Reference no: EM133297280

Question: Sharon, an experienced licensed practical nurse, was on duty on the labor and delivery unit when Ruth and her husband Aaron arrived. Ruth was flushed and distressed and obviously in labor. Aaron was bending over his wife, attempting to coach her breathing, and trying to keep calm. Aaron was wearing a yarmulke, so Sharon assumed they were Jewish. Despite the expectation of delivering a healthy baby, their infant son was stillborn due to prematurity (30 weeks' gestation) and a "true knot" in the cord that had denied oxygen to the baby during the later stages of the labor and delivery.

After the delivery, Ruth was transferred to the medical-surgical unit for postpartum care, a practice commonly followed when stillbirths occur. Sharon decided to assist the grieving couple by starting the funeral planning. She had done this many times before with positive results, so she expected that the parents would appreciate her efforts. Sharon told Ruth she had made some preliminary phone calls to start the process of funeral planning.

Ruth looked distressed, and Sharon misinterpreted this expression as her unfamiliarity with the funeral home that would be handling the arrangements. Sharon tried to reassure Ruth, stating that she had been present at many funerals of children who had died either before, during, or after birth and the funeral home she had called was reputable and respectful. Sharon recounted her personal experience with these events and stated that sometimes the ritual of the wake, the burial, and the gathering afterward were therapeutic in bringing some closure.

Aaron, who was visiting at the time, called Sharon out of the room and indicated his very strong displeasure that Sharon had begun arrangements. He explained rather tersely that he had contacted his rabbi, who as mara d'atra [halakhic authority] held the position of authority in Aaron and Ruth's community. The rabbi had made a p'sak [ruling/decision]. This p'sak meant that although the child was both premature and dead at birth, it was to be treated as a fetus. For this reason, it would be the family that would conduct the funeral, and there would be no ceremony attached. Aaron turned his back on Sharon and went back into the room Sharon completed her shift without additional communication with the couple, and Ruth was discharged before Sharon returned the next day. Sharon was plagued with a feeling that she had made a major error in judgment and had failed to meet Ruth's emotional and religious needs.

It is evident from this case that several major ethical principles were either ignored or transgressed. What do you think they were and why?