Nursing Ethics 19(4) 581–589 ª The Author(s) 2012 Reprints and permission: sagepub.co.uk/journalsPermissions.nav 10.1177/0969733012448348 nej.sagepub.com
Pediatric consent: Case study analysis using a principles approach
Adaorah NU Azotam
Villanova University, USA
Abstract This article will explore pediatric consent through the analysis of a clinical case study using the principles of biomedical ethics approach. Application of the principles of autonomy, nonmaleficence, beneficence, and justice will be dissected in order to attempt to establish resolution of the ethical dilemma. The main conflict in this case study deals with whether the wishes of an adolescent for end-of-life care should be followed or should the desire of his parents outweigh this request. In terminal cancer, the hope of early palliative care and dignity in dying serve as priorities in therapy. Application of the moral principles to both sides of the dilemma aided in providing an objective resolution to uphold pediatric consent. Keywords Consent, case study, decision-making capacity, end of life, ethics, pediatric oncology
Max is a 17-year-old Caucasian male previously diagnosed with acute lymphocytic leukemia at age 7. In the past, he has endured multiple relapses of his cancer requiring chemotherapy every 2 weeks followed by periods of remission. This regimen was difficult for Max because of the nausea, vomiting, and pain associated with treatment. After remission for 3 years, Max was admitted to the pediatric intensive care unit (PICU) with complaints of bone pain causing inability to bear weight on his legs and increasing respiratory distress. At this time, it was discovered that he had osteosarcoma. Despite oxygen and continuous positive airway pressure (CPAP) support, aggressive chemotherapy, and localized high-dose radiation for 1 month, lung metastases and organ failure were found. The health care team scheduled a family meeting to
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