Ethics and Law for Nurses - Case Study Example

Ethics and law for nurses Name: College: Introduction Every license offered from professional achievement comes with both legal as well as ethical responsibilities. Doctors have an oath of never to harm patients, lawyers are held responsible of the client they are representing in court. This is no exception with the nurses, as they are always responsible when they are administering medication, and also making sure that they get consent from the patient within all the set standards. Ethics are guides in decision making, and laws are the set standards that every individual involved have to abide by. Nurses normally make decisions independently depending on the situations facing them on daily basis; nevertheless they remain responsible to their profession. This paper gives an opportunity of reviewing some of the laws and ethics of nurses, presented in form of case studies to help identify and analyze how nurses articulate these laws and ethics in their day to day activities. It also gives suggestions on those cases, what should have been done by the involved nurses in the particular situations. Different information sources have been used in compiling this paper and books are available in library and other materials are available from the internet. Key to note is that, only up-to date information has been used. Further reading is recommended, so as to get additional information of all the other laws and ethics of nurses, as only some of them have been discussed which relate to the mentioned case studies. Analysis In case study 1, it is highlighting violation of patient's right to his/her information to remain confidential. The process of the nurse involved in revealing the information is shown in a context of public engagement in an ethical analysis. The process of communicating through the internet (face book) and disclosing her ideas and placement on the case, including information about the response from the patient’s friends and relatives, leaves a lot to be desired concerning the people trusted with sensitive information of patient and they are the people in public trust. In the analysis of this case, the paper will be examining the law of nursing council which has been violated as well as unethical behavior of the concerned nurse. It will also give an opportunity of reviewing the issues related to information, where a nurse discloses the patient’s information. Case Presentation I have a friend of mine who is a nursing student, Melanie Anderson who happens to post a message of her placement and caring of an injured motor vehicle accident patient. The message also includes information about the clinical status of the patient and the response from relatives and friends of the patient. Legal issue: Right to privacy It is the duty and responsibility of every nurse to observe the rules and ethics that come with the profession. Patients have a right to privacy. In this particular case, it was the duty of the nurse to secure patients information by safeguarding their right to privacy as well as being their advocate. The nurse’s job is more of caring than curing and they should therefore establish a good relationship with the customer trying as much as possible to win their trust. According to 1996 act of Health insurance portability and accountability, it is the duty of every nurse to protect and keep patients record and information in private and can only disclose to the immediate care giver of the patient .It is clear to all nurses that in case of any breach in privacy the liability lies with the nurse as they are the only ones with the information records. Any information concerning the patients should only be shared with permission from the patient ,or if it is felt that disclosing of information complies with a higher duty, for instance of saving life(International council for nurses 2006). According to the law all the records containing medical information belong to a physician. More so there is a strong legal obligation as well as ethical requirement that the records remain confidential. However other requirements are that, the physician can provide information on various occasions e.g. for court presentation among others. Generally it is a rule that, information cannot be provided, without permission from the patient, unless served with a subpoena. This is an order from the court requiring that the records to be produced and they must be, unless the order is reconsidered by the court. In times when such presentation is harmful to the patient or the family members an application is done to the court to block the disclosure. There are cases also where information can be disclosed without the patients consent e.g. cases of communicable diseases, injuries brought about by criminal acts, unconscious patients among others. Ethical issue: confidentiality This case also shows behavior of the nurse going against their ethics. This is because this particular scenario shows that the nurse had opinions of the case due to her clinical practicum and experiences, which were not supposed to be portrayed since there would be loss of, trust on the part of the patient .Despite the many challenges that nurses face they should remain truthful to the oath of profession. Sometimes they are faced with the dilemma of taking action and remaining trustworthy. In such cases the nurse need to be bright enough in deciding the best action to take .In this case study, we do not know the exact details of the relative and friends response but the fact is depending on the extent of harm of their response, the nurse was not supposed to disclose to public but rather seek for assistance from relevant organizations e.g. human rights or any other that would be relevant for this case. Publication of information means losing trust from public and giving a bad name to the profession. The nurse should also have consulted with nurses who are more experienced in the field. It is also advisable that the nurse would have offered counseling to the relatives upon realizing their response; make them understand what is happening. If such response is as a result of dissatisfaction, they should be made to understand the situation. This is according to queen’s law. Posting information on the internet does not solve the problem but rather exaggerates it. This is because the public have different opinions which will end up confusing the nurse and the final decision still lies with her. Case study 2 In this case there is a patient who is faced with a challenge of getting information concerning his/her medical condition. It is clear that the patient wants and has the interest to be informed of their condition but is lacking the information. This paper will focus on the legal issue of the patients get information regarding their health condition, and circumstances under which or when they can be denied. It will also focus on the dilemma that nurses are normally faced with where ethics is concerned. Presentation of the case Mrs. Suzuki a 69 year old lady is admitted in my ward with abdominoperinea resection for colon cancer. She is not very fluent in English. Her son and daughter in law have been liaising with staff on behalf of Mrs. Suzuki; and the surgical resident obtained consent for Mrs. Suzuki’s operation by using her daughter in law as interpreter. Two days after Mrs. Suzuki’s surgery, the ward clerk, who speaks Japanese, tells me that Mrs. Suzuki is asking why she has a colostomy and how long it will be necessary. Mrs. Suzuki’s daughter in-law is currently visiting Mrs. Suzuki, so I ask to speak to her. She tells you that the family does not want Mrs. Suzuki to know she has cancer as “she would give up the will to live”. Legal issue: The right of patient to information Most people do not know their right in times when they are under medical care, because these rights are not clearly defined. Probably patients have no right to medical records. The records are purely meant for physician for protection of patient’s health, unless the patient is considered to have a right. These records, giving them to patient ,does not improve their knowledge but might rather be misleading due to misunderstanding of the lay person. However the physicians have an obligation to provide information to the patient if it is requested by the patient but this is limited to the relationship of the two. Patients should be given information of their present health condition, course of treatment to be taken, how long it is going to take to heal what to expect and any information that will enhance the recovery process. This will also eliminate the misunderstanding that brings relationship breakdown. Ethical issue: Moral reasoning According to Victorian nursing ethics moral reasoning is the process of making logical decision from facts and being able to make sound conclusions from particular situations. These decisions mostly are from two different ideas/values and a good decision needs to be done to resolve a difference (Fry, Johnston 2002). Paramount is the interest of the patient and whatever needs to be done by all who have attended or are attending the patient, to serve that interest has to be done. It is clear that for instance when previous records are needed, the person who had attended the patient before have to produce them. Refusing to produce the records is unethical. Patient’s information should also be provided to them in a way they can understand even if the patient has refused to pay bills, they should not be denied information. In case information is denied and harm or damages results due to lack of information the nurse or physician is held liable. Patients with terminal illnesses like Mrs. Suzuki need to be informed of their condition as this is not just a therapy but also a component. It is preferred that relatives of the patients, be given information of the condition and they convey the message to the patient since they understand the patient better. However information given to them should be selective and they are made to understand since they are also undergoing the same denial and anger as the patient. They should be made to understand the condition to avoid misunderstanding. However it is not clear how much information should be given to the family members and any information given to them should remain ambiguous. In case of where the patient is being denied information e.g. Mrs. Suzuki the nurse should make a wise decision of either consulting the advanced physicians or relevant organization to the best interest of the patient. In making of a decision in this case, I would consult with the relatives privately without arousing a concern in the patient that something might be a miss. I want the relatives to understand the importance of their patient getting the necessary information and how it assists the patient in recovery, having accepted the reality of the situation. Ethical issue: Obtaining patients consent Every patient has the right to know everything concerning their diagnostic results; the method of treatment proposed and expected charges/expenses for their treatment, in order for them to make an informed decision. Informed consent can either be in writing or verbal. Every human being who is of sound mind and has attained an adult age has a right to decide on their treatment. The case study above, it is clear that the patient was given a chance to decide if a surgery was to be done. Patients should be informed in the best language they can understand. .In this scenario it is clear that the ethical requirement of a physician obtaining consent from the patient was observed. Occasionally informed consent is not always obtained, for instance in cases where the situation is a matter of life and death, and actions taken are for saving patients life. In addition there are cases where the patient does not want to be informed, and is such the physician should make the patient sign a waiver. In rare cases informed consent can be by passed especially where the nurse feel that giving the patient information may affect them negatively, and so under such circumstances the information can be disclosed to another person whom have to be approved of by the patient. Conclusion Following the analysis of the two cases it is clear that, nurses have a legal obligation to their profession and they need to protect the image of the nursing profession. It is clear that they make decisions independently since there are new situations every day. This is true due to the fact that situations present themselves differently and so the need to deciding depending on the particular case. This is unlike in doctors whereby they do the diagnosis and they have a manual of how to o in most of their cases. It is therefore appropriate, and in order, that nurses get proper training, in order to know what is required of them and when to take risks. For instance according to Victorian law it is the duty of a registered nurse to administer drugs and cannot seek the assistance of an enrolled nurse or an employee to do so. Such are the risks they need to know. It is also good that the general public to be educated on their rights and responsibilities as patients. Knowing their rights and responsibilities, will enhance a good relationship with the nurses and other care givers and also make work easier. References Boride, G. (2009).Ethics in Nursing Jobs and Profession: Retrieved on October 9, 2010 from http://www.buzzle.com/articles/ethics-in-nursing-jobs-and-profession.html Fry, S.T&Johnsone, M.J. (2002).Ethics in nursing practice: a guide to ethical decision making. A. Wiley: San Francisco. Gold, C., Chambers, J. & Dvorak, E. (1995). Ethical dilemmas in the live experience of nursing practice: Nursing Ethics. 2(2):131-141 Johnstone, M. (1998). Determining and responding effectively to ethical Professional misconduct in nursing: A report to the Nurses’ Board of Victoria. Melbourne. Lewis, W. (1983).Fundamentals of nursing. Lippincott: Michigan. Potter, A. &Perry.A. (2002).Basic nursing: essentials for practice. Mosby: U.K. SpeedyCeus, (2009).Laws and Ethics Course, retrieved on October 9, 2010 from http://www.speedyceus.com/ceus-courses/material_detail/30/ Westrick, S. &Dempski, K. (2009).Essentials of Nursing Law and Ethics. Jones & Bartlett Learningitle: London, U.K. Read More

In times when such presentation is harmful to the patient or the family members an application is done to the court to block the disclosure. There are cases also where information can be disclosed without the patients consent e.g. cases of communicable diseases, injuries brought about by criminal acts, unconscious patients among others. Ethical issue: confidentiality This case also shows behavior of the nurse going against their ethics. This is because this particular scenario shows that the nurse had opinions of the case due to her clinical practicum and experiences, which were not supposed to be portrayed since there would be loss of, trust on the part of the patient .

Despite the many challenges that nurses face they should remain truthful to the oath of profession. Sometimes they are faced with the dilemma of taking action and remaining trustworthy. In such cases the nurse need to be bright enough in deciding the best action to take .In this case study, we do not know the exact details of the relative and friends response but the fact is depending on the extent of harm of their response, the nurse was not supposed to disclose to public but rather seek for assistance from relevant organizations e.g. human rights or any other that would be relevant for this case.

Publication of information means losing trust from public and giving a bad name to the profession. The nurse should also have consulted with nurses who are more experienced in the field. It is also advisable that the nurse would have offered counseling to the relatives upon realizing their response; make them understand what is happening. If such response is as a result of dissatisfaction, they should be made to understand the situation. This is according to queen’s law. Posting information on the internet does not solve the problem but rather exaggerates it.

This is because the public have different opinions which will end up confusing the nurse and the final decision still lies with her. Case study 2 In this case there is a patient who is faced with a challenge of getting information concerning his/her medical condition. It is clear that the patient wants and has the interest to be informed of their condition but is lacking the information. This paper will focus on the legal issue of the patients get information regarding their health condition, and circumstances under which or when they can be denied.

It will also focus on the dilemma that nurses are normally faced with where ethics is concerned. Presentation of the case Mrs. Suzuki a 69 year old lady is admitted in my ward with abdominoperinea resection for colon cancer. She is not very fluent in English. Her son and daughter in law have been liaising with staff on behalf of Mrs. Suzuki; and the surgical resident obtained consent for Mrs. Suzuki’s operation by using her daughter in law as interpreter. Two days after Mrs. Suzuki’s surgery, the ward clerk, who speaks Japanese, tells me that Mrs.

Suzuki is asking why she has a colostomy and how long it will be necessary. Mrs. Suzuki’s daughter in-law is currently visiting Mrs. Suzuki, so I ask to speak to her. She tells you that the family does not want Mrs. Suzuki to know she has cancer as “she would give up the will to live”. Legal issue: The right of patient to information Most people do not know their right in times when they are under medical care, because these rights are not clearly defined. Probably patients have no right to medical records.

The records are purely meant for physician for protection of patient’s health, unless the patient is considered to have a right. These records, giving them to patient ,does not improve their knowledge but might rather be misleading due to misunderstanding of the lay person. However the physicians have an obligation to provide information to the patient if it is requested by the patient but this is limited to the relationship of the two. Patients should be given information of their present health condition, course of treatment to be taken, how long it is going to take to heal what to expect and any information that will enhance the recovery process.

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