Essay & Reflection
Topic: Identify and discuss the relevant legal and ethical considerations in Case Study
There are professional expectations in professional capacities held in the medical field. Australia has an accepted standard followed when performing the duties. Australia has laid down the nurse ethic code, governed by law and well regulated by a regulatory commission (Australia, 2018). It sets the guidelines for practicing as a professional nurse in all the domains of living. Combined with other laid down practice standards, the nurses have a legal mechanism that has guidelines on the accountability of their practices. They enhance nursing responsibilities in all fields it applies. Referring to the case study on page 6, there several compromised several issues in nursing conduct was compromised. It relates to the professional manner of nurses; Safety and competency, respect to the culture and values of care receivers, confidentiality, honesty, and transparency when referring to the patient information, support for wellbeing, and nurses should promote confidence in the patients with ethical applications in duties (Hudson et al., 2014).
The paper looks into the guiding principles available for professional medical conduct and judgment on the handling of the case presented by the medical professionals. The article also explores several guiding principles in Australia concerning the case study of Dorris. Australian Charter of Health Care Rights, confidentiality, and privacy, a duty of care, and bioethical principles analysis.
Three principles guide the Australian Charter of Health Care Rights. The right to access health care, adherence to international agreements on human rights on mental and physical health, and respect to people’s cultures. It provides the caregiver and receivers with a safe and quality health care system. It emphasizes a healthy relationship with the patients and health providers. The care providers may contact supportive services where the patient needs assistance. It addresses several rights to patients, including the right to health care access, quality health care, communication on cost and procedures to be undertaken, decision-making process inclusion of the patient, and privacy (Care,1). In the case study of Dorris and the husband, there is a breach of patient rights. The patient does not receive quality and safe healthcare. The surgeon left the inexperienced doctor to perform a complicated procedure, which left Doris incapacitated. Regarding the Australian Charter of Health Care Rights, the caregiver should not have entrusted the decision making to shim, due to the memory lapse noted. In this instance, Relevant authorities make the decision.
When practicing the medical profession, consent, confidentiality, and privacy are critical. Nurses have a legal responsibility to maintain confidentiality in the patient’s details unless the law requires them to disclose. It falls under common law in Australia. A patient may sue for compensation. The nurses must seek informed consent before disclosing a patient’s information; they should provide privacy for them (Ryan, Callaghan, & Large, 2014). In the case study of Dorris, its application got breached when a neighbor came to visit her. The nurse had no prior knowledge of his identity. The neighbor went further to know Dorris’s health issues and wanted to sign the consent forms on behalf of Peter, the husband. The hospital should have gone further to ask more about the neighbor and the values they share with the patient. It should involve the authority to certify it’s genuine. The nurse had Peter sign a blank form of consent without giving further information on the procedure to be undertaken by the doctor and its risk and benefits.
Duty of care falls under the common law, judged based on community values and expectations. It bases judgment on the degree of accepted values. Duty of care refers to the obligations undertaken by an individual to avoid harm and injury to others. Standard care is cr from reasonable workers, and how well one performs their duties is the measure. When a breach of duty of care occurs, standard care delivery to the patient gets compromised. This has been a concern in the case of responsibility from the head nurse, the surgeon, the nurse at the emergency, and the junior doctor. From a study done by Moses on patients’ experience in the emergency department and the inconsistencies in the ethic and duty of care observes that these ethics from his research from one to the other moment were conflicted and more investigation needed on their circumstances (Moss et al., 2014).
Health professionals seek guidance from the law in giving reasonable care in achieving the realistic being of patients. The court requires evidence on procedures undertaken and analyses their safety as well as correctness. The elements required are a duty of care, breach of duty, causal effects, the reason for, and damages encountered. A negligence case usually depends on the relationship between a patient and the healthcare provider. It is determined if the doctor owed the patient a duty of care in a reasonable way. From the journal article written by Griffith, he went further to explore the circumstances duty of care applies and the role of nurses in discharging it (Griffith, 2020). Concerning Dorris’s case study, the doctors owe her a duty of care; he knew the case but later left the medical procedure to a junior doctor who does not perform it correctly. With this understanding, the doctor breached that law.
The other element is a breach of duty. This is where the healthcare provider does not fulfill their obligations as required by the law. In this case study, there are several elements of breach duty by the nurse and the surgeon. The surgeon does not explain to Peter and Dorris about the procedure now that they were incapable of doing so a relevant authority should have decided on their behalf. The nurse’s advice from the supervisor was to record details of the couple’s memory lapse, but the doctor’s considerations did not come through. The nurse did not go further into detail of Peter’s illness and went ahead to accept his acknowledgment of the surgery procedure. IT was explained through the book on TPerioparative nursing with a case study on breach of duty in the healthcare procedures (Hamlin, Richardson-Tench, & Davies, 2009).
According to Kim Atkins, Cause, in fact, is the action by the plaintiff causing the reason for the injury. In this case, indeed, if the surgeon was there to oversee the surgery as stated that the junior doctor did not have the necessary skill, there could have been a successful medical procedure. Damages caused are actual damages caused to a defendant who owed a duty of care. In this study, Dorris has a problem with the hipbone after surgery and cannot do the chores for the husband and herself (Kim Atkins, 2014).
The four of conduct are Autonomy, which is right for individuals to make their own decisions, beneficence the principle of putting mind other in actions taken, non-maleficence “above all, do no harm,” as per Hippocratic Oath, and justice which emphasizes on fairness and quality. They all need to be thought of before determining any action in the medical profession. They need a convert into the patients’ needs, and their intention is guidance. These principles are helpful guidelines in treatment choices by patients (Havi & Cooper, 2014).
Autonomy is the principle that guides on respecting peoples to have the right to make their personal choices in health care. This translates into informed consent. There must be efforts to discuss the preferences of patients and proper documentation in the patient medical chart. It further guides on patient needs in understanding the consent and its consequences. The health care provider must make the information available to the patient and make sure the patient understands it through conversation. After that, the health provider recommends the option best fit, and in this case, signing a consent does not guarantee moral standard.
Autonomy also guides on the patient’s competency, patients must be an adult, and the patient can know that they are authorizing a medical procedure and its effects in terms of life after treatment socially and health-wise. In case the patient is not competent to make a sound decision on the treatment, the care provider should consult the patient will, if any, and if none, a surrogate decision-maker comes to task. The principle that governs Autonomy of patient once declared not competent according to Beauchamp and Childress; prior preference followed. Through consulting the patient cart and people with knowledge of her favorites. If this is not available, the physician may make a judgment in favor of the patient. It further explains how much information should go to the patient on the diagnosis. Risks involved the success rate, benefits expected, alternative treatment, and the effects of no treatment. There exist exceptions in seeking consent from patients. If it is an emergency case, and the patient is not in a position to make a decision nor the surrogate; thus, consent waived. Also, in case, the patient is not able to reason (Lachman, 2012).
In the case study of Dorris to apply autonomy Dorris, the case was an emergency case following a fall in her home and was not in her senses too. The consent form peter signed was blank too. The nurse had a conversation with Peter and realized he was mentally incompetent. The neighbor also visited Dorris in the hospital, but no one took the time to know more about his association with Dorris. Moreover, the nurse took no further action on Dorris case. From our earlier description of patient autonomy, there was a breach from the side of the doctor. Peter could not sign the consent form; he did not have sound judgment. The doctor did not go further to explain the procedure, risks benefits though Peter could make the right judgment. He had a right to know about it. Besides, there was no need for consent; the option of a waiver was in place, but the doctor to act in the favor patient. Which in this case, he does not (Havi & Cooper, 2014).
Beneficence and non-maleficence are in a big way related to one another. Beneficence requires doing well for patient preferences, and non-maleficence is about avoiding harm to the patient. First reflects on the positivity on the patient’s concerns; the second one is deviating from damaging the patient’s concerns. The secondary principle maleficence goes as not to kill, cause pain incapacitation of others. Principles of beneficence further define as Prevention of needless pain, killing, and incapacitating others (Sharma, 2014). To expound further the principle of beneficence, every person in the medical field should act in a way that only means well for the patients. On maleficence, medical practitioners need just to avoid practices that cause harm to patients. Thus, a health care provider needs to consider the standard of care guidelines and informed consent by the patient (Lachman, 2012).
In the case, study of Dorris, the two principles are not in application; this is evident on the doctor’s part where he prioritizes his engagement and leaves her to the hand of the unqualified doctor. She got incapacitated without further actions to prevent it. Besides, the case of incompetent consent lies here again.
The principle of justice requires the distribution of medical services reasonably. The factor contributing to medical needs is urgency, quality of life, equality in medical care provision. Some people are not treated with due respect and with a lack of concern, and the medical professional may look down upon them. In the case study, this is the ultimate result of unequal treatment to Peter. It got observed when he is no fully furnished with information about the wife’s sickness. He has memory loss; thus, justice did not apply.
To conclude, in Australia, all persons accessing health care have rights observed by health care professionals. Health providers and patients should provide a safe health system. In fulfilling these guidelines have been set on legal behavior, reporting, medical confidentiality, consent, and information to patients. Also, the medical profession has a bioethics guideline on all actions they take to secure the patient’s wellbeing. In the case of Dorris, medical caregivers breached many of the instructions. Personal initiative and moral responsibilities to do well in the medical profession were not in place.
References
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Care, A. C. (n.d.). Australian Commission on Safety and quality in Health Care. Retrieved from https://www.safetyandquality.gov.au/
Grant, P. D. (2017). Nursing Malpractice/Negligence and Liability. Law for Nurse Leaders .
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Havi, C., & Cooper, R. (2014). Health, Illness and Disease: Philosophical Essays. New York: Routledge.
Hudson, B., Glass, N., Wilson, I., Michellee, H., & Ush, T. (2014, Nov 19). Defining professionalism in medical education: A systematic review. Medical Teacher, 47-61. doi:10.3109/0142159X.2014.850154
Lachman, V. D. (2012). Applying the ethics of care to your nursing practice. Medsurg Nursing, 112.
Moss, C., Nelson, K., Connor, M., & Wensl, C. (2014). Patient experience in the emergency department: inconsistencies in the. Journal of Clinical Nursing, 275–288. doi: 10.1111/jocn.12612
Ryan, C., Callaghan, S., & Large, M. (2014). Communication, confidentiality and consent in mental health care. Retrieved from ses.library.usyd.edu.au
Sharma, P. (2014). Ethical Issues Encountered By Medical Students During Their Education.