NUR1299 Nursing Practice 3
Question:
Ethical Case Study:
CASE: Mr. K is a 90 year old man with metastatic prostate cancer. He lives alone but is currently hospitalized because of bone pain, and dehydration due to nausea and vomiting. He has been asked to participate in a clinical trial to test a new vaccine for prostate cancer. You were present when the clinical investigator informed Mr. K of the trial when he was first admitted. However, today when you tell him that he will receive his first dose of the new experimental vaccine tomorrow, he looks at you blankly without any expression on his face, and seems not to know what you are talking about.
Task:
- What questions should the nurse ask M. K to assess his understanding of the vaccination?
- What does Mr. K need to understand about the clinical trial for which he has been enrolled?
- What ethical principle is involved in this scenario?
Answer:
Questions the Nurse Should Ask
The nurse could try to ask Mr. K to express his choice of treatment. In doing so, the nurse could be able to assess whether Mr. K’s decision making is stable before any form of treatment can be implemented (Young, 2010). Additionally, the nurse can ask the patient if he is able to recall any previous conversation about the vaccination. Furthermore, the nurse can ask Mr. K if he is able to identify what ails him, the treatment options and the possible outcomes.
What Mr. K Needs to Understand
Mr. K should be able to understand this particular clinical procedure and the potential outcomes that will directly affect him if he accepts the clinical trial. He should also understand and weigh the risks and benefits of the clinical procedure being proposed by the nurse before coming to an informed conclusion (Krumholz, 2010). Furthermore, Mr. K should be able to understand the link between causal relationships and to process the probable outcomes of the clinical trial.
Ethical Principles
The ethical principles mandate that unless it is a matter of urgency and emergency, a nurse should not proceed with a treatment procedure without Mr. K consenting to the said trial (Beecher & Henry, 2017). However, if Mr. K is not able to remember the details of the initial interview when the said clinical trial was proposed, an indication that he is not in the right state of mind to make a competent decision, then a substitute consent could be allowed to let the nurse proceed with the vaccination (Carter, Detering, Silvester & Sutton, 2016). This is only allowed if the nurse deems this to be a life-threatening condition that requires being addressed urgently.
References
Beecher, M. D., & Henry, K. (2017). Ethics and clinical research. In Ethics and Medical Decision-Making (pp. 3-9). Routledge.
Carter, R. Z., Detering, K. M., Silvester, W., & Sutton, E. (2016). Advance care planning in Australia: what does the law say?. Australian Health Review, 40(4), 405-414.
Krumholz, H. M. (2010). Informed consent to promote patient-centered care. Jama, 303(12), 1190-1191.
Young, R. (2010). Informed consent and patient autonomy(pp. 530-540). Wiley?Blackwell.
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