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Everything you are going to need is the attachment and don’t forget to do as it asks. Ethical Dilemma topic: Parent withholding treatment from terminally ill children  Everything you are going to need is the attachment and don’t forget to do as it asks.  P.S please follow the instructions in the instructions box images. This PowerPoint is very important. Use the scholarly articles that are less than 5 years published.  Dont forget to go over the rubric while you work on the PowerPoint. I need 15 slides, please go over the Rubric and see what is required. AGAIN, PLEASE GO OVER THE RUBRIC.  Start on Selection C. Thank you  NR328 Pediatric Nursing RUA: Ethical Dilemma Assignment Guidelines NR328 Ethical Dilemma Guidelines V6.docx Revised: 3/2020 1 Purpose For this assignment, you will examine an ethical dilemma that exists in pediatric settings with a group of your peers. You will examine the ethical dilemma from two opposing positions and consider ethical principles, conflict between the principles and the relationship of the ANA Code of Ethics in relation to both positions. You will also discuss potential resources, possible outcomes of both positions and develop a plan for resolving the issue (for patient, family and the nurse). Your team will then present this information in class with a poster grounded in scholarly sources. You will also submit individual speaker notes describing your assigned part and reflection on your values. Course outcomes: This assignment enables the student to meet the following course outcomes: 1. Provides individualized comprehensive care for children and their families with multiple health problems in institutions and community care settings from birth through adolescence. (PO 1) 4. Utilizes critical thinking skills in clinical decision making in the care of pediatric clients. (PO 4) 6. Utilizes legal, ethical, and professional standards and principles, including those related to child abuse recognition and intervention, as a basis for pediatric clinical decision‐making. (PO 6) 8. Utilize research findings as a basis for nursing interventions in pediatric healthcare settings and the development of professional nursing papers. (PO 8) Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment. Total points possible: 100 points Preparing the assignment Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions. 1) An ethical dilemma with opposing positions will be assigned by your instructor. 2) A template for the poster will be made available. 3) Although you may not agree with one of the positions, reflect on your views, respect other perspectives, and examine scholarly literature on both positions. 4) Form a group of 5‐6 students. 5) Each student is responsible for an assigned part: a. Team Leader • Prepares and submits the poster on behalf of the group. The poster must clearly indicate the specific part that each team member completed. Describes statistical significance to pediatric nursing grounded in scholarly literature. Collates utilized references and summarizes key points. b. Description of the dilemma • Performs preliminary research on the assigned ethical dilemma and describes the dilemma. Clearly identifies both positions grounded in scholarly literature. Disseminates information found to all group members. c. Ethical Principles and ANA Code of Ethics Provisions (2) • Determines the ethical principles that apply to each position, possible conflicts in principles, and components of the ANA Code of Ethics that apply using three (3) Provisions. Disseminates information found to all group members. Supports ideas with scholarly literature. d. Resources to resolve the dilemma • Describes resources to resolve the dilemma and describes how each resource could help to resolve the dilemma. Supports ideas with scholarly literature. e. Possible outcomes and plan for resolving the issue • Discusses possible outcomes of both positions. Presents a plan for resolving the issue (for patient, family and the nurse). Supports ideas with scholarly literature. 6) Each team member will provide their part of the poster to the team leader including citations and references. NR328 Pediatric Nursing RUA: Ethical Dilemma Assignment Guidelines NR328 Ethical Dilemma Guidelines V6.docx Revised: 3/2020 2 7) Each team member will complete and submit speaker notes of their assigned part and a reflection of own values and morals as it relates to the ethical dilemma. The title page must clearly indicate the specific part that the team member completed. Can be bullet points, listed, or written out. 8) Practice as a group how you will present this issue. Make notes for your reference during the presentation and be prepared to discuss your scholarly literature. 9) Each team member will present their assigned part of the poster to the class. The presentation will last no more than 15 minutes. 10) Use this link to take you directly to the ANA website to access the Code of Ethics. When prompted, choose “No I do not wish to register at this time. Take me to the Code now.” https://www.nursingworld.org/practice‐ policy/nursing‐excellence/ethics/code‐of‐ethics‐for‐nurses/ 11) For APA, formatting, or grammar assistance visit the APA Citation and Writing page in the online library. 12) Include the following sections (detailed criteria listed below and in the Grading Rubric): a. Professionalism ‐5 points/5\% • Team members are professionally dressed. • Team is introduced and assigned roles are identified prior to starting the presentation. • Full group participation. • Respectful and professional language is used throughout the presentation. • Adhere to the time limit of 15 minutes. b. Team Presentation ‐50 points/50\% • Description of the dilemma is clear and includes statistical significance to Pediatric nursing. • Both positions of the dilemma are presented crediting supporting scholarly sources. • Appropriate ethical principle(s) to support each position are used. • Consideration of which, if any, ethical principles are in conflict with the opposing positions. • Three (3) provisions of the ANA Code of Ethics that apply to the ethical dilemma are used. • Present all pertinent resources available to resolve the dilemma. • Explain how resources could help in resolving the dilemma. • Discuss possible outcomes of each position. • Present a plan for resolving the issue. c. Team Poster ‐ 15 points/15\% • Full names of all team members included and team member initials are present in the assigned sections. • Content is presented clearly and scholarly. • Citations included for each section. • Poster includes sections for: o Title o Dilemma description o Statistical significance o Ethical principles o Applicable ANA Code of Ethics Provisions o Resources to resolve dilemma o Potential outcomes of the dilemma o Plan for resolving the dilemma o Key Points o References d. Speaker Notes and Reflection‐ 20 points/20\% • APA Title page with assigned individual part identified. • Ideas presented clearly. • APA citations throughout. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/ https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/ https://library.chamberlain.edu/APA NR328 Pediatric Nursing RUA: Ethical Dilemma Assignment Guidelines NR328 Ethical Dilemma Guidelines V6.docx Revised: 3/2020 3 • At least two (2) nursing, peer reviewed, primary sources from the last 5 years, excluding the textbook used to support work. • APA reference page. • Reflection of own values and morals. e. Poster APA Style and Organization – 10 points/10\% • References are submitted with assignment. • Uses current APA format and is free of errors. • Grammar and mechanics are free of errors. • At least three (3) scholarly, nursing, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided • One (1) scholarly source must be the ANA Code of Ethics Provisions and each position must be supported by a scholarly source. NR328 Pediatric Nursing RUA: Ethical Dilemma Assignment Guidelines NR328 Ethical Dilemma Guidelines V6.docx Revised: 3/2020 4 Grading Rubric Criteria are met when the student’s application of knowledge demonstrates achievement of the outcomes for this assignment. Assignment Section and Required Criteria (Points possible/\% of total points available) Highest Level of Performance High Level of Performance Satisfactory Level of Performanc Unsatisfacto ry Level of Performanc Section not present Professionalism (5 points/5\%) 5 points 4 points 3 points 2 points 0 points Required criteria 1. Team members are professionally dressed. 2. Team is introduced and assigned roles are identified prior to starting the presentation. 3. Full group participation. 4. Respectful and professional language is used throughout the presentation. 5. Adhere to the time limit of 15 minutes. Includes no fewer than 5 requirements for section. Includes no fewer than 4 requirements for section. Includes no less than 3 requirement for section. Includes no less than 2 requirement for section. Includes 1 or no requirements for section. Team Presentation (50 points/50\%) 50 points 40 points 30 points 20 points 0 points Required criteria 1. Description of the dilemma is clear and includes statistical significance to Pediatric nursing. 2. Both positions of the dilemma are presented crediting supporting scholarly sources. 3. Appropriate ethical principle(s) to support each position are used. 4. Consideration of which, if any, ethical principles are in conflict with the opposing positions. 5. Three (3) provisions of the ANA Code of Ethics that apply to the ethical dilemma are used. 6. Present all pertinent resources available to resolve the dilemma. 7. Explain how resources could help in resolving the dilemma. 8. Discuss possible outcomes of each position. 9. Present a plan for resolving the issue. Includes no fewer than 9 requirements for section. Includes no fewer than 8 requirements for section. Includes no fewer than 7 requirements for section. Includes no fewer than 6 requirements for section. Includes 5 or fewer requirements for section. NR328 Pediatric Nursing RUA: Ethical Dilemma Assignment Guidelines NR328 Ethical Dilemma Guidelines V6.docx Revised: 3/2020 5 Team Poster (15 points/15\%) 15 points 10 points 7 points 5 points 0 points Required criteria 1. Full names of all team members included and team member initials are present in the assigned sections. 2. Content is presented clearly and scholarly. 3. Citations included for each section. 4. Poster includes sections for title, dilemma description, Statistical significance, Ethical principles, Applicable ANA Code of Ethics Provisions, Resources to resolve dilemma, Potential outcomes of the dilemma, Plan for resolving the dilemma, Key Points, and References. Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes no fewer than 2 requirements for section. Includes no less than 1 requirements for section. No requirements for this section presented. Speaker Notes and Reflection (20 points/20\%) 20 points 15 points 10 points 5 points 0 points Required criteria 1. Title page with assigned individual part identified. 2. Citations throughout. 3. Ideas presented clearly. 4. At least two (2) sources used to support work. 5. Reference page. 6. Reflection of own values and morals. Includes no fewer than 6 requirements for section. Includes no fewer than 5 requirements for section. Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes 2 or fewer requirements for section. Poster APA Style and Organization (10 points/10\%) 10 points 8 points 6 points 4 points 0 points 1. References are submitted with assignment. 2. Uses current APA format and is free of errors. 3. Grammar and mechanics are free of errors. 4. At least three (3) scholarly, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided 5. One (1) scholarly source must be the ANA Code of Ethics and each position must be supported by a scholarly source. Includes no fewer than 5 requirements for section. Includes no fewer than 4 requirements for section. Includes no fewer than 3 requirements for section. Includes 1‐2 requirements for section. No requirements for this section presented. Total Points Possible = 100 Purpose Preparing the assignment RUA: Ethical Dilemma By: Stephanie Zepeda, Taylor Brown, Kelsey Dauzat, Tyleisha Bowser Dilemma Description ● Blood transfusion is an increased risk procedure ● It requires a written consent which can be refused ● Generates medical and ethical concerns ● Understanding patients beliefs and practices are important ● Jehovah’s Witnesses firmly oppose to blood transfusions S.Z. (Jakubowska, 2018) . Dilemma Description ● This situation can be difficult especially when dealing with pediatric patients. ● What if the child could make this decision? ○ Case of Jehovah witness S.Z (Conti, 2018) (Cobb, 1994). Pro Position ● Four capacities have been described for medical decision-making 1. Communicating a choice 2. Understanding 3. Reasoning 4. Appreciation ● Fully developed by age 12 ● Countries such as the Netherlands involve children in decision making ● Parents may not always know what is best S.Z (Grootens, wiegers, 2017). Con Position ● Decision making can be affected by various factors ○ Mental capacity ○ Stress ○ Peer Pressure ○ Easily persuaded ● It can cause a divide in families S.Z (Grootens, wiegers, 2017). Ethical Principles ❏ Autonomy ❏ Beneficence ❏ Nonmaleficenc e ❏ Justice ❏ Veracity ❏ Fidelity T.Brown (Elarousy and AlNajjar, 2017) Ethical Principles Are there special circumstances in which minors can be legally allowed to make autonomous health care decisions? The mature minor “In circumstances in which a minor wishes to make an autonomous decision contrary to the wishes of parents or medical professionals, courts may grant the minor total or partial emancipation (mature minor status) to make decisions. Such judicial actions are based on existing case law, state statutes, or common law practices, and will therefore be determined on a case-by- case basis. Courts often consider the patient’s prior experience with his or her medical condition, intelligence, and general evidence of maturity in making these determinations” T.Brown (Frader and Flanagan, 2017) Applicable ANA Code of Ethics Provisions Provision 1. The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person. T.Brown (Haddad, 2020) Applicable ANA Code of Ethics Provisions Provision 2. The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population. T. Brown (Haddad, 2020) Applicable ANA Code of Ethics Provisions Provision 3. The nurse promotes, advocates for, and protects the rights, health, and safety of the patient. T. Brown (Haddad, 2020) Resources to resolve dilemma ❏ The American Academy of Pedatrics ❏ Consult with anaesthetists, surgeon, parents, and child (if old enough to understand) ❏ Assure Confidentially T.Bowser (Chand, Subramanya, & Rao, 2014) Potential outcomes of the dilemma ❏ The healthcare provider can administer a blood transfusion to a child without constant of the parent. ❏ The can be temporarily removed from home for child neglect. ❏ The Court can make a decision to have constant or refusal blood transfusion if there is no emergency. ❏ Accept receiving blood plasma fractions or the reinfusion of their own blood ❏ Parents can be okay with healthcare team consulting on child’s behalf T.Bowser (Chand, Subramanya, & Rao, 2014) Plan for resolving the dilemma ● Respect the childs and familys religious beliefs and practices. ● Consider the childs development when talking about spiritual concerns. ● Contact the institutions chaplaincy department for patients and families who have symptoms of spiritual distress or ask for specific religious rituals. ● Become knowledgeable about the religious worldviews of cultural groups found in the patients you care for. ● Encourage visitation with family members, members of the patients spiritual community, and spiritual leaders. ● Allow children and families to teach you about the specifics of their religious beliefs. ● Develop awareness of your own spiritual perspective. ● Listen for understanding rather than agreement or disagreement. K.D. (Hockenberry and Wilson, 2018) Plan for resolving the dilemma ● Establish a therapeutic relationship with the child and family. ● Assess your own personal beliefs about the ethical delimma. ● Educate the child and family of the benefits, risks of blood transfusions. ● Assess the childs cognitive ability in making medical decisions for themselves. ● Evaluate and educate on the possible outcomes of treatment vs. not having the treatment. ● Allow the child and family to make educated desicions for treatment. ● Respect the desicions made and advocate for their rights. K.D. (Levy, 2018) Key Points ● Religions, such as Jahovah Witness, revokes blood transfusion treatments. ● Parents typically have the legal right to make the decision regarding treatment. ● There are other avenues to treatment. ● The child may have the ability to counteract this decision if deemed appropriate. K.D Key Points ● Provide advocacy and autonomy to your patients’ care. ● Be sure to assess your own values and morals in order to make a clear thought out plan. ● Education is important in order for the child and family to make an informed decision. K.D References Chand, N. K., Subramanya, H. B., & Rao, G. V. (2014). Management of patients who refuse blood transfusion. Indian journal of anaesthesia, 58(5), 658–664. https://doi.org/10.4103/0019-5049.144680 Conti, A. et. al. (2018). Blood transfusion in children: The refusal of Jehovahs witness parents. Open Medicine. Vol 13. doi: 10.1515/med- 2018-0016 Grootens-Wiegers, P. et al. (2017). Medical decision-making in children and adolescents: developmental and neuroscientific aspects. V 17: 12. doi: 10.1186/s12887-017-0869-x El-Arousy, Wafa, and Casestudies Journal. “Ethical Considerations in Pediatric Nursing.” Academia.edu, 10 Oct. 2017, www.academia.edu/36947190/Ethical_considerations_in_pediatric_nursing. Frader, Joel E, and Erin Flanagan. Minors as Decision-Makers. American Academy of Pediatrics Bioethics Resident Curriculum: Case-Based Teaching Guides, 2017, www.aap.org/en-us/Documents/Bioethics-MinorsAsDecisionMakers.pdf. Haddad LM, Geiger RA. Nursing Ethical Considerations. [Updated 2020 Sep 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526054/ Hockenberry, M. J., & Wilson, D. (2019). Wongs nursing care of infants and children (11th ed.). Mosby. Jakubowska, K. et. al (2018). Opinions of pediatric nurses about Jehovah’s witnesses refusal of blood transfusion for their child. DOI: 10.2478/pielxxiw-2018-0028 Levy, N. Shibboleth Authentication Request, 12 Jan. 2018, eds-b-ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/detail/detail?vid=2&sid=d303c3ae-1955-4cc8-888f-fade96c83b01 \%40pdc-v-sessmgr04&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ\%3D\%3D#AN=T705106&db=nup. https://doi.org/10.4103/0019-5049.144680 https://dx.doi.org/10.1186\%2Fs12887-017-0869-x http://www.academia.edu/36947190/Ethical_considerations_in_pediatric_nursing. http://www.aap.org/en-us/Documents/Bioethics-MinorsAsDecisionMakers.pdf. https://www.ncbi.nlm.nih.gov/books/NBK526054/ https://eds-b-ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/detail/detail?vid=2&sid=d303c3ae-1955-4cc8-888f-fade96c83b01\%40pdc-v-sessmgr04&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ\%3D\%3D#AN=T705106&db=nup https://eds-b-ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/detail/detail?vid=2&sid=d303c3ae-1955-4cc8-888f-fade96c83b01\%40pdc-v-sessmgr04&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ\%3D\%3D#AN=T705106&db=nup Slide 1 Dilemma Description Dilemma Description Pro Position Con Position Ethical Principles Ethical Principles Applicable ANA Code of Ethics Provisions Applicable ANA Code of Ethics Provisions Applicable ANA Code of Ethics Provisions Resources to resolve dilemma Potential outcomes of the dilemma Plan for resolving the dilemma Plan for resolving the dilemma Key Points Key Points References