The key participants are Nora, Eric, the fetus, Janis, Nora`s mother and society at large. Janis is the nurse responsible for providing safe and informed care for both Nora and the fetus. Nora being the principle decision maker has the rights to autonomy and self-determination without coercion. Nurse`s have a professional responsibility to uphold and advocate for their patients, protecting their rights of autonomy. This in turn can lead to a stronger patient-nurse relationship and work towards integrating the patient into a mutually accepted plan of care. The nurse however, can find it exceedingly difficult to maintain or preserve client relationships, knowing the client can chose to end engagement in care at any time. Protecting the fetus, while maintaining patient rights can be extremely taxing and cause distress if viewed through the lens of the biomedical model. Eric, being the father also attempts to impose his values onto Nora, which just further adds to her already complex situation. Nora`s values and decision making capacity has been shaped through her environment and her mother while she transcended into an adolescence. The lack of knowledge, sense of attachment, brewing frustration and unwillingness to adapt outlines the need for support and motivation. The Relational approach puts nurse`s into the role of trusted caregiver, and usually patients confide to telling nurses things they usually wouldn’t tell other people. This puts nurses into morally distressing situations. Difficulties often arise when the rights of individuals conflict and the beneficence of one patient versus the non-maleficence of another. The nurse would want to honour Nora`s autonomy in making an informed choice, but would also understand that providing autonomy to the mother can put the fetus at risk. The nurse has to provide optimal support to preserve the health of both baby and mother.
Nora as the principle decision maker is tasked with a plethora of questions. Questions like whether or not to carry through with the pregnancy, to try and reduce or halt drinking, entering a rehabilitation program or to re-kindle a relationship with the father to be. These challenges instill fear