The case involved a 12-year-old girl being brought in by the parent to get three months of birth control injection, which she would be required to visit the hospital every three months to acquire. The parent was concerned about the daughter’s future since she did not want her daughter to get pregnant at an early age before completing her studies. The parent insisted on the injection since she had one herself, and her daughter would be safe from conceiving a child in which the family would not be capable of offering a good life due to their financial status.
The injections are 99% effective in preventing pregnancies. Still, I had to consider the risks associated with the injections such as contraction of STIs if the girl became sexually active again, mortality if the injections were used for long, and the failure of the girl to show up every three months for the injection given that she was so resistant ( Marugg, Atkinson, & Fernandes, 2014) . The girl could be helped by discussing a wide variety of issues with her and the parent, such as educating on the need for abstinence, the need to test for STIs among others to allow the girl and the mother to choose the best option with fewer harms.
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The benefits of getting the injections were clearly explained and discussed. Still, only a few risks were mentioned without further explanations since the parent needed the girls to know the benefits alone. The girl was mentally alright, and according to the law, she was legally competent to keep her decisions regarding birth control as confidential. The girl was resistant to the extent of running away from the hospital. She claimed that she had stopped being active sexually for two months and planned not to have sex anytime soon since the boyfriend broke her heart. The girl also expressed other fears, such as weight gain, injection pains, among others. She opted for abstinence.
The girl's life would be normal if she were not injected because it would be according to her desires. Injecting her, however, would mean affecting her self-esteem since she already felt no need for birth control because she had decided to abstain. Other considerations of quality of life included the risk of gaining weight, depression, which can lead to suicidal thoughts, becoming pregnant, and risks of blood clots ( Itriyeva, 2018 ). As a Christian nurse, I would be biased to believe that the girl should be trusted in the decision to abstain; hence no need for the injection. Trusting the girl would mean going against the parent’s decision without understanding their unethical viewpoint.
In assessing the quality of life of the girl, there were no other plans which were considered. It was either the injection as per the parents’ will or no injection as the girl wanted. The parent would cause havoc if the girl were not injected since that was the reason she brought the daughter to the clinic. Yet, she did not have the right to force the daughter, given that legally matters concerning birth control should be the patient’s confidentiality. The long-term effect of not getting the injection which the parent raised as a concern would be financial constraints if the girl became pregnant because the family was not financially stable to raise a child. There were no religious factors raised by the girl or the parent. Abstinence education was offered to the girl and the parent to make the girl understand that abstinence is the only sure way of being safe from STIs, pregnancy as well as avoiding birth control ( Blythe, Diaz, & American Academy of Pediatrics Committee on Adolescence, 2007) . Education was also meant to change the parent’s decision.
The approach helped me make the right decision, which was to have the girl receive the injection and convincing her to come back every three months for the same. The approach helped decide without putting too much emphasis on just a few aspects such as quality of life and the preference of the girl, which could not result in beneficial outcomes in the future ( Toh et al., 2018) . Through the approach, I sought more clinical help, researched, and educated the family on matters regarding birth control, which was of great help. If faced with such a challenging situation, I would use the process once more.
References
Blythe, M. J., Diaz, A., & American Academy of Pediatrics Committee on Adolescence. (2007). Contraception and adolescents. Pediatrics , 120 (5), 1135.
Itriyeva, K. (2018). Use of long-acting reversible contraception (LARC) and the Depo-Provera shot in Adolescents. Current problems in pediatric and adolescent health care , 48 (12), 321-332.
Marugg, L., Atkinson, M. N., & Fernandes, A. (2014). The five-box method: The “four-box method” for the Catholic physician. The Linacre Quarterly , 81 (4), 363-371.
Toh, H. J., Low, J. A., Lim, Z. Y., Lim, Y., Siddiqui, S., & Tan, L. (2018). Jonsen’s Four Topics Approach as a Framework for Clinical Ethics Consultation. Asian Bioethics Review , 10 (1), 37-51.
