A primary care nurse practitioner has advised a care recipient that she is positive for BrCA2, the gene associated with breast cancer in women.The care recipient has two small children.What would be the most appropriate next step for the nurse practitioner to take with respect to this care recipient?

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There is no one best solution, as is suggested by choice A, which is universally applicable to all persons or all settings.Simply allowing for care recipient autonomy is not sufficient.Nurses are expected to be knowledgeable regarding specific circumstances for each care recipient in order to best serve the care recipient.The nurse practitioner is functioning as a primary care provider.Accordingly, deferring the problem to a physician does not appropriately discharge the nurse's duties and responsibilities.The nurse would be expected to assist the care recipient in exploring options and choosing a course of action.Specific principles derived from ethical theories have proved useful because they highlight salient aspects of complex problems and help to examine implications of different proposed courses of action.Selection of pertinent principles, however, depends both on the context of the problem and on the beliefs and values of the individual or group for which action is needed.For example, imagine a woman who seeks assistance in deciding whether to undergo genetic testing for the breast cancer gene BRCA2 because several members of her immediate and antecedent families have been diagnosed with breast or associated cancers.She tells her nurse practitioner that she is not sure whether it would be beneficial to be tested.The nurse practitioner, in facilitating the woman's health-promotion efforts, understands that she must use clinical judgment to facilitate the woman's autonomous choice.Understanding the requirements of the principle of autonomy is important in helping the woman make her decision.It is not sufficient, however, to understand the meaning of autonomy and its limits; the nurse practitioner must also know something about the woman's life, values, beliefs, and relationships in order to provide her with the information and resources necessary for her decision.If the woman is screened and the results found positive for the gene, the woman not only must decide her next actions but also must consider the implications of the results (e.g., how the results affect her children or her decision to have children).

A Primary Care Nurse Practitioner Has Advised a Care Recipient