The case study presents a dilemma by the nurse pertaining Lora’s case. On one side, she is obliged to report the abuse against Lora, but on the other hand she is guided by moral principles of confidentiality. The ethical issues surrounding this situation are utilitarianism and deontology. The principle of utilitarianism focuses more not on the nature of the decision to be taken, but on the results obtained by making the decision. According to this theory, an ethical decision is right when it produces positive results by solving a problem (Burkhardt, 2013, p. 40). If the nurse is to apply this situation, then she is supposed to report the abuse to the authorities. The decision would be wrong as concerns to confidentiality, but it will have positive implications since justice would have been served and Lora would have peace of mind.
The principle of deontology on the other hand lays emphasis on the nature of the decision to be taken rather than on the results that the decision would yield. This principle insists that nurses should act only based on the interest of the patient, and as per instructed (Burkhardt, 2013, p. 46). If the nurses uses this theory to guide her actions, then she will not report the case and instead stick to the moral principle of confidentiality.
Given that Lora is 17 and can hence make sound decisions, the nurses’ obligation to report the abuse case would be outweighed by the moral principle of confidentiality. This is more attributed by the fact that the patient requires complete discretion. However, if Lora was 14, then she would not be deemed to make sound decisions by her own (Diekema, 2014). The nurse will hence be allowed to report the case. Lora’s autonomy and gives her the independence to make her own decisions and outweighs the nurses’ responsibility to report the abusive situation.
The nurse has two options. The first option is to report the abuse case to the authorities and break the ethical principle of confidentiality, and option which may lead to lose of trust of the patient and jeopardy of the nurse’s career, but will enable recovery of the patient and prevent further cases. The second option is to maintain the principle of confidentiality by maintaining discretion about the abuse and refrain from reporting the abuse, which will lead to protection of the nurse’s career but will slow down or impair the patient’s recovery, and possibly lead to a legal liability on the nurses’ side if discovered.
- Burkhardt, M. A. (2013). Ethics and Issues in Contemporary Nursing. Stamford: Cengage Learning.
- Diekema, D. S. (2014). Parental Decision Making. Retrieved March 3, 2017, from University of Washington School of Medicine: https://depts.washington.edu/bioethx/topics/parent.html