Mr. Rodriquez, a 78-year-old man who recently immigrated to the United States, was admitted to the medical unit, and diagnosed with acute lymphocytic leukemia. The hematologist caring for this patient has explained reasonable treatment options for an individual of Mr. Rodriquez`s age and general medical condition. His daughter, who is distraught and unable to comprehend everything happening, tearfully asks the staff nurse, "If it were your father, what would you do?" The staff nurse repeats much of what the physician has said, attempting to clarify whether the daughter understood the recommended treatment and palliative care measures.

Although her father appears to accept these interventions, the daughter continues questioning the nurse, repeatedly asking the nurse what she would do if it were her father. She tells the nurse that she does not want her father to suffer, but she also wants her father to live as long as possible. She has also used the Internet to learn more about possible treatment options and has questioned many of the staff nurses on the unit about whether they would insist that more be done to preserve the life of a loved one.

The staff nurses have now come to you, the nurse manager, for advice on working with this patient and family.

1. Determine which ethical principle or principles are the most appropriate to consider in this instance and which principle or principles would best assist in guiding staff members.

2. What role, if any, does health literacy play in this scenario?

3. Are there additional resources within the facility that you might ask to assist in helping the staff care for this patient and family?

4. How might you begin to ensure that the staff nurses can better deal with such issues in the future?