Healthcare Ethics
In the mid 1970s, a nursing educator in Idaho had contact,
through a student, with a female client who had chronic myelogenous leukemia.
This form of leukemia can often be managed for years with little or no
chemotherapy. The woman had done well for about twelve years and ascribed her
good condition to health foods and a strict nutritional regime. However, her
condition had turned worse several weeks before and her physician had advised
her that she needed chemotherapy if she were to have any chance at survival.
The physician had also advised her of the potential side effects of the therapy
including hair loss, nausea, fever, and immune system suppression.
The woman consented to the therapy and signed the
appropriate forms, but later, she began to have second thoughts. The nursing
educator and student had given the patient one dose of the therapy when the
woman began to cry and express her reservations about the therapy. She
questioned the nurse about alternative treatments to the use of chemotherapy.
The patient related that she had accepted the therapy because her son had
advised her that this was the best treatment. She related that she had not
asked about alternate forms of treatment as the physician had indicated that
chemotherapy was the only treatment indicated. The nurse did not discuss the
patient’s concerns with the physician, and later that evening, she talked to
the patient about alternate therapies. In the discussion, rather nontraditional
and controversial therapies were covered including reflexology and the use of
laetrile. During the talk, the nurse made it very clear that the treatments
under discussion were not sanctioned by the medical community.
The patient’s feelings toward alternate therapies were
strengthened by the evening’s conversation; however, she continued with
chemotherapy. The treatments, however, did not bring remission to her crisis
and she died two weeks later. Upon hearing about the conversation between the
off duty nurse educator and his patient, the physician brought charges against
the nurse for unprofessional conduct and interfering with the patient-physician
relationship. (In re Tuma, 1977).
1.What, if anything, did the nurse do wrong?
2.Had she moved beyond her scope of practice?
3.Could the nurse’s conduct be justified under the patient
advocate portion of her role?
4.If you were a member of the state board for nursing and
had to decide the issue of unprofessional conduct and interference with the
patient-physician relationship, would you sanction the nurse?
Support your responses with evidence and cite your sources.
5. Do you think the electronic availability to medical
records is responsible for the government mandated Health Insurance Privacy and
Portability Act (HIPPA)? Explain. (1 Paragraph)
