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Ethical Dilemma in Pediatric Acute Care – Minors’ Consent on Treatment and Medial Emancipation

In this paper I will be talking about the Dilemma that appears when minors don’t get a say about their medical treatment, what is done to their body in a medical facility and/or their faith and future. I will be taking as an example the case represented in the movie Sister’s Keeper, which discusses in details medical emancipation for the 11 years-old daughter Anna who was forced to provide her blood and bone marrow to keep the older sister, Kate, alive. Kate was suffering from Acute Promyelocytic Leukemia, and the desperate need to keep her alive was the reason Anna was born in the first place (Cassavetes, 2009).

Dilemma Description

The Dilemma I chose to talk discuss is the right for minors to have a decision, or at least be a part of the decision-making process, when it comes to their medical conditions and treatments. In the movie Sister’s Keeper, Anna was born through in vitro fertilization just so that her body was compatible to her sister’s, Kate, body, and thus provide everything her body could offer in order that her sister could be kept alive for the longest time possible. The story tells how Anna, at her young age, decides to ask a lawyer to help her achieve medical emancipation after her mother requested her to donate a kidney to her sister, and Kate told her that she didn’t want it, as she was finally ready to die, after spending the majority of her life sick, and knowing there was not permanent solution to her illness. Kate wanted to achieve as well independence in decision-making about her treatment (Cassavetes, 2009).

Ethical Dilemma in Pediatric Acute Care – Minors’ Consent on Treatment and Medial Emancipation

ANA Code of Ethics

A few codes from the ANA Code of Ethics can be applied in this situation.
Provision 1: The nurse is obligated to practice with compassion and respect for the dignity, worth and unique attributes of every person. This means that the nurse needs to build a trust relationship with their patients, a dialogue to help them through the decision-making process, take their time to make both the parents and patient understand the situation and propose all the possible solution, advising which one they, with their medical and ethical knowledge, believe to be the most suitable (“Nurses Code of Ethics”, 2018).

Provision 3: The nurse promotes, advocates and promotes the rights, health and safety of the patient (“Nurses Code of Ethics”, 2018).

Provision 7: The nurse advances the profession through research. This means that the nurse will take their time to research new methods and solutions in case they don’t have an answer and will keep themselves updated with new discoveries (“Nurses Code of Ethics”, 2018).

Application of Code of Ethics to Dilemma

Provision 1: The nurse needs to understand the stress the family must be going through: Kate has been sick for most her life, Jesse (their eldest son) is not receiving the needed attentions, Anna is forced to give up her own body under her mother’s will. The nurse is obligated to start a dialogue with both the parents and the children to understand what would be the best applicable solution to get across this situation causing the minimum damage possible (Code of Ethics, 2018).

Provision 3: The nurse is obligated to guarantee the safety of the patients. In this case, as a result of the dialogue had with both the daughters and understating their wills, the nurse should act upon this knowledge and advice both them and the parents on what procedure would be best acquiring (Code of Ethics, 2018).

Provision 7: In order to advise the family on the best procedures, the nurse needs to be sure that they have taken into consideration every possible solution available, and this is only possible by research and acquiring every information on the specific case (Code of Ethics, 2018).

Ethical Dilemma in Pediatric Acute Care – Minors’ Consent on Treatment and Medial Emancipation

Outcome of Dilemma

In the movie, ended developed in Anna’s medical emancipation being approved in court, but only after her sister had died. Kate finally had a say in her treatment, and her wish to stop her medication had been granted by her mother, who had agreed upon not going through with the kidney transplant. Both children’s wishes had been granted and the family’s relationship, which was deteriorating, has started to restore (Cassavetes, 2009).


If this case were to have happened in Columbus, Ohio, the primary pediatrics hospital is the Nationwide Children’s Hospital, which is one of America’s top hospitals for child’s healthcare. It has more than 10,000 employees whose philosophy is a “family centered care”, which means that both the parents and the child’s needs are taken into consideration. It prides itself with the services of Family Advisory Council, Family Health Information Center, Family Resource Center, and many more support systems available for the entire families in order to reach achievements in the best and most peaceful and stress-free way possible. In the state of Ohio, minors must seek the consent of a parent or legal guardian regard their procedures, but the state allowed those fifteen and older, who can show they are mature enough to understand their responsibilities, to make their own decision (“Ohio Legal Ages Laws – FindLaw”, 2018).


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