| Course | DNP 619 Principles of Pediatric Acute Care II |
|---|---|
| Module | Module 6 |
| Paper type | Moderated case discussion with final summary |
| Length | About 549 words |
| Format | Discussion post with APA 7 citations |
| School | Arizona State University |
| Program | DNP |
| Updated | October 2026 |
Free sample paper for DNP 619 Module 6
Student-Led Discussion Board 3: A Sixteen-Year-Old Who Says No
Her Diabetes, Her Pump? Moderating an Ethics Case About an Adolescent's Assent and Her Parents' Permission
Opening the Board: A Refusal on Day Three
Welcome to our final student-led board. Our composite patient, L.M., is 16 and was admitted to the PICU in diabetic ketoacidosis, newly diagnosed with type 1 diabetes. She is now stable on subcutaneous insulin. Her parents, both engineers, want her started on an insulin pump and continuous glucose monitor before discharge. L.M. says she does not want "a device stuck to me all the time" and wants to use injections. She is a strong student and plays soccer. Her parents say the decision is theirs.
Roles: Hannah, ethical principles; Kevin, legal and developmental considerations; Rosa, confidentiality and communication; Tom, alternatives and risks; all, plan.
Contributions From Each Role
Ethical principles (Hannah): Respect for her developing autonomy competes with parents' beneficence. I replied that pediatric ethics frames this not as autonomy versus authority but as parental permission plus adolescent assent.
Legal and developmental (Kevin): Parents generally hold legal authority for medical decisions for a 16-year-old in Arizona, but adolescents often have decision-making capacity similar to adults for many choices. I added that research on children's competence suggests many children from about age 12 can understand and reason about medical decisions (Hein et al., 2015).
Confidentiality (Rosa): She suggested meeting L.M. alone to learn her reasons, which turned out to include worry about how a pump would look in her soccer uniform. I noted that the reason changes the conversation entirely.
Alternatives and risks (Tom): Injections are a safe, effective standard therapy; diabetes technology is encouraged for youth, but its use should match the young person's preferences and readiness (American Diabetes Association Professional Practice Committee, 2025), so refusing a pump is not refusing treatment.
Moderator's Final Summary
Analysis: The American Academy of Pediatrics describes decision-making for minors as parental permission combined with the child's assent, with growing weight given to the adolescent's views as maturity increases (Katz et al., 2016). Assent matters most when the choice is between reasonable options, as it is here. Unlike refusing insulin entirely, which would endanger her life and justify overriding her wishes, choosing injections over a pump is a preference between two accepted treatments.
Plan:
Communication: A family meeting led by the diabetes team, with time for L.M. to explain her concerns. Acknowledge her parents' wish to protect her.
Shared decision: Start with injections and a continuous glucose monitor if she accepts one, with a plan to revisit pump therapy in three months. Offer to show her discreet device options and connect her with an athlete who uses a pump.
Education: Teach injection technique, carbohydrate counting and hypoglycemia management to L.M. and her parents together.
Psychosocial: Screen for adjustment difficulties and diabetes distress, common in newly diagnosed adolescents, and involve the diabetes psychologist.
Safety limits: If L.M. refused insulin itself, the team would explain that her life was at risk and that her parents' permission for life-saving treatment would take precedence.
Documentation: Record her assent and preferences and the family's agreement.
Endocrinology and diabetes education consults complete the plan.
This case showed how much ethics depends on knowing why a patient says no, and how often a respectful conversation resolves what looks like a conflict. Thank you for a thoughtful week.
References
American Diabetes Association Professional Practice Committee. (2025). 14. Children and adolescents: Standards of care in diabetes-2025. Diabetes Care, 48(Suppl. 1), S283-S305. https://doi.org/10.2337/dc25-S014
Hein, I. M., De Vries, M. C., Troost, P. W., Meynen, G., Van Goudoever, J. B., & Lindauer, R. J. L. (2015). Informed consent instead of assent is appropriate in children from the age of twelve: Policy implications of new findings on children's competence to consent to clinical research. BMC Medical Ethics, 16, 76. https://doi.org/10.1186/s12910-015-0067-z
Katz, A. L., Webb, S. A., & Committee on Bioethics. (2016). Informed consent in decision-making in pediatric practice. Pediatrics, 138(2), e20161485. https://doi.org/10.1542/peds.2016-1485
Reading the DNP 619 Module 6 assignment instructions
The third and last student-led board comes in Week 13, alongside readings on ethical considerations, care of the minor and legal implications. Moderators follow the familiar weekly rhythm, but ethics cases call for roles that differ from a clinical case, such as ethical principles, legal context, communication and clinical alternatives. The board is worth 10 points and expects evidence-based APA citations. Because the readings cover consent, assent and the legal care of minors, cases about adolescent decision-making fit especially well. Check any statement about state law carefully. Faculty can suggest topics if you are unsure. Start drafting roles early.
How this DNP 619 Module 6 example is built
The opening case presents a realistic disagreement, not a clear right answer, and assigns roles that match ethical, legal, communication and clinical angles. Moderator replies add key concepts, such as permission plus assent. The final summary applies the AAP framework, distinguishes refusing a treatment option from refusing treatment altogether, and builds a plan that includes communication, shared decision-making, education, psychosocial support and explicit safety limits. Three sources support the analysis. Each role brings a different lens, ethical, legal, communication and clinical, which helps the class see the case from several angles before the summary decides. Safety limits are stated plainly. Three sources support it. Moderator replies add concepts at each step. The summary ends by naming the lesson the case teaches about listening.
Reading the DNP 619 Module 6 grading rubric
Ethics-focused boards are usually graded on a case with a genuine ethical tension, accurate use of ethical and legal concepts, moderator engagement, a summary that reaches a reasoned recommendation, a practical plan and APA references. Strong summaries distinguish situations where an adolescent's choice should guide care from those where safety must override it. Exploring the patient's reasons shows clinical wisdom. Accurate statements about consent law matter. Summaries that separate preference between reasonable options from refusal of life-saving care show nuanced ethical reasoning. Attention to the adolescent's own reasons is valued. A plan that includes documentation of assent and family agreement shows professional completeness. Clear structure matters too. Clear role assignments matter.
DNP 619 Module 6 help with common mistakes
Students often frame pediatric ethics as parents against child. Use the permission and assent framework instead. Another mistake is stating legal rules without checking your state's law. Ask why the adolescent is saying no before deciding how to respond. Make safety limits explicit. Use a composite case. If you would like help preparing an ethics case for your board, send it to the desk. Check your state's rules on minors' consent before stating them, and cite a reliable source. Use a composite case. Ask why the adolescent is refusing before planning a response, since the reason often points to a solution. Name your safety limits clearly. Respect privacy throughout.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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DNP 619 Module 6 questions, answered
Where can I find a free DNP 619 Module 6 sample paper?
The third student-led discussion is shown above in full: a 16-year-old refusing an insulin pump, roles and replies on assent, permission and confidentiality, and a summary with a shared decision plan.
What is the difference between assent and permission in pediatrics?
Parents give permission for a minor's care, while the child gives assent, agreement appropriate to their development; both are sought.
Can an adolescent refuse treatment?
Their views carry growing weight, especially between reasonable options, but parents and clinicians may override refusal of life-saving treatment.
Why meet an adolescent alone?
It allows the adolescent to share concerns confidentially, which often reveals the real reasons behind a decision.
When is DNP 619 Student-Led Board 3 due?
The syllabus places it in Week 13, the ethics and care of the minor week.