Problem
You are a nurse working in a downtown community clinic. You have known 18 y/o Rebecca for the last 6 months. She left home 2 years ago and stayed with friends on and off until she ended up living on the street. Her mother died several years ago and her father has been unemployed since then and struggles with alcohol abuse. Rebecca has struggled with depression since her mother's death.
She identifies as queer, and although born a boy she has lived as a girl as long as she can remember. While her parents were always supportive of her gender identity, when her father remarried, Rebecca felt "uncomfortable, invisible and in the way" in their tiny apartment. Today, Rebecca has tiny bruises on her face and neck.
When you inquire about her bruises, she brushes you off and says, "It's not a big deal." her voice is much less animated than usual. You ask her if someone has hurt her and she is quiet, staring at the ground. You offer to call the sexual assault nurse or help her make a report to the police. Finally, she says, "No way, no police."
Task
a) Is this an ethical dilemma? Why or why not?
b) As the nurse caring for Rebecca, how would you respond? What will be your next course of action?
c) Reference in formation.