Law and Ethical Decision Making in Nursing - Assignment Example

LAW AND ETHICS IN NURSING STUDENT’S NAME INSTITUTION Question 1 Dr Lawrence tries to demonstrate the events that led to the death of Mr Whiley while at the care centre. He achieves this by conducting an autopsy on the body of Mr Whiley. An autopsy involves investigation of body parts ion attempt to determine the actual cause of a death where the cause of death is unknown. Therefore, in relation to the case involving Mr Whiley, Dr Lawrence in his report was of the view that Mr Whiley died as a result of ischaemic heart disease, left cerebral infarct and morphine intoxication. However, this report was inconclusive in determining the actual death, thus creating a vacuum in determination of Mr Whiley’s death. This is attributed to the fact that, one nurse by the name Ms Lord could face legal actions in relation to the death of Mr Whiley. This is attributed to the fact that, Ms Lord had given Mr Whiley an overdose of morphine prior to the death of Mr Whiley. Therefore, failure to clearly state the cause of death of Mr Whiley further complicates the issues at hand. However, according to the doctor, the health of Mr Whiley was deteriorating quite rapidly and was not expected live for more than a week. Additionally, upon the completion of the autopsy the doctor stipulates that Mr Whiley might have suffered a stroke which resulted to aspiration pneumonia. According to the doctor the patient suffered from aspiration pneumonia prior to him being given his medication. As a result the doctor stipulates that it was very unlikely for Mr Whiley to live for more than several hours. The discovery by the doctor does not necessarily absorb liability on the part of the care centre in relation to the standard of care owed to the patient. Medical practitioners are at all time required to observe a high standard of care when handling patients. However, the level of standard of care depends on the nature of the illness. This is to say that, terminally ill patients require a higher standard of care compared to less terminally ill patient. Therefore, Mr Whiley a palliative patient demands a higher standard of care. However, this was not the case as he was left neglected time after time. According to Berger et al (2007), palliative patients should be placed under individuals with sufficient knowledge and skills. This is attributed to the fact that, due to the nature of such patients it is quite difficult to predict their health patterns. Therefore, by placing them under the care of individual with sufficient knowledge and skills it becomes quite easy to offer the best health care. However, this was not the case with Mr Whiley who was placed under the care of Ms Lord. Ms Lord who was placed as his caretaker had only been in practice for not more than two weeks. This meant that she neither had the knowledge nor the skill to go about the handling of palliative patients. Additionally, the fact that Ms Lord was oversee the operations of the care centre all by herself meant that it is quite impossible to keep a close check on Mr Whiley. According to Lucas and Wells (2009), a care centre should be well staffed so as to offer better medical care to ailing patients. Therefore, in relation to Mr Whiley, had the care centre put more staff to look at the patients the life of Mr Whiley could have been extended. This is attributed to the fact that, according to the autopsy, Mr Whiley had suffered a stroke prior to the overdose. However, due to lack of enough staffing the stroke was never noticed which led to Mr Whiley suffering from aspiration pneumonia. However, despite the main casualty of the errors of the care centre being Mr Whiley, it should be noted that Ms Lord is equally a victim of his death. This is attributed to the fact that, the autopsy was not clear as to the cause of Mr Whiley’s death. However, this experience could have psychological effect on Ms Lord, particularly due to the fact that she had never experienced such an event. According to Oneschuk et al (2012), death of patient could have devastating effects on medical practitioners especially on those that feel responsible for the death of the patient. Therefore, medical institution should make it their objective to ensure that such medical practitioners are subjected to psychological treatment. This is attributed to the fact that, failure to do so could greatly hamper the performance of such medical practitioners. Therefore, it is quite possible that medical practitioners could also be a victim as stated by Dr Ullman. Therefore, going by the event that led to the death of Mr Whiley it is quite clear that t\he care centre was partly responsible to his death. This is attributed to the fact that, the care centre was under staffed. This is evident in the fact that Ms Lord was left to oversee the operations of the care centre. Therefore, it was quite impossible for Mr Whiley to receive the level of care his condition demanded. Additionally, the fact that Ms Lord never had sufficient knowledge to take proper care of Mr Whiley. Therefore, this proved quite fatal since Ms Lord not only gave Mr Whiley his medication late but also gave him an overdose of his medication. Therefore, in order to ensure that patients are offered the best health care, the care centre should equip the facility with enough staff. This would go a long way in ensuring that the patients are well taken care of. Additionally, the care centre should ensure that nurses are properly informed of the patients and the conditions each patient suffers. This in return ensure that patients are taken care off at the prescribed time and are given correct prescriptions. b). Negligence refers to a breach of duty resulting to an injury by an individual owing the duty. The level of duty of care is dependent on what a prudent person would do under the same circumstances. Therefore, based on these definitions it is quite clear that a tort of negligence is made up of various elements (Anderson 2007). These elements have to be proven in order to sustain a claim of negligence on the part of an individual. The first element is in relation a breach of duty, which basically stipulates that an individual ought to undertake a certain standard of care when performing a particular act. The standard of care will vary from activity to the other, meaning that there are instances whereby the standard of care is higher than others (Choctaw 2008). However, the standard of care is dependent on the test of a prudent person. A prudent person refers to an individual of similar skills and of right mental state. Therefore, the standard of care is dependent on the events that a prudent man would undertake in tackling a particular event. However, when actions of an individual deviate from those of a prudent then such an individual is deemed to breached their duty (Anderson 2007). Therefore, in the case of Mr Whiley the failure of the nurse to properly read the prescription is a clear breach of duty. This is attributed to the fact that, a prudent nurse would first read the prescription before administering the drug to a patient. Therefore, the nurse in question did not observe the standard of care required in administering of the drug to Mr Whiley (Anderson 2007). The second element stipulates that an individual must suffer injury as a result of the breach of duty by the other. Therefore, the absence of injury automatically quashes a claim on negligence (Sloan & Chepke 2010). In relation to this statement, the death of Mr Whiley satisfies this element. This is attributed to the fact that, autopsy reports indicate that Mr Whiley died as a result of morphine overdose. Additionally, this proves that Mr Whiley was a victim of the action of the nurse. This goes further to support the claim of negligence bearing in mind that the nurse was in breach of her duty of care by administering an overdose of his prescription. Therefore, as a result of this action by the nurse Mr Whiley succumbed to the overdose leading to his death. The third element necessary to support a claim in negligence is in relation to proximity. Proximity refers to the relationship that exists between the offender and the offended. Therefore, a claim of negligence can only be sustained if it is proven that there existed a close proximity between individuals in the case (Sloan & Chepke 2010). In relation to Mr Whiley’s death, it is quite clear that there existed a close proximity between the nurse and Mr Whiley. Therefore, the fact that the nurse was in charge of taking care of Mr Whiley means that there existed a relationship between the nurse and Mr Whiley. Proximity also creates a standard of care on the part of the defendant towards the plaintiff. This is to say that by the virtues of their relationship, the nurse owed Mr Whiley a standard of care. However, this was not the case as she breached this standard of care by failing to observe the recommended prescription (Anderson 2007). Question 2 Ethic and ethical decision making is quite an important discipline in the field of nursing. This is attributed to the fact that, nurses experience numerous situations that require human judgement (Laabs 2011). This is to say that such situations are nowhere to be found in textbooks but rather solely rely on the ability of the nurse to make a decision based on their judgement. Therefore, ethics can be described as the ability to make a decision based on nursing theory and practice bearing in mind the morality of the decision while at the same time observing the core principles of nursing namely; culture, human, heath, care and the nursing practice itself. Therefore, going by this description it is quite clear that nursing ethics entails the observation of moral principles (Katz 2007). As a result nurses should be able to distinguish between wrong and right even though the decision may not have any legal binding. Therefore, in relation to the case study, the nurses were required to exercise ethical decision. This is in relation to the fact that the care centre required that nurses r5emove artificial teeth from patient and have them stored. This is attributed to the fact that, the care centre believed that there was a likelihood of patients choking from their teeth while sleeping. However, this did not go well with the daughter of Mr Neilson and Mr Neilson. The argument was that Mr Neislon who at the time was 92 years had never chocked as a result of sleeping with his teeth. However, the nurse requested there request stating that it was the policy of the care centre. Despite it being a decision based on policy it is quite clear that the nurse had to make an ethical decision bearing in mind that there is always a first time for everything. Therefore, it would be advisable to take a risk simply because Mr Neilson had never choked. However, the fact that the nurses never took the time to explain to their patients and in particular Mr Neilson as to the policy and where the teeth would be stored at night. This exposed Mr Neilson to psychological torture as he feared that his teeth might be stepped on by individuals getting into the room. This resulted in Mr Neislon staying up all night. Additionally, the fact that no nurse made night routines to check on the patients demonstrates unethical nursing practice. This is attributed to the fact that, nursing ethics entail caring of the patient (Holm 2006). However, this was not the case as the patients were left out to take care of themselves at night. Therefore, this meant that patients were prone instances that would affect their health without the knowledge of the nurses. Additionally, by not conducting routine check-ups at night was in itself inhuman. This is attributed to the fact that, nursing ethics entail that nurses should promote humanly characteristics. Additionally, based on the fact that most of the patients were deemed to be incapable of taking care of themselves. Therefore, in relation to the case study, it is quite clear that ethical principles were not observed. As a result Mr Neilson was exposed injuries bearing in mind his state of health demanded high standard of care (Berger et al 2007) References Anderson, R.E (2007). Medical Malpractice: A Physician's Sourcebook. Berlin: Springer Science & Business Media, Berger, A.M., Shuster, J.L & Von Roenn, J.H (2007). Principles and Practice of Palliative Care and Supportive Oncology. Philadelphia: Lippincott Williams & Wilkins, Choctaw, W (2008). Avoiding Medical Malpractice: A Physician's Guide to the Law. Berlin: Springer Science & Business Media, Holm, S (2006). What should other healthcare profession learn from nursing ethics. Nursing Philosophy, 7, 165-174. Katz, J.R (2007). A Career in Nursing: is it Right for me? St. Louis: Elsevier. Laabs, C (2011). Perception of Moral integrity: Contradictions in Need of Explanation. Nursing Ethics, 18(3), 431-440. Lucas, C., Hoy, A & Wells, J (2009). Oxford Handbook of Palliative Care. Oxford: Oxford University Press. Oneschuk, D., MacDonald, N & Hagen, N (2012). Palliative Medicine: A Case-based Manual. Oxford: Oxford University Press. Sloan, F.A & Chepke, L.M (210). Medical Malpractice. Massachusetts: MIT Press. Wecht, C.H (2009). Preparing and Winning Medical Negligence Cases. Juris Publishing, Inc. Read More