Introduction

Case Summary

Ayesha, a 22 year old female has moved to Australia with her husband, Suman, who is 43 years old. Despite the age difference there married life is content. She is accepted into an Architecture degree and aspires to establish an architecture firm of her own. After completing her three years study she could work in a Sydney based architecture firm from where she has been offered a job. 

One day Ayesha was taken to the hospital due to dehydration, severe nausea and vomiting, which she is experiencing from past two weeks. Being from a patriarchal culture it is the male who takes all the decisions for the female counterpart. Similarly, Suman brings her to the hospital and is always by her side. 

In the meantime, Ayesha secretly tells the nurse that she suspects a case of pregnancy because she did not had her periods for six weeks. Her husband wants a baby, but it would mean a complete detachment of Ayesha’s dreams. A baby at this point of time would ruin all her desires of pursuing the Architecture course for many years. Thus, she asks the nurse to conduct pregnancy tests and if the result is positive then she prefers to go for an abortion without informing her husband. 

Without informing Suman, Ayesha is taken for the pregnancy test and the result confirms her pregnancy of four weeks. As per the legislation of the country, the medical officer determines that Ayesha is eligible for an abortion and the next procedures follow. The ward nurse misinforms Suman about the real picture. When he learns that Ayesha is taken for an operation he becomes upset as there was no consent taken from him before initiating the surgery. The team leader assists Suman telling that Ayesha is having her appendix removed as all her symptoms indicated appendicitis.          

Ethical Principles

The ethical principles guide the conduct of the doctors and nurses towards their patients, as there is not only one concern. Along with ensuring physical and mental health there are other factors as well like privacy, consent and more that are taken care by incorporation of the ethical principles. The main ethical principles in nursing are identified as confidentiality, beneficence, nonmaleficence, accountability followed by justice, fidelity, autonomy and veracity (National Abortion Federation, 2011). 

Truthfulness and confidentiality is directly aligned to the patient. Anything related to the health of the patient must be honestly conveyed to him or her no matter how bitter the news might be. It is the first rule of the profession, as observed by Jackson, Burns & Richter (2014). Confidentiality accounts for sharing the truth only with the patient and nobody else unless the patient consents the disclosure to their family members or friends, mentions McNaughton et al. (2006). 

Beneficence is the act of doing well to the patient under all circumstances. Similarly, nonmaleficence forbids care providers to cause any harm either intentionally or unintentionally to the patient (Ethical Practice: NCLEX-RN, 2019). The care providers must be accountable for their own actions. They should be well aware of the steps they are taking and the consequences it would lead to. 

One of the most important principles is fidelity that is keeping one’s promises. Following all professional standards, the nurses must be true to their word and should not undertake any step that would break their promises to the patient, as pointed out by Blightman, Griffiths & Danbury (2013). Subsequently, justice is the fair practice that has to be provided to the patients irrespective of any other considerations. Autonomy is important from the patient’s side and the nurses must oblige to their decisions. Especially, veracity is an imperative part of the ethical codes that urges medical practitioners and nurses to be transparent to their patients, remarks Jackson, Burns & Richter (2014).          

Challenged Ethical Principles

As evident from the case scenario, from the patient’s standpoint almost all the ethical principles are in place. There is only one consideration that the nurse should be aware of and that it the mental stability of the patient. The decision that the patient is opting for should be autonomous and should not be a result of any coercive force, opines Blightman, Griffiths & Danbury (2013). In the case of Ayesha, in her complete state of sound mind she decides to go for an abortion and asks for secrecy. The nurse and medical practitioners maintained fidelity and refrained from telling to her husband about the pregnancy. 

The ethical principles are mainly directed at building a sense of trust and reliability between the health care providers and the patients. By the time the patients are able to understand and account for their own decisions there is no requirement of disclosure of any information. Here, Suman is misinformed about the actual condition of Ayesha and the reason for her operation. In a way, it is obliterating the ethical principle of veracity to hide the truth from the patient’s family. If anything happens to Ayesha during the operation then without knowledge Suman cannot be held responsible for the decision, but it also has to be considered that informing about Ayesha’s abortion to Suman would be against the ethical principles. Thus, in accordance with Ayesha’s decision the ethical principles have been justly applied unless familial obligations are to be considered. 

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