Case Study: Ethical Dilemma in Nursing - Angela, Emily, and Pill

This case study delves into a complex ethical dilemma faced by a nurse named Angela, who is assisting a 14-year-old patient, Emily, before her surgery. Emily requests a contraceptive pill, but she explicitly asks Angela not to inform her parents. The assignment requires an objective analysis of the ethical issues, particularly the conflict between patient autonomy, parental rights, and the nurse's professional responsibilities. It examines the relevant ethical and legal principles, focusing on the Australian context, including the roles of the Human Research Ethics Committee and the Nursing and Midwife Free Board of Australia. The study explores two options available to Angela, referencing the International Council of Nurses (ICN) Code of Ethics. The author then reflects on these options, providing a rationale for the preferred course of action, emphasizing the importance of protecting the patient's well-being, adhering to legal obligations, and maintaining professional integrity. The assignment concludes with references to relevant academic sources.

Professional Identity

Table of Contents
Question 1...............................................................................................................................................3
Question 2...............................................................................................................................................3
Question 3...............................................................................................................................................5
Question 4...............................................................................................................................................5
REFERENCES................................................................................................................................................7

Question 1
Clearly define the problem - Objectively note the ethical issue that the nurse (Angela) must
address in responding to Mrs. White.
The problem that is faced by Angela who is the nurse assisting Emily for surgery is that
whether she should tell Mrs. White about contraceptive pill or not. The case clearly describe that
Emily White is 14 years old and was at shopping Centre without consent of her parents. She
skips classes to meet her boyfriend and met him at a shopping center. Also she asks for a
contraceptive pill which Angela decides to provide her before her surgery. Emily was clear that
her parents should not know about the pill. In this following case Nurse Angela is required to
inform Mrs. White about the medications she is providing to Emily. Emily is 14 years old and
under aged to take her own decisions regarding medical treatment. However when Emily asked
for a contraceptive pill Angela is providing her the pill but when Mrs. White ask about the
medicine it is ethical for Angela to address her question and tell her about the medical treatment
she is providing.
Question 2
Examine the ethical and legal principles that apply to the case study
Ethical values are very essential for all the healthcare providers. Ethical values are some set
of universal rules which provide practitioners with practical basis in order to identify their
intentions, actions and motives which are to be valued. Ethical principles are the moral principles
which govern a person or a group of people to conduct or behaviour. The major focus is on what
is right and wrong and how decision making is done determining all these consequences. There
are different set of rules for ethics and morals for different persons (Ossenberg, Mitchell and
Henderson, 2020). In healthcare ethics are very important because it is necessary for
practitioners to recognize the dilemmas in healthcare and make good judgments and take
decisions which are majorly based upon different values to perform under laws which govern
them. It is the duty of nurses to completely practice with integrity like all other healthcare
professionals and also regulate and guide patients within the profession. There is a human

research ethics committee which is taking decisions in order to protect patients in healthcare
sector. The following case human research ethics committee of Australia is also responsible to
judge the actions which will be taken by Angela while dealing with her 14 years old patient
Emily. There are different levels of research which are required with different reviews under this
law which look towards all the risks and activities that can be negative for patients. The nursing
and midwife free board of Australia also has a code of ethics which is to be followed by all the
nurses and they have to abide by it while practicing in any hospital or any educational institution.
This helps to protect their moral in interests and also welfare of all the patients. It is necessary
to follow all these rules which helps in following ethical standards and professions in order to
show high commitment to quality and safety of patients in medical sector. The ethics related to
autonomy in which the person have to take their own decision is also included in this case and
the code of conduct which is required for minors in the organisation is also to be looked upon.
The nursing and midwife free board of Australia’s code of conduct clearly describes those legal
and ethical frameworks are very fundamental to professional conduct and practice when in
healthcare sector. It specially involves various aspects when dealing with young people and
special considerations are taken due to their legal status and the stage of development in those
young people. The law clearly defines the age for young people under 18 are not left with
judgment of their medical care on their own. There are a number of obligations for medical
practitioner and health practitioner which are based on different legislative source. There are a
number of applications which include application to privacy and which are covered into different
pieces of legislation these are to be followed by both medical as well as non-medical health
professionals. In Australia the legal age is 18 years in order to take decisions regarding their
health (Ryan and McAllister, 2019). Only after 18 years and individual can be an adult and
competent to make their own decisions regarding the medical treatment. Ever there is an
exception for the adults who are lacking in capacity to take their own decisions on treatment and
people who have different intellectual disabilities or certain kind of mental illness.. There are
different laws for different states and territories in Australia which allow the family members to
take decision for people who are lacking such capabilities. However in some cases the minors
who are below the age of 14 have to take the consent of the parent or guardian before any such
decision is taken for them. The miners who are aged above 18 are allowed to take consent of
their own medical treatment depending upon their maturity level. However they have to face

their consequences and the severity which comes with their treatments. It is required by the
health practitioner to make sure that they are assessing the case and understanding clearly
whether the young person is sufficient enough to take their own decision.
Question 3
Identify 2 options available to Angela in addressing the ethical problem identified in question
1 as they apply to the International Council of Nurses (ICN) Code of Ethics for Nurses
(2012)
The two different options which are present with Nurse Angela while addressing the ethical
problem she is facing to deal with Emily are mentioned below:
The first option is that Angela can come out clearly to Emily’s mother about the
contraceptive pill and status of her health. Emily is 14 years old and according to code of ethics
which is governed by legislation in Australia for healthcare providers state that when a patient is
14 years old they are considered to be adults but however it depends upon the medical
practitioner to study the case deeply and decide whether the individual is mentally capable to
take their own decisions or not (Daly and Jackson, 2020). Here Angela can inform Mrs. White
about the pills she is providing to Emily and the reason behind it. The decision of Angela will be
under international Council of nurses and also code of ethics for nurses. She won’t be doing
anything wrong by informing Emily‘s mother about her request for a contraceptive pill.
Another option which is present with Angela is that she can refuse to inform Mrs. White
about the contraceptive pill that she is providing to Emily before her surgery. This can confide
with the law which states that a person who is more than 14 years of age have right to take their
own decision and parental consent is not necessary for the treatment. Angela can clearly state
that she is working for Emily and Emily is above 14 years of age which provides her the right to
be competent to consent to treatment. New South Wales in Australia does not have any
legislation which specifies the capacity of a child to consult their medical treatment and under
this law reform Angela can take this decision.
Question 4
Reflect on the options identified in question 3 and present a rationale as to which ONE of the
options you would follow if you were in Angela’s position.

Both the options which are provided in the question before this provides with different options
which are available with Angela to deal with the problem. However both of the options are
correct but when looking at these closely I would prefer to inform Mrs White about condition of
her daughter and also about the contraceptive pill which is to be provided to her. She is only 14
years of age and when studying the case deeply it can be understood that she is not competent
enough to take decisions for her own. Her carelessness of missing the classes and going to
shopping center without informing her parents shows the level of maturity. Seeing all this if I
was in Angela‘s place I would prefer to inform Mrs. White about the contraceptive pill and let
her take the decision regarding a daughter. It is necessary so that any such condition would not
be faced by Emily in her coming life (Cleary and Lees, 2019). Also if Angela does not provide
this information about Emily to her mother now she could face some legal obligations in future
when Mrs. White comes to know about it. Even if Mrs. White did not asked about the
contraceptive pill it was duty of Angela to inform her and ask her to talk to her daughter about it.
In some states of Australia 14 years is considered to be the age where children can take decision
about their medical treatment. Where as in other states the age is 16 years or 18 years. Also the
case does not specifies which region of Australia is this case taking place in and in order to be
performing the task ethically and under laws if I was in Angela’s place I would prefer to inform
her mother about the treatment and medication she asked for.

REFERENCES
Books and Journals
Daly, J. and Jackson, D., 2020. Contexts of nursing: An introduction. Elsevier.
Ryan, C. and McAllister, M., 2019. The experiences of clinical facilitators working with nursing
students in Australia: An interpretive description. Collegian, 26(2), pp.281-287.
Ossenberg, C., Mitchell, M. and Henderson, A., 2020. Adoption of new practice standards in
nursing: revalidation of a tool to measure performance using the Australian registered
nurse standards for practice. Collegian, 27(4), pp.352-360.
Cleary, M. and Lees, D., 2019. The role of conscience in nursing practice. Issues in mental
health nursing, 40(3), pp.281-283.