The nurse is caring for a child who is receiving a narcotic for pain relief. Which of the following assessment should be a priority in monitoring the child (select all that apply)?

A. Parents are shocked when their child is diagnosed with a malignant bone tumor. The orthopedic surgeon discusses the options of limb amputation and a limb-salvage procedure. The parents are asked to consider each option.

This situation involves a difficult medical decision, but it does not describe a conflict or ethical dilemma that necessitates immediate involvement of the ethics committee. The parents are being informed about treatment options, and their input is sought in making a decision for their child's care.

B. The physician recommends that a young child be taken off the ventilator. The parents, who are divorced and have joint custody of the child, have differing views about whether to discontinue the ventilator.

This scenario presents a clear ethical dilemma involving the withdrawal of life-sustaining treatment. The differing views of the divorced parents with joint custody may require the involvement of the hospital ethics committee to provide guidance and facilitate resolution.

C. A child in end-stage renal failure is placed on the renal transplant list. The parents are asked to sign permission for surgery after a cadaver kidney is located. One parent is out of town and gives telephone consent.

While organ transplantation involves ethical considerations, the described situation does not present an immediate conflict or dilemma that requires the ethics committee's urgent involvement. The scenario seems to involve a common process of obtaining consent for surgery.

D. After initial therapies have failed, a child with leukemia is evaluated for a new cancer protocol. The child, age 8 years, gives assent for the new treatment, and his parents give their consent.

This scenario involves a child participating in the decision-making process through assent, and the parents providing consent. While significant, it does not describe a conflict or ethical dilemma that requires immediate ethics committee involvement. The situation seems to involve standard procedures for obtaining informed assent and consent for medical treatment.

A. Informed consent

Informed consent refers to the process of obtaining permission from a person who has the legal capacity to make decisions for themselves. It involves providing comprehensive information about the nature, risks, benefits, and alternatives of a medical intervention to enable the individual to make an informed decision.

B. Emancipation

Emancipation is a legal process that grants minors the status of being free from the control of their parents or guardians. It is usually granted based on factors such as maturity, financial independence, or special circumstances. Emancipated minors may have legal capacities similar to those of adults.

C. Assent

Assent is the process of obtaining a child's agreement or approval for medical treatment. It recognizes the child's developing capacity to understand the nature of the treatment, and it allows the child to express their willingness to participate in the decision-making process regarding their healthcare. Assent is sought in addition to the informed consent of the parents or legal guardians.

D. Confidentiality

Confidentiality involves keeping private information secure and not disclosing it without proper authorization. While confidentiality is an important aspect of healthcare, it is not specifically related to the process of obtaining a child's agreement to medical treatment.