Advance Practice Nurses deal with many clinical ethical issues, concerns, and dilemmas during the course of their work. Many of these clinical situations could be easier to handle with the implementation of definitive clear health policies and laws that removes the ambiguity, thus helping to solve the ethical dilemmas. Use your understanding of ethical principles (Beneficence, Nonmaleficence, Autonomy, Ethical decision masking along with ANA/ICN ethical codes to address the following discussion question.
Choose ONE of the clinical ethical dilemmas below and do the following to answer the discussion question:
• State what you believe the main ethical dilemma is.
• Propose a new health policy or change in health policy law that you believe would allow you as an advanced practice nurse to definitively deal with it.
• Defend your proposed health policy/health policy law change.
Ethical Dilemmas:
1. There is an outbreak of measles in a community with many unvaccinated children. You are the NP sent to deal with the situation, but some parents are refusing vaccination.
2. You diagnose a male patient of yours with multiple STI’s and he tells you not to tell his wife who is also a patient in your practice. He also tells you that he has had several recent visits to male and female sex workers. You offer him a HIV test and he declines to take it.
3. Your 55-year old patient who is a truck driver comes into your office for a work related physical that she needs to renew her CDL driver’s license. She admits to having a few recent headaches and to fainting. You do a physical and find that her neural exam is abnormal. She pleads with you to clear her so she can continue to work driving trucks cross country.
4. You have an adolescent male patient who tells you that he knows that she is transgender and recently started taking hormones to transition to female that she buys from a friend at school. Her parents do not know about the hormones which she now wants you to prescribe for her.
5. You have a patient who you know needs in patient residential mental health care, but the insurance company has denied the claim. The patient has attempted suicide in the past and you are concerned that they will attempt suicide again if they do not receive intensive residential care. The insurance company states that you must stipulate that they have failed outpatient treatment and that their current psych medications are not working for them to reconsider.
