Sterilizing the Developmentally Delayed Patient

Sterilizing the Developmentally Delayed Patient

Case Study 4: Sterilizing the Developmentally Delayed Patient

Mary Ellen Thompson, a skilled maternal-child nurse, has recently been employed by a public hospital in a large southwestern city. Because she speaks fluent Spanish, she has been asked to serve as a translator for the scheduled C-section of a 14-year-old, mildly developmentally delayed, Hispanic teenager. The patient undergoes epidural anesthesia without incident and delivers a small but healthy 6 lb. 4 oz. baby girl. While completing the C-section, Mrs. Thompson suddenly realizes that the surgeon is going to perform a tubal ligation. Checking the patient’s chart, Mrs. Thompson does not find any specific consent for the tubal ligation and asks the physician if the procedure was anticipated and whether the patient was informed of its possibility. The physician tells Mrs. Thompson that he believes the procedure is “medically necessary” and that he will record it as such in his operative report.

Several days later, Mrs. Thompson visits the patient and her parents. The parents are concerned about their daughter’s ability to care for her child, but they have made a commitment to shoulder the responsibility for both the mother and the child. In talking to them, Mrs. Thompson realizes that they have no awareness that a tubal ligation was performed on their daughter. They are economically indigent and poorly educated, yet Mrs. Thompson does not think that these circumstances warrant the involuntary sterilization of a mildly developmentally delayed individual without parental consent. What should she do?

If you were Mrs. Thompson, which of the following actions would you consider and why (respond to all that apply)? Discuss the ethical principles used in making decisions with this type of case study. Use APA format with proper in-text citations.

1. Speak to the physician and ask him to inform the girl and her mother of what had happened.

2. Speak to nursing staff about taking collective action against the physician.

3. Report to administrators that a surgical procedure was done without adequate consent.

4. Ask not to be assigned to work with that physician again.

5. Explain to the mother what took place.

6. Speak to a public advocacy group about the ethical issue of sterilization without consent.