Ethics statements for the ANA and Nursing Code of Ethics for Nurses

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Scenario – John is a 32 year old male nurse working in a prison. He is married and has two children at home- one boy at 14 years of age and a girl that just turned ten years of age. A new prisoner to the institution has requested that John be a healthcare surrogate for him because he is 72 years of age and not in good health. John discovers that this prisoner is a pedophile and although no one at work is aware of this, John’s son was molested by the father of a friend of his sons while visiting their home. The son has gone through therapy and they continue to have problems with the son, John is hopeful that his son will improve his mental health.
John feels divided because on one hand he feels obligated to serve as an RN professional and on the other hand he feels very hateful of the pedophile lifestyle that seems to encompass the newly admitted prisoner.

1. Read the scenario above, and then answer the following questions:
a. What kinds of issues ethically is John dealing with?
b. How would you counsel John in his dilemma?
c. Finally, what would be a reasonable approach to this problem that John has professionally and personally?

Sample Solution

Analyzing John’s Ethical Dilemma

a. Ethical Issues

John is facing a complex ethical dilemma that involves several competing interests:

  • Professional Obligation: As a healthcare professional, John has a duty to provide care to all patients regardless of their personal beliefs or actions.
  • Personal Trauma: John’s own experience with his son’s molestation has deeply affected him and makes it difficult to empathize with a pedophile.
  • Patient Autonomy: The new prisoner has requested John as his healthcare surrogate, which suggests a level of trust and reliance.
  • Societal Values: There is a strong societal condemnation of pedophilia, which may influence John’s personal feelings.

b. Counseling John

Counseling John in this situation would involve:

  • Empathy and Validation: Acknowledging the complexity of his feelings and the pain he has experienced.
  • Exploring Personal Boundaries: Helping John identify his personal boundaries and limitations in providing care to someone who has committed a heinous crime.
  • Ethical Decision-Making: Guiding John through a process of ethical decision-making, considering the principles of beneficence, non-maleficence, autonomy, and justice.
  • Seeking Support: Encouraging John to seek support from colleagues, supervisors, or mental health professionals to cope with the emotional challenges of this situation.

c. A Reasonable Approach

A reasonable approach for John might involve:

  • Professional Detachment: While maintaining empathy for the prisoner’s medical needs, John should strive to maintain professional detachment from the prisoner’s personal actions.
  • Setting Boundaries: John should establish clear boundaries with the prisoner, ensuring that his personal feelings do not compromise his professional duties.
  • Seeking Guidance: John should consult with his supervisor or other healthcare professionals to discuss the ethical implications of this situation and explore potential strategies for managing his feelings.
  • Self-Care: John should prioritize self-care to manage the emotional stress of this situation. This may involve seeking counseling, practicing relaxation techniques, or engaging in hobbies.

Ultimately, John must weigh the competing interests and make a decision that aligns with his personal values and professional obligations. It is important to remember that seeking support and guidance from others can be invaluable in navigating such complex ethical dilemmas.

 

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