Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient

Assignment 1: Lab Assignment: Ethical Concerns

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As an advanced practice nurse, you will run into situations where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur?

In this Lab Assignment, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.

To Prepare

Review the scenarios provided by your instructor for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your scenarios.

Based on the scenarios provided:

Select one scenario, and reflect on the material presented throughout this course.

What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?

Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.

The Lab Assignment

Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature. CORE SKILL: reasoning through a conflict between a patient’s expressed wishes and clinical evidence — the situation where “respect autonomy” and “do good” point in opposite directions.
THE FOUR-PRINCIPLE FRAMEWORK (Beauchamp & Childress) is your scaffold: AUTONOMY (self-determination), BENEFICENCE (act in the patient’s interest), NONMALEFICENCE (avoid harm), JUSTICE (fair distribution). The mature move is not to recite them but to show which two are in TENSION and how you adjudicate. A narrative that says “I respected autonomy and also did good” has dodged the assignment.
DECISIONAL CAPACITY is the hinge concept and the one students misuse. Capacity is: (1) CLINICAL, not legal (competence is a court determination); (2) DECISION-SPECIFIC — a patient may have capacity to refuse a flu shot but not to manage anticoagulation; (3) assessed on four abilities — UNDERSTAND the information, APPRECIATE how it applies to oneself, REASON through options, and EXPRESS a choice. A patient with capacity may make a choice you consider unwise; that is precisely what autonomy protects. Refusing treatment is not itself evidence of incapacity — the “she must be irrational, she disagreed with me” inference is the classic error.
WHEN THE PATIENT IS A MINOR, the calculus changes: ASSENT (the child’s agreement) versus PARENTAL PERMISSION. Know the mature minor doctrine and state-specific exceptions (contraception, STI treatment, mental health, substance use) — this varies by jurisdiction and citing your state’s actual statute is what separates a strong paper.
WHEN FAMILY CONFLICTS WITH PATIENT: the standard hierarchy for surrogate decision-making is (1) the patient’s own expressed wishes/advance directive, (2) SUBSTITUTED JUDGMENT — what would THIS patient have wanted, and (3) BEST INTERESTS — only when the first two are unavailable. Families routinely argue best-interests when substituted judgment is available; naming that is a strong analytic move.
ALSO CITE: the ANA Code of Ethics (Provision 1: respect for dignity; Provision 3: advocacy for the patient), informed consent as a PROCESS not a signature, therapeutic privilege (and its narrow limits), and cultural humility — a refusal grounded in cultural or religious values is not irrationality.
STRUCTURE THE NARRATIVE: situation → the specific ethical conflict named in principle terms → who has capacity/authority → what you would do and WHY → what you would document. One page, so the analysis must be tight.