Background:

Amira gets in a car accident with her partner, Casey and her three-year-old daughter, Samantha. Amira and Casey are both in critical condition upon arrival to the hospital. Samantha comes out of the accident with only minor injuries. When in the emergency room, Casey’s health declines rapidly and the trauma team tries to resuscitate her with no success. The nurses have to figure out if, when, and how they should update Amira on her partner’s death in a timely manner. Keep in mind that Amira is due for an urgent surgery and then will be induced into a coma for a week while her body recovers.

Dilemma:

Because Amira is declining in health, any distress can affect if she will pull through the urgent surgery she needs. The doctors are not even letting the police question Amira to make sure there is no unnecessary stress.

Reasons for telling Amira about Casey’s death immediately:

Amira is entitled to know of her partner’s death as soon as possible. Moreover, the nurses, especially, have a job to develop a healthy relationship with the patient, which includes trust and assurance that the patient is not being deceived.

Reasons for telling Amira about Casey’s death after surgery:

Even though the nurses should tell Amira as soon as possible, there are factors that should allow for the nurses to stall on giving out that information. For one, if the nurses do decide to tell Amira of her partner’s death, Amira will inevitably experience increased stress. Any person who is already in critical condition and is put into a mental state of even more anxiety could worsen his or her condition. In this article it is said that, “if she is told the tragic news about her partner’s fate in the emergency room, her response may have a serious effect on her chances of survival. Her condition may deteriorate, and her condition could become even more unstable.” If Amira is told, there is a large chance that she could lose hope in surviving or become so mentally unstable that she cannot pull through the surgery.

My thoughts:

Given the circumstances of Amira’s case, I would argue that the nurses should wait until after the surgery to tell Amira about Casey’s death. Although, it would seem more appropriate to tell Amira as soon as possible, there much more other factors to consider than just saying that the patient deserves to know. There are too many risks involved in informing Amira while she is in such a critical condition as it might lead to death. If Amira does not survive this condition, then Samantha, her three-year-old daughter will be affected tremendously. Hypothetically, if Amira dies Samantha is left with no parents. Samantha will have gone through a traumatic event at an age where she is still developing and very vulnerable.

Excerpt from “The Benevolent Deception: When Should a Doctor Lie to Patients?”:

“Every clinician has encountered situations in which being too bluntly honest about a diagnosis can actually be harmful to the patient, and so we employ what is euphemistically referred to as “benevolent deception.” Consider mentally fragile patients with whom full disclosure of a devastating diagnosis may cause excessive anxiety, abandonment of ongoing therapies, or total loss of hope. In these circumstances, strict adherence to the clinical virtues of truthfulness and candor risks violation of the core ethical principle to do no harm”

This excerpt relates to this case because Amira is a mentally fragile patient

where there is “devastating” information that she needs to receive at some point

but the negative risks of knowing in her state are too high. So in some aspect,

according to this article, it is ethical for the nurses to not tell her, because it

would be causing Amira mental and, in turn, physical harm if told about

Casey’s death.

Works Cited:

Agronin, Marc E. “The Benevolent Deception: When Should a Doctor Lie to Patients?” The Atlantic. Atlantic Media Company, 24 Oct. 2011. Web. 30 Jan. 2017.

RD Yeo, M., A. Moorhouse and P. Khan “Case 3: Emergency and Trauma Nurses: When to Give Bad News” Concepts and Cases in Nursing Ethics.