt that they needed time to accept their mother's recent death and Ralph's impending death.
The doctor ordered the nurse not to oppose him and not to disclose any further infomation to Ralph.
THE PRINCIPLE: TRUTH-TELLING & DECEPTION (Should be 'FIDELITY')
In most cases, a rational person has a right to truthful information and avoidance
of deception, which will allow him to decide which course of treatment to follow.
A patient's right to decide includes the right to know the truth, not be brainwashed, and not
be lied to or deceived by having information withheld that is relevant to his own health.
There is a moral standard that condemns lies, deception and withholding of relevant
information. To tell Ralph that 'everything was all right and he would be up and
around the house in no time at all' is deceptive, as his condition is terminal,
although he does not yet realize it.
The ANA Standards of Clinical Nursing Practice states that clients should be educated
about ther illness, which is subsumed within Standards of Care (p3). In Standard
V-Ethics (p15), measurement criteria #3 states that 'the...