Skip to ContentGo to accessibility page
OpenStax Logo
Fundamentals of Nursing

Chapter 16

Fundamentals of NursingChapter 16

Chapter 16

Unfolding Case Study

1.
The highest priority concern at this time is that the patient is requesting to discuss palliative care options. It is important for the nurse to ensure the patient has all the resources she needs to make an informed decision about her medical care.
2.
Autonomy is the most relevant ethical principle to the patient’s current condition. Autonomy refers to the patient’s right to make their own care decisions, and in this case, the patient is advocating for herself to make the decision to pursue palliative care.
3.
There are many reasons why the patient may not want her family to know about her decision to receive palliative care. She may not be close with her children or may not want them to feel sad about her condition, especially since they lost their father in a car accident only a few years ago. Ultimately, because she is of sound mind, she can make this decision for herself, and the nurse should respect her autonomy. However, the nurse could have a conversation with the patient about contacting her children to make sure that’s really what she wants. The nurse must have this conversation in a nonjudgmental way, allowing for the patient’s concerns to be expressed and then following her wishes as expressed.
4.
The nurse has three options: The first option is to leave the situation alone and respect the patient’s wishes to not contact her family. The second option is to go ahead and contact the family since the nurse knows they will want to know about her condition. The third option is to continue to discuss the situation with the patient and hope she changes her mind about contacting her family.
5.
The nurse is obligated to honor the patient’s autonomy, which means that contacting the family without the patient’s consent would be inappropriate. This action would violate boundaries and disregard the patient’s wishes, demonstrating a lack of respect for their autonomy. The nurse should maintain an open dialogue with the patient about contacting her family but should do so in a nonjudgmental way without trying to coerce the patient to do it. If the nurse is unable to have these kinds of conversations without patronizing the patient, it would be best for the nurse to proceed with option one, which is to respect the patient’s wishes and leave the situation as is.
6.
Moral distress in nurses often manifests as physical symptoms including headaches, gastrointestinal upset, and depression. If the nurse’s distress has improved, these symptoms should be improved or resolved altogether. If the nurse is experiencing these symptoms or has feelings of dread or anxiety when caring for the patient, the distress is likely still present. If that is the case, it is important for the nurse to reflect on their feelings and values and actively find ways to resolve the internal distress.
PreviousNext
Order a print copy
Citation/Attribution
Reuse and redistribution of this content in digital or print format:
  • This book may not be used in the training of large language models or otherwise be ingested into large language models or generative AI offerings without OpenStax's prior written permission.
  • This book uses the Creative Commons Attribution-NonCommercial-ShareAlike License, which means that you can reuse and modify the material only for noncommercial purposes, must attribute OpenStax, and must distribute any derivative works under the same license.
  • Any commercial printing of this textbook, including using a local or custom printer, must be approved by OpenStax, and proper citation provided.
  • OpenStax-copyrighted images, activities, assessments, and similar components of this book are subject to the same licensing – CC-BY-NC-SA. They can be used for noncommercial purposes with attribution. Commercial use requires permission.
  • Permission requests: Anyone who intends to incorporate this content (including text, images, and other components) into large language models, use it in AI offerings, use it commercially (including in print), and/or has questions about another use case is welcome to complete our reuse request form.
Attribution information
  • If you are redistributing all or part of this book in a noncommercial print format, then you must include on every physical page the following attribution:

    Access for free at https://openstax.org/books/fundamentals-nursing/pages/1-introduction

  • If you are redistributing all or part of this book in a noncommercial digital format, then for every page that includes OpenStax content, you must license the derivative work under the same CC-BY-NC-SA license as the original, and include on every digital page view the following attribution:

    Access for free at https://openstax.org/books/fundamentals-nursing/pages/1-introduction

Citation information

The information below includes the information needed to generate citations in most major styles (APA, MLA, etc.); you must reformat and organize the information as needed to fit the requirements of the style. Use the information below to generate a citation. We recommend using a citation tool such as this one.

© Jul 23, 2026 OpenStax. Textbook content produced by OpenStax is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. The OpenStax name, OpenStax logo, OpenStax book covers, OpenStax CNX name, and OpenStax CNX logo, and Rice University name, and Rice University logo trademarks, or wordmarks are not subject to the Creative Commons license and may not be reproduced without the prior and express written consent of Rice University.