Question

Module 7B: Autonomy Case B (Jennifer)

Autonomy essentially means “self-rule,” and it is a patient's most basic right. As such, it is a health care worker's responsibility to respect the autonomy of her patients. However, at times this can be difficult because it can conflict with the paternalistic attitude of many health care professionals. The following two cases address patient autonomy. The first involves the rights of an individual to decide her own fate, even against her physicians' judgments. The second case involves the rights of a parent to care for her child in the manner that she sees fit.

You are a nurse and Jennifer, a mother, comes into the room with her child who is complaining of flu-like symptoms. Upon entering the room, you ask the boy to remove his shirt and you notice a pattern of very distinct bruises on the boy's torso. You ask the mother where the bruises came from, and she tells you that they are from a procedure she performed on him known as "cao gio," which is also known as "coining." The procedure involves rubbing warm oils or gels on a person's skin with a coin or other flat metal object. The mother explains that cao gio is used to raise out bad blood and improve circulation and healing. When you touch the boy's back, he winces in pain from the bruises. You debate whether or not you should call Child Protective Services and report the mother.

Questions for Case B:

1. Should we completely discount this treatment as useless, or could there be something gained from it?

2. When should a health care professional step in to stop a cultural practice? (If you are tempted to answer "when it harms the child" remember there is some pain in many of our medical procedures, for example, having one's tonsils removed.)

3. Should the nurse be concerned about alienating the mother and other people of her ethnicity from modern medicine?

4. Do you think that the nurse should report the mother?

Answer 1

1. In this case as a nurse should respect the ethnicity belief in some people's culture . Besides it will go against the autonomy of the parent and also on how they believe they should be raising their kids . And this is the way the believe it is helpful to improve circulations.

2. The health care professional should stop the procedure that harm to the child . And also the health care professional should stop the cultural practise that harm to the child . When it can stopped that is if cultural practise will cause permanent damage or disable the children performance. And in this case the cultural practise doesn't bringing a great harm . So instruct and educate the parent for the sterile and safer procedure.

3. No. Because as a nurse we should treat the people equally with medical ethical principles. That is justice , no matter what their races, cultural and social economy. Provide equal ethical principles to all.

4.No . I don't think the nurse should report the mother . Because it is still the right of a parent to care for her child in the manner that she is fit. So there is nothing to report it legally.