In this essay, I am going to discuss the reason for which I decided to pursue a career as a PA and the aspects I anticipate will be most important to me in clinical practice using the principles of beneficence and truthfulness.

In 2009, I accepted a job as a Wish Coordinator for the Make-A-Wish Foundation. In this role, I was responsible for granting the wishes of children with life-threatening medical conditions and exposed to the world of medicine. In my two-year tenure, I planned nearly 300 wishes and had the incredible fortune of working with families from many different walks of life. I came to recognize that my ability to help these wish children and their families was limited to alleviating the wish child’s emotional welfare yet I was unable to serve their deeper medical needs. In order to influence the wish child’s future well-being and health outcomes, I decided I needed to explore the broader scope of medical sciences and pursue a career in medicine as a Physician Assistant.

In pursuing a degree in medicine, I am hoping to treat children facing life-threatening medical conditions, specifically in pediatric oncology. PAs are afforded the opportunity to spend time building rapports with their patients and patient families, which is extremely important in pediatrics. When a child is sick, families face something that is traumatic and unimaginable. Children are often unable to make decisions as it relates to their care and parents play an integral role in the process. If my role as the care provider is to lessen the family burden by working to build a bond and to explain treatment options to parents comprehensively, I want to do everything in my power to ensure that occurs in practice. Additionally, it will be extremely important for me to stay up to date on current protocols and innovations as it relates to the chemotherapy and radiation treatment options. In remaining informed, I am ensuring I am able to provide my patients with the best option and care possible giving them the optimal outcome for survival.

I anticipate beneficence playing a strong role in my ethical decision-making in clinical practice. The act of beneficence is to produce a good for someone else (Yao et al, 2010, p. 103).   Children are not often able to advocate for themselves, which is why practitioners must work with their parents who are typically making decisions on their behalf. As a PA, it is my responsibility to ensure the interventions used in practice have more benefit than harm for my patient, the child. I am accountable for confirming the parents fully understand the scope of the treatment options presented and are making informed decisions as it relates to their child’s care. In oncology, parents often struggle to decide what is best for the child both ethically and emotionally. It is my responsibility to guide the parents by providing them with all of the treatment options and advocate for the child where appropriate. Parents want their best for their children but may prolong a treatment unnecessarily while grasping for hope and miracles (Yao et al, 2010, p. 117). While good intentioned, this action could cause more harm both physically and emotionally to the patient. As the provider, it is my responsibility to advocate for the child’s well being and use my relationship with the parents to ensure they appreciate the consequences of their decisions and derive a plan that maximizes benefit for the child.

Equally important, I envision truthfulness playing an important role in clinical decision-making. Truthfulness in practice is built through the comprehensive blending of facts and perspectives. An individual’s illness greatly impacts their well-being but there are also many external aspects that play a role in a patient’s life. Together these ‘aspects contribute to the shared and dynamic nature of the truth’ (Surbone, 2006 p. 944) and are aspects I envision taking into consideration in sharing the truth about a patient’s prognosis. I want to be as comprehensive as possible without overwhelming family members during an extraordinarily difficult time. Discussing mortality rates associated with various chemotherapy treatments and different protocol options when no treatment is working is inevitably going to be challenging but I owe my patients and their families the truth. I must show sensitivity and compassion as I deliver findings and present future options, or lack thereof, for treatment. Parents must have relevant information to make informed decisions as it relates to their child’s treatment and age should not factor into what truths are revealed. The child-adolescent population forces practitioners to focus the discussion, articulate the findings, and tell the truth in a way that all can understand even when the news is unimaginable.

In this essay, I discussed the reason I decided to pursue a career as a PA and use beneficence and truthfulness to discuss the aspects that I anticipate will be most important to me in clinical practice.

References –

Surbonne, A. (2006). Telling the truth to patients with cancer: What is the truth? Lancet Oncology, 7(11), 944-950.

Yeo, M., & Moorhouse A. (2010). Beneficence. In Yeo, M., Moorhouse A., Khan P., &   Rodney, P. (Eds.), Concepts and Cases in Nursing Ethics. [3rd edition] (pp. 103-116).           Ontario, Canada: Broadview Press.

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