INSTRUCTIONS: Ethical Issue Scholarly Paper (for Nursing) Maximum: Minimum 5 pages, maximum 6 pages - exclusive of Appendix which contains the scenario, references and cover page Purpose: To outline an effective, informed, professional response to an ethical dilemma which demonstrates application of relational ethics. Your response will integrate ethical principles and values within the Canadian Nurses Association Code of Ethics (2008) in addition to the application of relational ethics. Scenario Mr. Michael Grigio is a single, thirty-nine year old man who emigrated from Italy to Canada 15 years ago. He has a history of lung cancer and has just been re-admitted to the hospital. He suspects his cancer is back - he just doesn’t know how serious it is. Michael is accompanied by his parents who are his main source of social, psychological and emotional support. He has undergone a series of diagnostic tests and they are awaiting the results. When Michael is in the washroom his parents approach Michael’s critical care nurse Amir. They quickly and passionately make clear that for cultural reasons they do not want a poor prognosis to be shared with Michael because they believe it will burden him and destroy any hope he may have. They say that if the healthcare team discloses this information to Michael it will destroy their relationship with him, the staff and ruin the quality of whatever life remains to him. When Amir asks Michael what his wishes are with respect to the diagnoses, Michael states that he would like to know but he doesn’t want to risk losing his family. The oncologist consents to the family’s wishes on the basis that the healthcare team should respect the cultural practices of patients. Amir is uncomfortable with this and is unsure what to do. He believes that if a prognosis is poor that patients such as Michael should have all the information regarding treatment to make their own decisions. Amir approaches the doctor with this concern and the doctor says he will leave the decision about disclosure up to Amir. The results of the test come back and reveal that Michael has aggressive stage four non-small cell carcinoma of the lung. The prognosis is poor and even with treatment Michael likely won’t live long. Amir decides to use a relational ethics approach to guide him in his nursing care of the family. Scholarly Paper: Write a scholarly paper that argues for the use of an effective, informed, appropriate Relational Ethics response to one of the above scenarios. Integrate at least 4 of the following themes of relational ethics: engaged interaction, mutual respect, embodiment, uncertainty, vulnerability, freedom, choice and significance of the environment. Show clearly that you understand what each of the themes means and how to apply them. Using appropriate examples describe how these themes might be expressed in your ethical response to the client and/or his/her family. Describe a clear and effective nursing response which takes into account ethical principles and CAN Code of Ethics to support your care. Integrate a minimum of 5 current peer-reviewed, scholarly references. Paper must be written in a scholarly manner following current APA (6th edition) guidelines, using only Times Roman font, 12pt, with one inch margins. Omit the use of headings; instead incorporate the themes in a seamless, integrated way. Use correct grammar, spelling and syntax, having someone else proof-read if unsure of your grammar and spelling. Writing style, syntax and APA format will be rigorously marked and represents 15% of your mark for the paper. The professor wants no more than 1 direct quotation, others should be paraphrased. The paper will be submitted through turnitin (plagiarism checker) A Guide for Ethical Decision Making 1.Gather data and identify conflicting moral claims. • What makes this situation an ethical problem? Are there conflicting obligations, duties, principles, rights, loyalities, values, or beliefs? • What are the issue? • What emotions have an impact? • What are the gaps in information at this time? 2.Identify key participants. • Who is legitimately empowered to make this decision? • Who is affected and how? • What is the level of competence of the person most affected in relation to the decision to be made? • What are rights, duties, authority, context, and capabilities of participants? 3.Determine moral perspectives and phase of moral development of key participants. • Do the participants think in terms of duties or rights? • Do the parties involved exhibit similar or different moral perspectives? • Where is the common ground? The differences? • What principles are important to each person involved? • What emotions are evident within the interaction and with each person involved? • What is the level of the moral development of the participants? 4.Determine desired outcomes. • How does each party describe the circumstances of the outcome? • What are the consequences of the desired outcomes? • What outcomes are unacceptable to one or all involved? 5.Identify options. • What options emerge through the assessment process? • How do the alternatives fit the lifestyles and values of the person(s) affected? • What are the legal considerations or implications of the various options? • What alternatives are unacceptable to one or all involved? • How are alternatives weighed, ranked, and prioritized? 6.Act on choice. • Be empowered to make a difficult decision • Give yourself permission to set aside less acceptable alternatives • Be attentive to the emotions involved in the process 7.Evaluate outcomes of actions. • Has the ethical dilemma been resolved? • Have other dilemmas emereged related to the action? • How has the process affected those involved? • Are further actions required?