Healthcare not be the same as our patients,



Healthcare providers play important roles in
the recovery of patients. How they behave and how they display their learned
ethics in the practice of their profession has somehow influence and has
effects on their patients’ lives. We all know that nursing professionals have
the responsibility of being altruistic. This means that we have the ethical
obligation to serve others without self-interest. Makayla is not a child in
need of children Aid; she has family that cares and supports her. They are open
to treatments that cause no harm to their children, which mean they are looking
at the best interest of their Makayla. Health care providers must respect the
cultural beliefs and value of their patients. Just because we think it is the
right thing to do, does not necessarily make it right. We should listen and
respects our patients’ choice because it’s their life, so it’s obvious that
they know what is best them. As a healthcare provider, we should be there for
them, support them, to improve their quality of life in whatever decision they
take. Our values and beliefs may not be the same as our patients, but we must
respect them for what they believe, and we have the ethical principles that
guide and shape us toward becoming better nurses.

The principle of non-maleficence states that
we should act in ways that do not inflict evil or cause harm to others.
“Non-maleficence requires four things: an act is not intrinsically wrong, a
good effect is intended, the good effect is not a by-product of a bad effect,
and the good outweighs the bad” (Alaska L, 2008). Although the chemotherapy was
intended to treat cancer, it was doing more harm than good to Makayla. The side
effects of the chemotherapy were very severe that she decided to live her life
that she had left without pain. Makayla said, “It’s not leukemia but is the chemo
that is going to kill me’ (CTV News). Weeks after Makayla stop the
chemotherapy, she regains her weight that was lost during the chemotherapy and
felt fresh and strong. This demonstrates that the kind of treatment that she
was receiving was doing more harm than the cancer itself.

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Furthermore, doing good is thought of as
doing what is best for the patient. Nurses generally see patients and think in
terms of long-term outcomes for patients. Since beneficence is centered on
doing good for the patient, the difficulty with this principle often lies in
defining what good means to the patient. To some patients, good would be
allowing them to die, while to others it would be prompting a patient to
undergo a difficult procedure to prolong and better their lives. Before acting
with beneficence in mind, nurses must consider the patients wants and needs for
their best life. Makayla does not what to undergo the chemotherapy because it
causes her a lot of pain and reduces the quality of her life. It had a lot of
side effects, which make her be weak and sicker. She decided to stop the
chemotherapy so that she can have a quality life. According to Nahnda Garlow, a
spokesperson for the Sault family said, “Makayla was suffering severe side
effects from the chemotherapy, including mouth sores and severe nausea; and her
mother and her father would have to watch her overnight to ensure that she
didn’t choke on vomit because she was so weak that she couldn’t sit up herself”
(CTV News). Makayla is a minor, but she has her beliefs and she knows what is
best for her. Makayla said, “I feel awesome. I gained some of my weight back.
I’m eating and drinking, and I can hold it all down. And I am getting my
strength back” (CTV News). Nurses need to be careful that in their haste to
take care of their patients, that they do not insert what they perceive to be
the best for what the patient would perceive to be the most good (Arlene G,
1995). For instance, Makayla wishes to withdraw cancer treatment because she
feels her quality of life is more important than living longer.  It would be practicing beneficence for the
nurse to advocate for Makayla and arrange for cancer treatment to be stopped
rather than forcing her into the treatment. Even if the healthcare providers
want the patient’s treatment to continue, they must put the patient’s idea of a
good life ahead of their own.

Autonomy, the right of people to choose for
themselves what they think is best for them. It involves the concept of
self-determination or overseeing one’s self. As a patient, one can expect a
certain amount of rights and responsibilities when requesting medical
treatment. These rights include the right to make decisions, have questions
answered accordingly prior to those decisions being made, and the right to have
your decisions upheld and respected by the medical professionals from which
care is obtained (Kay Wheat, 2009). Although Makayla was a minor, her parents
legally have the autonomy to make the decision for her unless they are proved
that they cannot give informed consent. Forcing Makayla to receive care that
she and her parents are against, and threatening her parent that she would be
taking away from them, was going against their autonomy. Parents know their
children better than anyone else, they make the decision for the best interest
of their children’s.  Health care
providers must always respect their patient’s wishes if it does not place harm
to the client or to others.  In this
case, Makayla and her parents’ decision do not place harm to either Makayla or
anyone else. Makayla’s family thought about another way that can improve their
child quality of life before refusing the care she was receiving.  Considering that clients have the right to
refuse, it is unethical and against patient the right to force Makayla to
receive chemotherapy.

Makayla suffered from acute lymphoblastic
leukemia and was receiving treatment at McMaster Children’s Hospital in
Hamilton, Ontario. During Makayla’s 11 weeks of chemotherapy, she experienced
severe side effects that sent her to the intensive care unit (ICU). Makayla and
her parents decided to stop the chemo treatment due to its harmful side effect
and decided to use traditional medicine, which her parents believe that they
will not cause any harm to Makayla. When Makayla decided against continuing
chemotherapy, the hospital referred her case to Brant Family and Children’s
Services. After a brief investigation, it decided Makayla was not a child in
need of protection and that it would not apprehend her to return her to
treatment (CTV News). I think respecting the wishes of Makayla refusal to take
chemotherapy for her acute lymphoblastic leukemia is ethically justified and I
agree with Children’s Aid’s Society’s decision not to intervene in this
case.  The reasons I agree with
Children’s Aid’s Society is because they are an organization that protects
children from harm. They protect children who they believe their parents are
violent to each other, parents who do things that could harm their children or
parents who do not stop their husband, wife, or other people, including other
family members, from doing things that could harm their children. In Makayla’s
case, she is not a child who is in danger, abuse or harm by her parents or

Ethical problems are problems that are most
difficult to handle appropriately because of their naturally sensitive nature
(Alan, R., & Sheila, P,2009). Ethics require sound judgment and adherence
to rules that are not always as clear-cut as laws(Potter&Poetry,2013).
Ethical issues often arise in the healthcare practice due to the delicacy of
patient-caregiver interactions (CTV News). 
It is the health care team members’ duty to assist the patient to the
best of their abilities and to ensure that their workplace is beneficial for
all patients (Potter& Pottery,2013). 
Ethics can come into question in an individual’s own practice as well as
observed issues in the practices of fellow nurses and doctors. It is vital that
these issues be considered from an objective standpoint, and reported in
situations where ethical codes are clearly broken (Alan, R., & Sheila, P.
2009). This ethical paper will analyze the ethical issues in the story of Makayla
Sault, a 10-year-old Ojibwa girl who had cancer, and chose to quit her
chemotherapy to pursue traditional Aboriginal treatments.


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