Discussion
Directions:
Scenario
A child was brought into the office for hallucinations and was diagnosed with schizophrenia. The physician prescribed psychiatric medications as part of the treatment plan. The parents are members of the Church of Scientology and declined psychiatric medications based on their beliefs.
Initial Post
In your initial post address the following prompts and/or questions.
· Explain how a nurse’s bias could impact the care of this client.
· Discuss the ethical issues that exist in this scenario.
· Explain how the treatment plan could be modified to include culturally and spiritually appropriate care for this client.
In the scenario presented, where a child diagnosed with schizophrenia is prescribed psychiatric medications but the parents, who are members of the Church of Scientology, decline this treatment based on their beliefs, several critical points need consideration:
**Impact of Nurse’s Bias:**
A nurse’s bias could significantly impact the care of this client in several ways:
1. **Attitude Towards Treatment**: If the nurse holds biases against alternative religious beliefs or practices, there may be a tendency to dismiss or undermine the parents’ decision, which can lead to friction and breakdown in communication.
2. **Quality of Care**: Bias could affect the nurse’s ability to provide empathetic and culturally sensitive care. This could result in reduced trust between the nurse, parents, and the healthcare team, potentially compromising the overall quality of care for the child.
3. **Communication and Education**: Biased attitudes might hinder effective communication regarding the child’s condition, treatment options, and potential consequences of refusing standard psychiatric medications. This could prevent the nurse from effectively educating the parents about the benefits and risks associated with the treatment plan.
**Ethical Issues:**
Several ethical issues arise in this scenario:
1. **Autonomy vs. Best Interest**: There is a conflict between respecting the parents’ autonomy to make decisions based on their religious beliefs and the healthcare team’s duty to act in the child’s best interest, which typically involves evidence-based psychiatric treatment.
2. **Child Welfare**: The primary ethical concern is ensuring the welfare of the child. Schizophrenia is a serious mental health condition that often requires medication for stabilization and symptom management. Refusal of treatment could potentially harm the child’s health and development.
3. **Cultural Competence**: There is an ethical imperative for healthcare professionals to provide culturally competent care. This involves understanding and respecting diverse cultural and religious beliefs while striving to find solutions that align with both the family’s values and the child’s health needs.
**Modifying the Treatment Plan:**
To include culturally and spiritually appropriate care:
1. **Open Dialogue and Respect**: Initiate a respectful and non-judgmental dialogue with the parents to understand their beliefs and concerns regarding psychiatric medications. Validate their perspectives while expressing the importance of addressing the child’s mental health needs.
2. **Exploring Alternative Approaches**: Collaborate with the family to explore alternative treatment approaches that align with their beliefs and also provide therapeutic benefits for the child. This might involve incorporating spiritual practices or alternative therapies that are acceptable to the family.
3. **Monitoring and Support**: Establish a plan for close monitoring of the child’s symptoms and well-being if medication is declined. Offer regular follow-up visits and supportive interventions to assess the impact of alternative treatments and ensure the child’s safety.
4. **Ethical Consultation**: In complex cases where ethical dilemmas persist, involving an ethics committee or consulting with colleagues experienced in cultural and religious diversity can provide additional insights and guidance.
By approaching this situation with empathy, cultural competence, and a commitment to understanding and respecting the family’s beliefs, nurses and healthcare providers can strive to achieve a balanced approach that promotes the best possible outcome for the child while honoring the family’s religious convictions.
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