Please Respond to the discussion post below: You can add differential diagnosis, treatment and plan on How you would handle an ethical dilemma.
Discussion Week 9-
Case Study Discussion: Working Through Ethical Dilemmas and Other Issues in Advanced Nursing Practice
In this week’s discussion, I will be relating to the case study about the 14-year-old female, Felicia Walker. In this discussion, I will address the ethical, psychological, physical, and financial issues that Felicia Walker would face. The differential diagnosis of pregnancy will be the focal point along with a treatment plan and evidence-based research examples that guide my decision making.
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Felicia Walker presents to the clinic with complaints of daily stomach aches for the past few weeks. She is new to the town and school and lives with her aunt and uncle that are her legal guardians. She expresses that her aunt and uncle are very religious and that she was removed from her mother’s care due to drug use. She reports that she is happy with her new living situation but is worried because she has not had a period in 3 months. She eventually opens up to the practitioner and explains that her mother’s boyfriend sexually assaulted her. A urine pregnancy test yields a positive result and Felicia states she does not want to keep the baby. Due to the state’s regulations, the practitioner must report the abuse and a social worker is brought in to help Felicia make the next steps.
The situation described is a very stressful one. Felicia reports that she is worried her aunt and uncle will not allow her to continue living with them due to the pregnancy and their religious beliefs. Felicia is also new to town and does not have any established friendships nearby. Furthermore, without further investigation, it seems as though Felicia may have been raped by her mother’s boyfriend and that is how she conceived. According to Basile, Smith, Liu, Kresnow, Fasula, Gilbert, and Chen (2018), almost 2.9 million U. S. women experienced a pregnancy resulting from rape in their lifetime. This statistic is significant, and it is something we as future practitioners must keep in mind when treating women. As explained in the case study, Felicia has a number of options including abortion, depending on gestational age, keeping the baby, and adoption. Any one of these options will be associated with potential ethical, physical, psychological, and financial issues.
According to Reardon (2018), some women have significant mental health issues that are caused, triggered, aggravated, or complicated by their abortion experience. These mental health issues are usually propelled if the woman feels pressure to abort rather than making her own decision, (Reardon, 2018). Another aspect of abortion that makes it a difficult decision is the health risks associated and the potential complications, (Reardon, 2018). Women may experience a kind of post-traumatic response and it may remain prevalent as the woman progresses through life and eventually wants to have children, (Reardon, 2018). Abortion also comes at a price. According to Planned Parenthood (2020), abortions at their clinics can cost anywhere from $0-$1000 based on certain criteria including where you live, health insurance coverage, and gestational age. As a 14-year-old adolescent, it is fair to assume this could be a significant financial burden.
Adoption is another potential option for Felicia. Adoption would involve Felicia completing the pregnancy, giving birth, and giving up all parental rights to her child. This could cause significant emotional and psychological strain as the pregnancy continues. Sisson (2015) explains that the decision between parenting, adoption, and abortion is an ethical one because of the decision to prioritize the option that is best for the mother as well as the baby. It was concluded that adoption was often thought of as the last solution for a woman when she felt she had no other options, (Sisson, 2018). While it is known that many people who are anti-abortion promote adoption, it is said that women reported significant dissatisfaction, grief, and complex emotions following adoption, (Sisson, 2018). With the help of the social worker, Felicia should be fully informed on her different options and be given support no matter which decision she makes.
If Felicia chooses to keep the baby, she will need a lot of support. As a 14-year-old, she likely cannot financially support a child on her own. Raising a child has many emotional implications that she will need to consider if she chooses this route. A baby is also a huge expense. The decision Felicia is faced with is no easy feat. The practitioner and social worker must work with Felicia to inform her and best support her in the decision she chooses.
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