Failed bone marrow transplant

Robbie, a 14-year-old boy, is hospitalized for leukemia after a failed bone marrow transplant. The family has been told his condition is terminal; there is nothing more to be done except keep him comfortable. His mother is distant, uncommunicative, and rarely visits.

When she does, she doesn’t touch Robbie or speak to him. She sits in a recliner by the window, reading novels and requesting cokes multiple times per visit. The staff calls a family meeting, but the mother is conspicuously absent. Robbie’s father is frantic, demanding further treatments, regardless of the low likelihood of efficacy. During the family meeting, he directs the team NOT to tell Robbie he might die, as he would lose hope. He states: “In our culture, we keep this news from patients to avoid upsetting them.” You are the nurse. When you are alone caring for Robbie, he asks you, “Am I dying?”

Critical Thinking Questions

  1. How should you respond?
  2. What are three options you could select? Cite the advantages and disadvantages of each.
  3. How does the Code of Ethics for Nurses guide you in the virtue of truth-telling?
  4. Who is the authorized decision maker in this case?
  5. What other considerations play a part in your response?
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