Assignment task:
Emily, who is 8-months old, was brought to the hospital by her 17-year-old unemployed mother, who stated that the baby refused to eat at home and vomited a lot.
History: Emily is small for her age and below the growth curve for weight. Neurologically introverted and shows little interest in her surroundings, sleeps a lot and was admitted to the hospital.
Diagnosis: Nonorganic failure to thrive.
Notes: During the hospital stay- Emily eats well and has gained a significant amount of weight. Neurological status has improved.
Concern: One nurse suspects that this is a case of neglect (a form of child abuse) and suggested to the physician that child protective services be notified to evaluate the care. The physician resists because there is not enough evidence to make a definitive case, and believed it not appropriate to make such a claim. Other nurses perceive that if reported the mother will lose trust in the health system and she would avoid care. In addition, the nurses cited a case where the hospital and nurses were previously sued in a another instance when the accusation later proved to be false.
Follow Up: Emily was sent home after 3 weeks and was readmitted 1 month later with the same complaints of poor feeding, weight loss, and neurolgically withdrawn. The physician refused to notify child protective services stating the data did not warrant an investigation and possible removal of the child from the home. The nurse still advocates that the mother should be reported to child protective services
Questions:
According to Catalano, what conflicting ethical principles are sometimes forgotten in the reporting of suspected child abuse?
Should the nurse report the case and go against the physicians decisions? Explain.