Reference no: EM133251744

Case - Mr. Smith is a 58 year old gentleman with aggressive prostate cancer being cared for in the oncology department of a local hospital.  Mr. Smith was diagnosed with prostate cancer seven years ago but refused medical and surgical treatment at the time. He chose to seek alternative treatment instead and did not follow up with the urologist over that seven-year period.  Mr. Smith has now presented with anemia and is in significant pain.  After several diagnostic tests, it was discovered that the cancer had metastasized to his bones, and the primary tumor was invading the bladder and partially obstructing his left kidney. 

Mr. Smith had several admissions to the hospital over the last couple months. During his most recent hospitalization, Mr. Smith was told that he may only have 4-6 weeks  to live (previously it was 6-12 months) after a cystoscopy showed further extensive growth of the tumor.  It was determined at that time that any further surgical/medical intervention would not be effective and a palliative care regimen to make him comfortable was recommended.

At this point, the patient reported to the health care team that he had resigned himself to the fact that he was going to die. Mr. Smith then pulled one of the nurses who he was closest to aside and confided to her that he planned to kill himself, but that he wanted it kept a secret and she was not to tell anyone.

Questions -

Of the ethical principles (beneficence, non-maleficence, respect, justice, utility, and truth telling), which one(s) do you feel apply most to this scenario? Please explain.

Are there any provisions in the nurse's code of ethics that could guide this nurse in her decision-making process? If so, what?

If the nurse honored the patient's wishes and did not report this, could there potentially be legal implications?  Why or why not?

If you were the nurse in this case, what would you have done?