Legal and Ethical Issues in Health Care- 4 Scenarios - Case Study Example

Title Name Institution Abstract Kate and I are RN nurses working together, but Kate is still pursuing her Masters Degree. She is doing her project in which she hopes to use some of the residents of the place where she works. She plans to subject them to tests from which she will obtain the results for her study. In this paper, the legal and ethical issues of healthcare pertaining to Kate’s case will be assessed. The case of Kate is divided into four scenarios and the first three scenarios will be discussed against bioethical principles namely; beneficence, non maleficence and autonomy respectively. The fourth scenario is related to the ANMC codes. I her plan for the project, Kate obeys the principle of beneficence alone, but violates the others. Kate does not follow all the ANMC codes and therefore her project is in violation of almost all the legal and ethical principles of healthcare.   Scenario 1 Introduction In scenario 1, the bioethical principle of beneficence will be applied to the case of Kate. Kate, who is a registered nurse working together with me is also a Masters student. She has a research project and she wants to do some tests on people and use the results in her project. In this scenario, the relevance of the principle of beneficence will be discussed and applied to Kate’s case, and this will reveal if the principle has been followed or not. Afterwards, a conclusion on the assessment of the scenario will be made. The bioethical principle of beneficence demands that the providers of health care such as RN Kate, and me take the responsibility of ensuring that patients benefit from our activities and behavior. Health care providers should also ensure that they make the appropriate steps to avoid, and take away harm from their patients (Runciman, Merry and Walton, 2007). This should be done to the patient and to the rest of society as well. The patients and the rest of the society must stand to gain form whatever thing the nurses are doing. The bioethical principle of beneficence can be applied to the case of Kate. Since the principle of beneficence requires that Kate should be of benefit to the society and to her patients, (Kerridge, Lowe, and Stewart, 2012). it can be deduced that she is doing the right thing. She is following this principle because through her research she hopes to release findings that will add to the pool of knowledge in the society (National Health and Medical Research Council, 2011). Her project results may also contribute new ideas to existing medical practice and treatment of various diseases. The groups of people involved could also come to know of the project results and through this they could benefit by knowing the effects of alcohol and tobacco to their health. Those that have no history of smoking or alcohol may be encouraged to maintain their good health by avoiding these substances. Therefore, through the research, Kate stands to be of benefit to the patients and the entire society (Martin, 2000). Conclusion  When the principle of beneficence is applied to Kate’s case, the assessment shows that she obeys the principle. She is a nurse and a Masters student carrying out research on residents. She is of benefit to the society and the patients because she is carrying out research whose results are bound to benefit everyone. The groups of people involved and the rest of society will benefit from the results of her research project by knowing how smoking and alcohol affect their health. Through this they can then take appropriate action. Scenario 2 Introduction In this scenario, the bioethical principle of non maleficence will be discussed and applied to the case of Kate. Kate has finally found the sample which includes 20 people aged between 80 and 84. 10 of them have never used alcohol or smoked but the other 10 have smoked and used alcohol before. Her tests on these people will include walking, lifting weights, stretching, pulse and blood pressure. The assessment will reveal whether the principle has been followed or not. The bioethical principle of non maleficence demands that nurses and other healthcare providers should avoid unnecessarily injuring or creating harm on people (Kerr, 2011), or patients by doing things to them or failing to do to them what they are required to do that would prevent the harm (Atkins, De Lacey, Britton, 2011). The healthcare provider must ensure that she takes sufficient care so that her patients are not exposed to risks that could harm them. Failure to do this can be termed as negligence. In the case of Kate, she intends to test the two groups of people through quizzes and physical activities including walking a distance of 300 meters, stretching, bending and lifting bar bells. For elderly people who are over 80 years old such tests would simply be torturous to them. They are physically frail, their strength is considerably low and their mental capacity is crumbling. They may not do the language, arithmetic and recall quizzes comfortably, and without suffering some negative effects (Runciman, Merry, and Walton, 2007). They may also find it hard to stretch, bend, lift bar bells and walk for 300 meters because their strength and flexibility are low. Kate is deliberately subjecting these elderly people to risky tests that could potentially harm them. They could break their bones, collapse or sustain other types of injuries. She is therefore violating the principle of non maleficence. Her quizzes could strain these elderly people mentally, while her physical activities could cause them bodily harm. She has not done anything to reduce the risk or prevent them from being harmed. Instead she has done the opposite (Kerridge, Lowe, and Stewart, 2012). She seems not to care what could happen to them. Conclusion In scenario 2, the principle of non maleficence has been applied to Kate’s case. By her testing the elderly people with strenuous and mentally demanding tasks she is putting them at risk either mentally or physically. These people could suffer from mental stress, collapse and faint or sustain serous physical injuries. She shows negligence by planning to do this and this is evidence of violation of the bioethical principle of non maleficence. Scenario 3 Introduction In the third scenario, Kate intends to use the records belonging to their clients in her study but has not sought or received approval from them. The bioethical principle of autonomy will be applied to Kate’s case in scenario 3. Kate thinks that the clients need not to know about her use of their records and that they will benefit from what she is doing. This will be gauged against the principle of autonomy. The principle requires that her clients be allowed to make decisions with understanding and out of their own volition since they are rational people (Kerr, 2011). The bioethical principle of autonomy requires that every healthcare provider should respect the patients’ autonomy by allowing them to act rationally and intentionally having understood what is going on (Martin, 2000). Kate as a healthcare provider should not use the records of clients without their consent. She must inform them of her intentions, and plans beforehand so that she can obtain their approval before proceeding on. From the information given, Kate has failed to consult with her clients but intents to utilize their records in her studies. She goes ahead to ignore my advice over the same matter. My advice to her was that she should ask the clients first before taking their records. This goes against the principle of autonomy since she does not recognize the right of her clients to be informed or consulted over the issue. Since her clients are rational enough they must be included in decision making where they should be allowed to make decisions voluntarily without coercion or manipulation (National Health and Medical Research Council, 2004). In her case, Kate should allow her clients to act intentionally and with understanding by allowing her to use their records in her study. She must not keep them in the dark or ignore their will or position. She needs to give them all the information they require to make informed decisions over the matter before she can be free to carry on with the study (Hendrick, 2000). Conclusion Kate wants to use the records of clients in her study without obtaining approval from them. When this is assessed against the principle of autonomy, it is not right. Every rational client must be allowed to approve or disapprove the use of his or her records in the study. These clients should do this with understanding and without being influenced by Kate or any other person. Since this is not happening, Kate is therefore going against the autonomy principle. She denies the clients the freedom to make decisions on the use of their health records. Scenario 4 Introduction In this section, the ANMC codes will be used in the discussion about Kate’s plans for her study. Kate’s case will be assessed against each of these codes. The codes are Quality nursing care for all, respecting self and other people, value for diversity, and access to good healthcare among others. a) Quality nursing care for everyone According to this code nurses should be responsible for the quality of the care they give to their patients. Kate does not seem to consider this code in her plans. She is not giving the highest standard of care to patients when she subjects then to risky and potentially harmful tests (National Health and Medical Research Council, 2004). b) Respecting self and other people Based on this code, the nurse should show respect to the patients by allowing them to participate actively in their care (Runciman, Merry, and Walton, 2007). Kate being the nurse is supposed to agree with her colleagues. Kate fails to allow her clients to know about or even take part is their care. By this her respect for them diminishes and she refuses to listen to my advice. c) Value for diversity In her plans Kate should consider any diversity existing among the groups she has identified. Kate may not have considered this code. Some cultures could be against the use of old people in her study (National Health and Medical Research Council, 2004). d) Accessing good healthcare Instead of using her patients as subjects for her project, Kate should ensure that she gives them the best healthcare they require (Australian Nursing and Midwifery Council (ANMC), 2008). She goes against this code because of wanting to subject them to harmful tests in their old age. This is anything a part from giving them the best care. e) Informed decision making Patients of all ages need to be allowed to decide on matters pertaining to the care they receive (Australian Medical Association, 2004). Kate does not consult with her patients and therefore denies them the opportunity of deciding anything about their involvement in her project. She violates their right to be informed. f) The Safety Culture Nurses are obliged under this code to work towards reducing harm to the patient as much as possible (Australian Nursing and Midwifery Council (ANMC), 2008). Kate is not observing this code. She plans to pass the elderly clients through torturous treatment so that she can get results for her study. By doing this she is not reducing harm to them but is increasing it. g) Managing information ethically Personal information concerning the patients has to be kept safely. It is unfortunate that Kate plans to use the health records of the patients in her study. This is simply obtaining information from secure storage to be used in a study whose results would be made public. This is not an ethical way of managing patient information (Australian Medical Association, 2004). In conclusion the paper has assessed Kate’s case in relation to the ANMC codes. The assessment reveals that in her planned study, Kate plans to violate all the ANMC codes of healthcare. Reference List Atkins, K., De Lacey, S., Britton, B. (2011) Ethics and Law for Australian Nurses. Cambridge University Press. Australian Medical Association (2004). AMA Code of ethics. Retrieved 14th August from http://ama.com.au/codeofethics Australian Nursing and Midwifery Council (ANMC), (2008). Code of Ethics for Nurses in Australia. Retrieved 6 August 2012, http://www.nrgpn.org.au/index.php?element=ANMC+Code+of+Ethics Hendrick, J. (2000) Law and Ethics in Nursing and Healthcare. Nelson Thornes. Kerr, K. (2011). Good Medical Practice: Professionalism, Ethics and Law. Australian Medical Student Journal. Vol. 2 (1), 87. Kerridge, I., Lowe, M., and Stewart, C. (2012). Ethics and Law for the Health Professionals. Retrieved 14th August from http://www.federationpress.com.au/bookstore/book.asp?isbn=9781862877306 Martin D. P. (2000). Virtual Anaesthesia Textbook: Legal, Ethical and Professional Issues. Retrieved 14th August 2012 from http://www.virtual-anaesthesia-textbook.com/vat/vatissue.htm National Health and Medical Research Council (2011). Health Ethics. Retrieved 14 August 2012 from http://www.nhmrc.gov.au/health-ethics/ National Health and Medical Research Council, (2004). Communicating with Patients - Advice for medical practitioners, fact sheet. Retrieved 14 August 2012 from http://www.bioethics.gov.au Runciman, B., Merry, A. and Walton, M. (2007). Safety and Ethics in Healthcare: A guide to Getting it Right. Ashgate Publishing. Read More