Coreys Amputation

Ethics- Little Egypt CNC

Dylan Beres, Kristen Garringer, Brittany Hamstra, Erika Jones,
Maribel Montes de Oca, Rachel Nelson, Brandon O'Brien,
Alexis Ricci, Donna White

Main ethical dilemma
Corey does not want the amputation
because he values being an athlete. His
mom wants the amputation because she
believes that it will get rid of the cancer and
save his life

Relevant Data (Present the facts)
Corey has been through all conventional
treatment without success. The tumor in his
left leg is aggressive. With amputation there
is a strong chance the cancer will be gone.

Clarify Values (distinguish fact, opinion,
values)
Coreys opinions/values: being an athlete is important to him and
does not want his leg amputated. He is thinking about the short
term and the immediate consequences.

Moms opinions/values: she is concerned about the cancer
spreading and insists on having Coreys leg amputated to try to
get rid of the cancer. She is thinking about the long term and the
lifelong consequences.

Verbalize the problem
Corey and his mom do not agree on the action to take. Corey is
under the age of consent and therefore it legally becomes his
moms decision. The problem is that Corey is old enough to
verbalize his wishes, but is not legally at the cognitive age to
make the decision for himself. Who should decide what to do?
Should his mom make the decision for him, against his wishes?
The issue is also time sensitive because it is an aggressive
tumor, and therefore they may not have the luxury of time to try
other options first to try to save the leg. It would be important to
do the amputation soon to keep the cancer from spreading.

What are the possible actions (present
your view and other options)
Moms view: Have the surgery to save
Coreys life. Look at options for
prosthetics and what his quality of life
could be like after the surgery with a
below the knee amputation
Other options: No surgery or
treatments and focus on palliative
care and pain control. Try an allograft
or metal implant. Try more rounds of
chemotherapy and radiation.

ANA Codes considered:
Nurses primary commitment is to the patient.
The nurse has a commitment to the health outcome of the patient.

Nurse promotes, advocates for and strives to protect the health and safety of
the patient.
The nurse is concerned with the health and safety of the patient.

Nurse collaborates with other health professionals and the public.
Nurse could consult with a child psychologist to get counseling for Corey and his
mother. Bring in a specialist on prostheses to speak with Corey about the
options after amputation and what he could expect. Bring in a former
patient that has had a similar amputation who has the full quality of life
that Corey is wanting to keep.

Ethical Principles and why they are important here.
Autonomy: Corey should have a say/decision on his care he receives, but he is not of age of consent.

Beneficence: The nurses actions should all be geared towards helping Corey, whichever decision is
made regarding the amputation. This could include providing counseling, support groups to help Corey
and his mom cope and get along despite their disagreement.

Nonmaleficence: Part of not doing harm to Corey might include just listening to him and his opinion
and try to understand his point of view while respecting the decision of the mother

Justice: Let Corey voice his opinion, but understand that moral fairness does not equal legal fairness.
To be fair to the patient, you cannot let them make a decision that they are not
cognitively/developmentally able to make at this time.

Fidelity: You cannot promise Corey that the surgery will not be done.
Additional information that would have
been helpful
It may be helpful to bring in other experts and look at other
non-conventional options that have not been tried yet.
Figure out where exactly the amputation would be done to
figure out the specifics on how it would impact Coreys
lifestyle. Figure out how long of a window they have to
make the decision or possibly try other options before the
cancer spreads.

How aggressive of a cancer is it?