Inscenario 1, it is important for the medical professional tounderstand the parent’s reasoning and why she thinks vaccination isnot necessary. This will enable the nurse to counter themisconception with facts in order to arrive at a consensus. It isalso important to assess the health condition of the child and takenecessary actions. Due to the risk posed by the child to otherchildren, the nurse should refrain from issuing a certificate ofexamination. It is important to note that parents have the right tomake an informed consent to children vaccination. However, thedecision by the parent should not risk the life of the children orpublic health (Isaacs et al, 2009).
Inthis scenario, the nurse needs to get information from both themother and the girls. The mother should provide information on whyshe wants birth control put on her daughters. On the other hand, itis important to obtain information from the girls such as whetherthey are sexually active or they understand what birth control is.Based on this information, the nurse will be able to guide them inmaking an informed decision. Although their consent may be overruledby the parent due to their competence, they should be informed aboutthe risk, benefits, alternatives and an explanation of the procedure(Parsapoor et al, 2014, Sepucha & Mulley, 2009).
Inthis scenario, the decision of the old man to remain in the facilityshould be treated seriously. However, the interests of others,especially the spouse should also be considered. For example,prolonging the life of a terminally ill patient or extendedconfinement in a nursing home or medical facility may result intosuffering among the family members (Billings & Krakauer, 2011).The first information a nurse need to obtain from the patient is aninformed consent from the patient as well as his financialbackground. The client should provide information on how he wouldlike to treated, and person or persons to be consulted if he isunable to make decisions or in a coma. It is also important to knowwhy his wife would like him to stay at home. Based on thisinformation, a decision that recognize the autonomy of the patientand the interest of the family will be reached.
Billings,A. & Krakauer, E. (2011). On Patient Autonomy and PhysicianResponsibility in End-of-Life Care, ArchIntern Med.171(9):849-853.
IsaacsD., Kilham H., Leask J. & Tobin B. (2009). Ethical issues inimmunization. Vaccine.27:615-8.
Parsapoor,A. et al (2014). Autonomy of Children and Adolescents in Consent toTreatment: Ethical, Jurisprudential and Legal Considerations, IranJ Pediatr.24(3): 241–248.
SepuchaK. & Mulley A. (2009). A perspective on the patient’s role intreatment decisions. MedCare Res Rev,66(1) (suppl):53S-74S