Legal and ethical issues in health Essay Example

  • Category:
    Nursing
  • Document type:
    Case Study
  • Level:
    Undergraduate
  • Page:
    3
  • Words:
    2214

Legal and ethical issues in healthTitle:

Legal and ethical issues in health

Abstract

legal and ethical issues within health care. The principle of non maleficence means “do no harm”. This principle enforces the requirement not to harm a person deliberately or directly. The nursing code provides the nursing profession’s obligation to respect, support, protect as well as maintain the rights of individuals who receive and also those who provide nursing and health care. All the four scenarios influence the meaning and relevance of This paper examines the legal and ethical issues within health care. Four case studies involving ethical principles and ethical issues are analyzed. Ethical principles form the basis of ethical analysis since they are the standpoints from which guidance can be obtained in order to make a decision. In the principle of autonomy, the patient has the right to make reject or choose his/her treatment. This principle acknowledges the rights of people to self-determination. The beneficence principle entails that a physician is supposed to act to the patient’s best interest. Therefore, the medical practitioners’ actions should promote others’ welfare.

Scenario 1: Principle of beneficence

Johnstone 2007).Beneficence refers to the action taken to benefit others. Beneficent actions can be taken to assist in preventing or removing harm or just improving the situation of others. Medical practitioners are expected to desist from causing harm and they also have a duty of assisting their patients. The aim of medicine is promotion of patients’ welfare and the medical practitioners have the required skills and knowledge that help them in assisting others. Because of the nature of the relationship between medical practitioners and the patients, the physicians have a duty of preventing or removing harms, weighing and balancing the possible benefits against likely risks of a given action. Beneficence could also comprise protection and defending of the rights of other people, saving people who are in danger and assisting people with disabilities (

. Bruckman 2002). The proposition by the nurses to transfer Gemma to a 2 bed room at the end of the ward where the other patient is dying should be weighed appropriately. This decision should be based on the possible benefits of separating Gemma from the other patients and the possible risks associated with her witnessing the death of the other patient. For example, as much as the other patients require calmness with Gemma being separated from their ward, there is a likelihood that Gemma being disturbing, abusive and restless, the decision to take her to a ward where a patient is dying is also disturbing and may worsen her situation. The physicians are supposed to assist her with mobility. Her demands to be discharged should be ignored since this is likely to risk her health more than benefit her health. In spite of Gemma being extremely difficult, the physicians should do everything possible to assist her since the principle of beneficent requires the physicians to assist and save others (Steven 2009)In this case, the physician is required to encourage Gemma to quit alcohol since it is detrimental to her health. The physician is required to make efforts to ensure that Gemma goes through a suitable process to help her manage and control her alcohol taking effectively. The physician also has the responsibility of preventing or removing harms and hence the physician is supposed to make sure that Gemma does not cause any disturbance to the other patients. However, her healing process should also be taken into consideration and therefore before any action is taken the possible benefits and risks should be considered (

Scenario 2: Principle of non maleficence

The principle of non maleficence obligates that professionals should not deliberately make an unnecessary harm or injury, either by the acts of commission or omission. This means that it is considered negligence if someone imposes a careless or irrational risk of harm on another person. Giving appropriate standard of care that eliminates or reduces the risk of harm is supported by both moral convictions and also societal laws. Within the professional care model, a person can be morally or lawfully blamed if he or she fails to fulfill the standards of appropriate care. The lawful standard for establishing negligence include; the professional should have a duty of protecting the affected party, the professional should violate that duty, the affected party should experience harm and the harm is supposed to result for duty violation. This principle asserts the necessity to have medical competence. It is apparent that medical mistakes take place; nevertheless, this principle expresses an essential commitment in health care professionals in protecting their patients from harm (Kanitsaki 2007).

In this case, Andrew is imposing harm on some of his clients intentionally which means he is breaching the principle of non malificence. In this case, Andrew is not providing the appropriate standard of care owing to the fact that he is treating some clients with over-the-counter nutritional supplements and high protein diet that he has started and the other people without these additions. Here, Andrew is only gives precedence to his research study. Obviously there is negligence in this case since Andrew as a professional duty of protecting the parties under study, he has violated the duty of offering professional care to the involved parties, the involved parties have the likelihood of experiencing harm because of Andrew’s negligence, for example where Andrew is limiting the second group of patients gifts of food to make sure they eat merely facility meals. In a way, he is exposing the parties to dietary deficiencies which could result to some malnutrition diseases because of Andrew’s negligence (James 2001). Moreover, in this case a sole action can lead to two effects, where one is good and the other effect is bad. Here, the research study is good and supplying the patients with high protein is good but on the other hand this effect is also bad since it could have detrimental effects on the patients in the long run. However, the principle of non maleficence is not breached if a suitable balance of benefits occurs; in case there is no intention of harming directly but the unfortunate side effects occurs when trying to improve the health of the involved parties. But in this case, Andrew is undertaking a self initiated research study which means that the entire project is solely required to benefit himself and not the patients. This implies that Andrew clearly violated the principle of non maleficence (Fox 2006).

Scenery 3: Principle of autonomy

The bioethical principle affirms that people should be authors of their own fate and this means that autonomy focuses on the personal responsibility an individual has for his or her own life; a person has the right to choose who they want or wish to be with, to make their own decisions and to control what is done on them. Autonomy comprises the ability to deliberate regarding a planned course of action and also the ability to execute the action. An autonomous decision is the one that is made freely, without being influenced, by a competent individual who is knowledgeable and understands all the relevant information required to make such decision. The autonomous decision is supposed to be applicable to the present situation. In this scenario respecting Paula’s autonomy involves the nurse keeping what Paula has told him/her as a secret; this means respecting the privacy and confidentiality of the information shared between the two. Respecting the autonomy also involves letting Paula to make an independent decision on what she wants. However, this principle is not entirely applicable to the minors and in this case Paula is a minor (May 2000).

In the analysis of the this scenario, the nurse has a prima facie duty of respecting the autonomous choice of Paula and also a prima facie duty of avoiding harm and providing medical benefit to Paula. In this scenario, Paula is 14 years old which means she is still a minor and hence this means she is not entirely responsible for her own life. Therefore, in this case the legal precedence overrides the wish of Paula since she is still a minor. Paula cannot make her own decisions independently. Therefore, in this case, Paula, the principle of avoiding the harm and the principle of offering a medical benefit that can restore the health and life, would be given precedence over the autonomy of Paula (Klein 2003). The respect of autonomy is not should always be respected but in this case, respect to autonomy is not just a matter of attitude, but a means of taking an action so as to acknowledge and even promote the autonomous actions of the patient who in this case is Paula. As a result, the nurse should give precedence to Paula’s health and her well being. The nurse should take the action of counseling and guiding Paula and in the long run informing Paula’s parent regarding the relation between her and the drug user and also informing the parents that their daughter is at the risk of getting in drug taking if the relationship between her and her boyfriend continues. The parent and the guardian should be informed so as to take the necessary precautions about Paula because she is still a minor. The reason behind not giving precedence to Paula’s autonomy is because she is still a minor. Therefore, the principle of providing a medical benefit that is helpful to Paula would be given priority over the autonomy of Paula (Veatch 2002).

Scenario 4: ANMC Codes

The first ethical issue is that Ms. G does not value quality nursing care. This is because valuing quality nursing care also includes a nurse taking the necessary action when she/he considers on logical ground, the standard of nursing care to be improper. This also comprises the duty to question or report what the nurse considers to be unethical behavior or unethical treatment. In this case, Ms. G witnessed E H, who is a domestic staff dragging client A by his ankles along a cement path. This is obviously an unethical behavior and also unethical treatment by the domestic staff to the client and hence Ms. G should have taken the appropriate action. Ms. G failed to take any action and hence this is one of the ethical issues in this scenario.

Secondly, Ms. G never recorded or reported this unethical treatment. Here she violated the code of ethics which requires the nurses to report such incidents. The nurses are also supposed to respect self as well as other people and also value the moral worth and dignity of self and other people. Kindness is the illustration of simple actions of tenderness, concern in addition to the care. In this regard, Ms. G did not show any kindness to the client because she never bothered or took any action after what she witnessed. She did not even record the injuries that the Client A sustained as a result of being maltreated by the E H, the domestic staff (Johnstone 2007).

A nurse who values quality nursing care acknowledges that he/she is responsible for any decisions he/she makes concerning an individual’s care. This means that the nurse accepts the moral and legal duties in making sure that he/she has the appropriate knowledge, expertise and experience to offer safe and proficient nursing care. Furthermore, a nurse who values quality nursing care should make sure the professional duty he/she embarks on are according to the agreed practice standards of the profession. Nurses are supposed to take the necessary steps to make sure that they as well as their colleagues offer quality nursing care and hence the nurses should maintain the standard reporting procedure and effective record keeping. In regard to Ms. G, she was supposed to take the required steps to ensure that the domestic staff was providing quality nursing care. Apparently E H, the domestic staff was not providing quality care to client A but Ms. G never took any action and this is where another ethical issue comes in. she should have reported the incident and recorded the injuries sustained by client A (Johnstone 2007).

Bibliography

Alfred, T., 2005, Patient Autonomy and the Ethics of Responsibility, MIT Press, Cambridge.

Klein, W., 2003, The Story of Bioethics: From seminal works to contemporary explorations Georgetown University Press, New York.

James F., 2001, Principles of Biomedical Ethics, Oxford University Press, New York.

Bruckman, A., 2002, «Studying the amateur artist: A perspective on disguising data collected in human subjects research on the Internet», Ethics and Information Technology, Vol, 4/21.

May, W., 2000, Catholic Bioethics and the Gift of Life, Our Sunday Visitor Publishing Division, Huntington IN.

Kanitsaki, O, 2007, ‘An exploration of the notion and nature of the construct of cultural safety and its applicability to the Australian health care context’, Journal of Transcultural Nursing, Vol, 18/3.

Johnstone, M, 2007, Bioethics: A nursing perspective, Elsevier Australia, Sydney.

Fox, R., 2006, They call it ‘‘patient selection’’ in Kayelitsha: the experience of Medicins Sans Frontieres-South Africa in enrolling patients to receive antiretroviral treatment for HIV/AIDS, Cambridge Quarterly of Healthcare
Ethics, Vol, 15/302–312.

Veatch, R, 2002, The birth of bioethics: autobiographical reflections of a patient

Person, Cambridge Quarterly of Healthcare Ethics, Vol,11/344–352.

Steven, E., 2009, Inclusion: The Politics of Difference in Medical Research, University of Chicago Press, Chicago.